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1. Analyze the functional benefits of cardiac rehabilitation for a variety of specific patient types.
2. Differentiate between the goals, outcomes, and coverage considerations between inpatient and outpatient cardiac rehabilitation programs.
3. Develop strategies to promote patient adherence following completion of a formal cardiac rehabilitation program.
4. Formulate effective interventions to the common and less common obstacles in cardiac rehabilitation.
5. Analyze current insurance and other payment sources pertinent to cardiac rehabilitation coverage.
6. Construct a plan for the future of cardiac rehabilitation services.

Designing a Cardiac Rehab Program

• Equipment needs - must haves/nice to haves
• Covering the bases - addressing aerobic, resistance and flexibility needs
• Limitations of space to consider
• Departmental staffing (acuity/census)

Cardiac Rehabilitation: Individualized Treatment Plans

• Key considerations for exercise programs
• Patient goals to reduce further cardiac risk
• Exercise prescription for aerobic and resistance training in the cardiac patient
• Contraindications you MUST be aware of

Evidence-Based Practice Changes

• Core competencies to incorporate the current best practices
• The latest AACVPR updates
• Process improvement initiatives to “drive” success

Demonstrating Patient Outcomes

• Establishing initial goals for the patient
• Quantifying/measuring patient progress
• Is the patient ready for discharge?
• Collaborating with the patient on a plan for home
• Anticipated and realistic quality of life

Inpatient vs. Outpatient Phases

• Phase 1 - The acute phase
  • How to capture different diagnoses
• Phase 2 - The subacute phase
  • When to start
  • Continuing patients towards progress
  • The concern with re-admissions
• Phase 3 - Intensive outpatient
  • Strategies to encourage patient commitment at this phase
• Phase 4 - Independent ongoing conditioning
  • The ultimate goal

Specialized Needs by Cardiac Diagnosis/Patient

• Status post stent
• Acute myocardial infarction
• Heart transplant
• Angina
• CHF
• CABG
• COPD
• Diabetes
• Hypertension
• Women
• Older Adults

Overcoming Key Obstacles

• Insurance
  • Obama Care
  • Do you understand all the changes?
  • CMS coverage vs. private insurance
  • Making insurance coverage work for you
• Reimbursement
  • Number of sessions
  • Continuing to qualify for services
  • Relieving the physician offices
• Physician Referrals
  • How to educate/market to increase referrals
  • Getting the physician to “buy” in to Cardiac Rehab
  • Easing physician burden on Medical Supervision requirements
• Patient Challenges
  • Depression
  • Smoking Cessation
  • Commitment to lifestyle changes - Exercise/Diet
  • Motivation
  • Adherence to pharmacological therapies
  • Risk factor management
• New Exercise Modalities
  • Skype appointments/monitoring
  • Virtual reality
  • Making the most of available technology

Karyn Gallivan, MS, ATC, CSCS, NSCA-CPT, is a certified athletic trainer with over 25 years of experience in all applications of sports medicine including traditional athletic training in school settings, and clinical settings, strength & conditioning and teaching, as well as personal fitness training. Karyn is an instructor in the Sports & Health Sciences Department for American Public University and a PhD student in Public Health at Walden University. She is a past state director for the National Strength & Conditioning Association. In her work with clients and patients, Karyn specializes in post-rehab and fitness/weight loss programs. In this capacity, she works to train and educate the whole person using a balanced approach to design safe and effective programs that will strengthen "weak links" and lead to an enhanced level of health and fitness.

With international speaking experience, Karyn currently focuses her efforts on continuing education for rehabilitation and fitness professionals. She brings a passion and enthusiasm to her presentations and keeps the day moving with "hands-on" activities that are practical and easy to incorporate into everyone’s daily activities. Disclosures:

Financial: Karyn M. Gallivan is receiving a fee for speaking at this educational activity.

Non-financial: Karyn M. Gallivan has no relevant non-financial relationships to disclose.

For U.S. and Canadian customers, a CE test is available for $9.99 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion may be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Cardiovascular Technology Professionals
Cardiovascular Credentialing International (CCI) recognizes programs and providers approved by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC). This self-study package will qualify for 6.0 contact hour.

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Registered Dietitians & Dietetic Technicians

PESI, Inc., PE001, is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) from July 1, 2019 through June 30, 2022. Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 6.0 continuing professional education units (CPEUs) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute endorsement by CDR of a provider, program, or materials. This self-study program/material is designated as LEVEL 2.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 2/13/2018
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 7.2 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Occupational Therapists & Occupational Therapy Assistant: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 6.0 continuing education credits.

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Physical Therapists & Physical Therapist Assistants
This self-study course consists of 6.0 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

California Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 6.0 continuing competency hours.

Illinois Physical Therapists & Physical Therapist Assistants: PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 6.0 CE credit hours.

New York Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.2 contact hours.

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Other Professions
This self-study activity qualifies for 6.0 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Athletic Trainers, Cardiovascular Technology Professionals, Registered Dietitians & Dietetic Technicians, Exercise Physiologists, Occupational Therapists & Occupational Therapy Assistants, Physical Therapists/Physical Therapist Assistants, Physician Assistants, and other Healthcare Professionals