Original StudyPromoting Cardiac Rehabilitation in Acute Coronary Syndrome Patients: Quality Initiative Based on Education, Automated Referral, and Multidisciplinary RoundsMatthia, Eldon L. MD*; Mohadjer, Ashley DO†; Randall, Morgan H. MD†; Canha, Catarina MD†; Warren, Elizabeth RN†; Ashraf, Hassan M. MD*; Plasschaert, Jeffrey M. MS†; Winchester, David E. MD†; Keeley, Ellen C. MD, MS†Author Information From the *Department of Medicine †Division of Cardiovascular Medicine, University of Florida, Gainesville, FL. Received for publication July 3, 2021; accepted July 4, 2021. Reprints: Ellen C. Keeley, MD, MS, University of Florida, Division of Cardiovascular Medicine, 1600 SW Archer Road, Gainesville, FL 32610-0277. E-mail: [email protected]. Critical Pathways in Cardiology: September 2021 - Volume 20 - Issue 3 - p 115-118 doi: 10.1097/HPC.0000000000000263 Buy Metrics Abstract Cardiac rehabilitation is a class 1 recommendation for acute coronary syndrome (ACS) patients according to the American College of Cardiology/American Heart Association. However, only 1 in 5 ACS patients are referred for cardiac rehabilitation nationally, and even fewer at our institution. We sought to improve the number of referrals to cardiac rehabilitation for post-ACS patients admitted to our inpatient cardiology service, and ultimately their participation in the program. We designed a quality improvement initiative that included education of patients and house staff, automated referral order, and participation of cardiac rehabilitation staff members on multidisciplinary rounds. We compared the number of patients who received a referral to cardiac rehabilitation, had the first appointment scheduled before hospital discharge, and attended the program before and after our intervention. Six months after initiation of the project, the proportion of ACS patients referred to cardiac rehabilitation before hospital discharge increased from 10% to 43% (P < 0.001). The mean number of patients with a cardiac rehabilitation appointment scheduled before discharge was 2 before and 5 after the intervention (P < 0.001), and the mean number of patients who attended their scheduled appointment was 1 before and 3 after the intervention (P = 0.001). Run charts demonstrated that the number of referrals and the number of scheduled appointments remained above the median following the intervention. In conclusion, an initiative that included education, automated referrals, and direct one-on-one contact with cardiac rehabilitation staff before discharge increased the number of cardiac rehabilitation referrals, and appointments scheduled and attended in post-ACS patients. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.