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Group Enrollment and Open Gym Format Decreases Cardiac Rehabilitation Wait Times

Bachmann, Justin M. MD, MPH; Klint, Zachary W. MS; Jagoda, Allison M. MS; McNatt, Jeremy K. MS; Abney, Lesa R. RN; Huang, Shi PhD; Liddle, David G. MD; Frontera, Walter R. MD, PhD; Freiberg, Matthew S. MD, MSc

Journal of Cardiopulmonary Rehabilitation and Prevention: September 2017 - Volume 37 - Issue 5 - p 322–328
doi: 10.1097/HCR.0000000000000255
Cardiac Rehabilitation

Purpose: Wait times for the first cardiac rehabilitation (CR) session are inversely related to CR participation rates. We hypothesized that changing from individually scheduled appointments to a group enrollment and open gym format, in which patients were enrolled during group intake sessions and could arrive for subsequent CR sessions any time during open gym periods, would decrease wait times.

Methods: A total of 603 patients enrolled in CR at Vanderbilt University Medical Center from July 2012 to December 2014 were included in the study. We evaluated the effect of changing to a group enrollment and open gym format after adjusting for referral diagnosis, insurance status, seasonality, and other factors. We compared outcomes, including exercise capacity and quality of life, between the 2 groups.

Results: Patients in the group enrollment and open gym format had significantly lower average wait times than those receiving individual appointments (14.9 vs 19.5 days, P < .001). After multivariable adjustment, the new CR delivery model was associated with a 22% (3.7 days) decrease in average wait times (95% CI, 1.9-5.6, P < .001). Patients completing CR had equally beneficial changes in 6-minute walk distance and Patient Health Questionnaire scores between the 2 groups, although there was no significant difference in participation rates or the number of sessions attended.

Conclusions: Implementation of a group enrollment and open gym format was associated with a significant decrease in wait times for first CR sessions. This CR delivery model may be an option for programs seeking to decrease wait times.

Changing from individually scheduled appointments to a group enrollment and open gym format was associated with a 22% decrease in wait times for first cardiac rehabilitation sessions at Vanderbilt University Medical Center. Cardiac rehabilitation participation rates and increases in exercise capacity were not significantly different between the 2 groups.

Departments of Medicine and Health Policy (Dr Bachmann), Department of Physical Medicine and Rehabilitation (Messrs Jagoda and McNatt, and Ms Abney), Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico (Dr Frontera), Department of Biostatistics (Dr Huang), and Department of Medicine (Drs Liddle and Freiberg), Vanderbilt University Medical Center, Nashville, Tennessee; and Healthways, Inc, Franklin, Tennessee (Mr Klint).

Correspondence: Justin M. Bachmann, MD, MPH, Vanderbilt University Medical Center, 2525 West End Ave, Ste 300-A, Nashville, TN 37203 (

All authors have read and approved of the article.

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.