Cwm Taf NHS Trust Cardiac Rehabilitation ROYAL GLAMORGAN HOSPITAL LLANTRISANT

Transcription

1 Cwm Taf NHS Trust Cardiac Rehabilitation ROYAL GLAMORGAN HOSPITAL LLANTRISANT

2 Meet the Team Clinical Specialist Nurse Manager Band 8a x1 WTE Cardiac Rehabilitation Specialist Nurse Band 7 x 1 WTE Cardiac Rehabilitation Nurses 2.55 WTE Dietitian Band 7 x1 WTE Occupational Therapist Band 7 x 0.8 WTE Physiotherapist Band 6 x2 WTE Pharmacist Band 8a 1 x WTE Co-ordinator ordinator Band 4 x1 WTE Clerical support Band 2 x 0.26 (10 hours) Based in a very small office at RGH! AF nurse managed by Cardiac Rehabilitation

3 Patient Groups Accessing Cardiac Rehabilitation Myocardial Infarction Angina/ACS Post Angiography/Angioplasty Funded Post Coronary Artery Bypass Graft (CABG) ICD,Valve replacement (Exercise Only) Not Funded

4 Service Definition Cardiac rehabilitation services are comprehensive, long term programmes involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counselling. These programmes are designed to limit the physical and psychological effects of cardiac illness and control cardiac symptoms.

5 Service Provision Inpatient Ward visits Monday to Friday Post Discharge Telephone Follow up (7Days) Home Visits as required All patients invited to Education Programme All Patients Screened/Considered for Exercise

6 Education Programme 7 Weekly sessions of 2 hours duration Held at 3 sites RGH, Llwynypia,, Hawthorn Leisure Centre Transport if needed by PTS ambulance Invited to bring spouse, friend, partner Multi- disciplinary team input

7 Programme Sessions include: Risk Factors for Heart Disease Healthy Eating and Food Labelling Chest Pain management Exercise discussion Heart Medication Stress Management- relaxation Living Life to The Full return to normal Patients can and do select sessions from the programme to attend (Menu)

8 Exercise Programme All patients are considered for exercise Patients are risk assessed An agreed Policy is in place All patients assessed at RGH Exercise sessions at 3 sites High Risk patients exercise at RGH 12 Week programme pre and post assessment Referral on to Phase IV exercise

9 Individual Interventions Appointments with: Dietitian Occupational Therapist - one to one counselling sessions Physiotherapist for home exercise plan Home visits for more complex patients by senior cardiac rehabilitation nurse

10 Vocational/additional components Taff Ely Happy Hearts support group 2 Cardiac Bowls Clubs New development of Younger Persons Group All Affiliated to the BHF

11 Policies/ Protocols BACR, Sign, NSF,NICE, Pathways A updated operational plan is in progress. Updated to reflect the Quality Requirements Trust policies and procedures in place e.g Lone worker policy for home visits Risk Assessments Resus Policy Intra team policies eg.. Referral, discharge, waiting times etc

12 Strengths Fully funded Multi-disciplinary team Responsive service with the ability to provide tailored programmes and options (within some constraints) Patients not accessing full traditional service can still access components via MD team eg Dietitian Service provided across 3 geographical areas ensuring access close to people Well supported by Trust and LHB including managers and Cardiologists Excellent ongoing support via Bowls, Young Hearts and Happy Hearts CR team support the supporters

13 Weaknesses No education programme for ICD and Valve replacement patients Limited Phase IV programmes Transition from Phase 3 to Phase IV is lengthy Commencement of exercise programme delayed by waiting times for notes, reports etc. (Tertiary) In-adequate pre group assessment and goal setting Access to accommodation rooms for education and access to Gym space limited options in terms of days, time etc. Limited flexibilty to run additional prgrammes when demand is high

14 Miscellaneous Patient Held Records Discharge Summaries Clinical Support to primary care and community teams Angina Management Programme R2R BHF Pilot National Cardiac Rehabilitation data base Annual Study Day Journal Club/In House training