A fresh perspective, open communication, and an adaptable team can make all the difference.
We recently had the opportunity to connect with Cardiac Rehabilitation Manager Sarah Allen to learn more about Oklahoma Heart Hospital’s South (OHH) Intensive Cardiac Rehab (ICR) program. While OHH, a physician owned hospital, has been using the Pritikin ICR education curriculum for the past nine years, recent changes have revitalized the program resulting in improved patient attendance and engagement.
Taking Stock and Making Changes
Many changes can be attributed to Sarah Allen’s creative problem-solving skills and the relationships she’s built over the past 12 years at both the North and South Oklahoma Heart Hospital locations. In her early 20’s, Sarah began working for the organization as a receptionist. Since then, she’s advanced as a medical assistant, a Registered Nurse in the hospital, and a lead in the North location’s Cardiac Rehab Department. A year and a half ago, she was selected to fill her current position as Cardiac Rehab Manager at Oklahoma Heart Hospital’s South location.
Right from the start, Sarah took stock of every aspect of the patient's experience - from referrals and scheduling down to the arrangement of the exercise space. She asked her team and Pritikin ICR Account Manager, Kerri Whitley, to identify areas of improvement.
The Elevated Patient Experience
While patients with qualifying events were automatically referred to Cardiac Rehab, Sarah dug deeper and noticed that patients with a diagnosis of stable angina were rarely referred. To reach as many qualifying patients as possible and educate referring physicians, she spread the message that patients with angina qualify for ICR. Her efforts paid off. Prior to her outreach, there were only three stable angina patients admitted to the cardiac rehab program every month. On the day we spoke with her, she had four patients with stable angina on the intake schedule.
As Sarah moved through her various roles within the organization and earned her nursing degree, she maintained strong working relationships with many physicians and staff. These relationships helped to facilitate growth in the program. Through speaking with physicians, her team was granted access to review their daily schedules to identify patients that may have previously declined ICR. In the past, patients who declined ICR were provided with the phone number of the facility and encouraged to call should they change their minds in the future. The ICR team never followed up with them and would not often hear from those patients again.
Now, the approach towards these undecided patients has changed. For patients who have declined ICR, staff will send a message letting the doctor know that while the patient was not ready, they should still be encouraged to attend. These patients, along with all others who have declined, are added to a list that Sarah’s team maintains. After two weeks, patients on the list were called by Jennifer, a bilingual member of the team, who used the call to identify patients ready to enroll and if they were not, would ask if she could reach out again in another two weeks. This strategy has resulted in many patients signing up for the program several months after their qualifying event. When this strategy was first implemented, there were 200 patients on the list, after lots of work, the list now hovers around 70 patients. Multiple staff members are now trained to manage the call list and encourage enrollment.
Sarah’s improvements didn’t end with treating more patients. To better utilize her staff and offer more accommodating appointments, she introduced a more efficient schedule. After noticing patients often didn’t show up to sessions on Fridays, she instituted an exercise workshop and resistance training on Fridays. As a result of this and other related improvements, the department has expanded its scheduling capacity. So, while they are normally booked 2 weeks out, patients are never put on a waitlist. They can keep their books open all year seeing about 190 patients every week between regular sessions, 24 initial evaluations, and eight patient graduations.
To accommodate different fitness levels and physical limitations, Oklahoma Heart Hospital South offers a wide variety of exercise equipment and uses 24 telemetry channels. Patients have access to the following equipment on site:
- Recumbent Bikes
- NuStep Recumbent steppers
- Free Weights
- Weight Machines
- Yoga room
Initially, all this equipment was arranged in the same space. Something as simple as re-configuring the exercise area, by moving weights to the back, has made the space much more functional. The team is now able to offer cardio sessions during the same time as resistance training sessions.
When patients arrive, they are immediately welcomed by the friendly team comprised of eight exercise psychologists, eight Registered Nurses, and ICR Manager Sarah Allen. On alternating weeks, patients work with a Registered Dietitian and Chef shared with the Oklahoma Heart Hospital North location.
Sarah’s vision could never have come to fruition without her amazing team. Their dedication to patients coupled with their willingness to try new things and share ideas is the reason the program has been so successful. They all go above and beyond to make sure patients feel comfortable and welcome throughout their cardiac rehab journey. The ICR team not only calls prospective patients, but they also call patients if they miss a scheduled exercise session, offering words of encouragement and support. It’s little things like this that make a huge difference in a patient’s overall experience!
Patient Intake and Graduation
During a patient’s first two visits, several assessments are completed and a lipid panel and A1c test is done. These assessments are repeated at completion of the program where they often see a significant improvement.
Once patients have completed their cardiac rehab program, they celebrate with a group photo, a certificate of achievement signed by all staff, special digital signage on display throughout the floor, and their pre-and post-assessment results.
Before Sarah and her staff enhanced the program, the department enrolled an average of 45 patients/month. After a year of program improvements, they are now enrolling an average of 60 patients per month - a 33% increase in enrollment! These patients are also receiving more treatment time. Research has shown that more cardiac rehab equates to a reduced risk of having another heart event or death.
Sarah shared the story of one memorable patient who, were it not for the adjustments made to the program in the past year and a half, likely would not have graduated from cardiac rehab. This patient was in his 40’s and lived over an hour away. While he was interested in the program, he did not want to make the drive to the hospital three days a week. Sarah and her team worked out an accommodating schedule that maximized his time on site. He was able to complete a few of his cardiac rehab sessions during 1-2 visits per week after he got off work. He also took advantage of the newly scheduled Friday exercise workshop and resistance training. When he started the program, he was well over 300 pounds, but due to his dedication and some creative scheduling, he recently graduated 100 pounds lighter and much healthier.
We are honored to have Sarah and her dedicated team among our growing network of Pritikin ICR providers. Their creative approach and dedication to the cardiac patients in their community is inspirational! Heart patients in the Oklahoma City area are fortunate to have this ICR team serving their community.