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Many patients who could benefit from cardiac rehabilitation (CR) never enroll or take part. The Cardiac Rehabilitation Change Package (CRCP), from Million Hearts® and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), is a menu of process improvements for hospital quality teams and CR programs trying to get more eligible patients into rehab. Download the guide (PDF).
What's in it
| Layer | What it is |
|---|---|
| Change concepts (key drivers) | general ideas that lead to more specific changes |
| Change ideas | specific, actionable strategies for changing a process, which can be tested quickly on a small scale |
| Tools and resources | one or more evidence- or practice-based tools for each change idea, to adopt or adapt |
The package covers four focus areas: systems change, referral, enrollment and participation, and adherence.
The CRCP's four focus areas. Million Hearts
The second edition
First published in 2018 and used by hospitals and CR programs for five years, the CRCP came out in a second edition in 2023, with new concepts and ideas and twice as many tools, drawing on the latest evidence and experience. New content helps teams:
- make the case for improvement to hospital leadership;
- find and use data to drive improvement;
- build new staffing models;
- set up automatic "opt-out" referrals with care coordination (largely from the Agency for Healthcare Research and Quality's TAKEheart initiative);
- raise participation among groups historically underrepresented in CR;
- advance hybrid CR delivery.
Tools are tagged (New) if added in this edition, (SET) if they can be adapted for supervised exercise therapy — a separate service that CR facilities can deliver for certain cardiovascular diagnoses — and (HE) if they address equitable quality care.
How to use it
- Bring together CR professionals, physicians, administrators and other stakeholders to decide which parts of CR use most need improving.
- Pick the matching interventions.
- Test each one small first — "small tests of change" — to check feasibility and adjust before rolling it out more widely.
Don't try everything at once; not every intervention will fit every setting. A four-part video series from Million Hearts and the National Association of Chronic Disease Directors shares tips from CR champions.
Who made it
The original package was written by Hilary K. Wall, Haley Stolp, Briana Lucido and Kaitlin Graff; the 2023 revision by Haley Stolp, Megan Gross, Taylor Streeter, Allison Goldstein and Hilary K. Wall — with contributors and reviewers from CDC, AACVPR and health systems across the country, and tools shared by organizations including the Agency for Healthcare Research and Quality and the American College of Cardiology.
Sources
Based on "Cardiac Rehabilitation Change Package (Second Edition)," Million Hearts®, U.S. Department of Health and Human Services, with CDC's Division for Heart Disease and Stroke Prevention; a work of the United States government in the public domain. The page's social-media and newsletter copy is left out, as are its cover image and shareable graphic.
Licens: CC0 1.0 (offentligt eje) · Bearbejdet efter millionhearts.hhs.gov
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