Integration of Nutrition Education into a Multidisciplinary Cardiac Rehabilitation Program

Abstract

The multidisciplinary Cardiac Rehabilitation Program (CRP) at Wilford Hall Medical Center was redesigned to improve both efficiency and effectiveness of services offered to patients following recovery from either myocardial infarction or cardiac bypass surgery. Services were redesigned to provide a “one stop shop” approach for minimizing inconvenience to patients and for achieving the CRP's goals of increasing functional cardiac capacity, improving quality of life, and reducing risk of future cardiac events. To preclude problems encountered in the old program such as record unavailability, multiple patient visits to referral clinics, and lack of communication between referral clinics and the Primary Care Provider, several innovations were introduced. The CRP was reorganized into two phases of rehabilitation. During Phase 1, psychological and physical education sessions were provided in a group format followed by a second phase of rehabilitation highlighted by close individual follow-up. Nutrition Education was incorporated during Phase 1 through a six-week behavior modification program that included stress reduction and goal setting. A total of 75 patients have graduated from Phase 1 of the program. Eighty Percent have achieved weight loss of 5–10 pounds in 6 weeks and/or 15–25 pounds in 6 months. Eighty-five percent of nutrition goals set have been achieved. Ninety percent of patients have a perceived improvement in the quality of their lives and 95% have increased energy to complete activities of daily living. During Phase 2 of the program, the dietitian involved in the cardiac rehabilitation provides individual follow-up or consultation to the appropriate nutrition class. To date, 26 Phase 2 patients have been referred to the nutrition clinic for education. Thirteen of these received instruction from the cholesterol reduction program taught by the outpatient nutrition clinic. Seventy-seven percent of these patients have seen a decrease in their cholesterol levels. Multidisciplinary clinics have the unique ability to successfully provide effective and efficient patient care.