P16 Implementation of early rehabilitation post-sternotomy into a clinical setting
Evans, Becky Ennis, Stuart
Evans, Becky
Ennis, Stuart
Abstract
Background The effectiveness and safety of early initiation of cardiac rehabilitation (CR) post-sternotomy study (SCAR) was published in 2022.1 The study showed starting exercise training from as early as 2 weeks post sternotomy was safe and effective, with appropriate precautions. This can enable many patients to return to work/usual activities sooner than at present. Three years on, our service is unchanged, due to various logistical barriers. Aim To evaluate how UHCW could implement earlier initiation of CR into clinical practice and what resources it would require. Cardiothoracic surgeons at UHCW agreed to support the findings of the SCAR trial. Methods From October 2024 to June 2025, we invited cardiac sternotomy patients to commence CR from 2 weeks post discharge. Waiting times from discharge to baseline exercise assessment were recorded for patients in the nine months before and nine months after this time for comparison. To minimise waiting times and reduce multiple appointments, we decided to combine the nurse clinic and baseline exercise assessment. Results The average waiting time (n=48) in the nine-month period since earlier CR was implemented was 29 +/- 15.4 days, compared with 40 +/- 22.2 days in the nine months previous (figure 1). An additional two x 1-hour clinics were required weekly. Delays to starting CR earlier included inability to drive and post-surgical complications e.g. wound infections, re-admissions. 62% of patients attending this joint clinic were able to enrol on to the CR exercise programme within one week of this clinic appointment. Conclusion Implementation of earlier CR post sternotomy has meant an increase in weekly workload via addition of the joint clinics. However, the joint clinics are more time efficient and free up appointments for the wider CR service. Implementation of earlier CR has been achieved due to surgeon support and introduction of joint clinics.
MIDER Authors
Evans, Becky
Date
2025
Type
Conference Output
Subject
Cardiac rehabilitation
Collections
Citation
Evans B, Ennis SP16 Implementation of early rehabilitation post-sternotomy into a clinical settingHeart 2025;111:A14.
Journal / Source Title
Heart
DOI
10.1136/heartjnl-2025-BACPR.25
PMID
Publisher
BMJ Publishing Group
Publisher’s URL
https://heart.bmj.com/content/111/Suppl_5/A14.1