Quality standard
Quality statement 2: Referral for cardiac rehabilitation
Quality statement 2: Referral for cardiac rehabilitation
Quality statement
Adults admitted to hospital with a myocardial infarction (MI) are referred for cardiac rehabilitation before discharge.
Rationale
Cardiac rehabilitation aims to address the underlying causes of cardiovascular disease and improve physical and mental health after a heart attack. Cardiac rehabilitation encourages a healthy lifestyle which slows the progression of heart disease. It also reduces the risk of dying prematurely, especially as a result of a heart attack or stroke. People who are referred to rehabilitation programmes before they are discharged from hospital have better rates of uptake and adherence and improved clinical outcomes.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that adults admitted to hospital with an MI are referred for cardiac rehabilitation before discharge.
Data source: Local data collection.
Process
Proportion of discharges from hospital after an MI where the patient was referred for cardiac rehabilitation while in hospital.
Numerator – the number in the denominator where the patient was referred for cardiac rehabilitation while in hospital.
Denominator – the number of discharges from hospital after an MI.
Data source: Local data collection.
Outcome
Uptake rates of cardiac rehabilitation programmes.
Data source: Local data collection. National data on the uptake of cardiac rehabilitation are available from the British Heart Foundation National Audit of Cardiac Rehabilitation (NACR).
What the quality statement means for different audiences
Service providers (secondary and tertiary care services) ensure that adults admitted to hospital with an MI are referred for cardiac rehabilitation while they are in hospital.
Healthcare professionals refer adults admitted to hospital with an MI for cardiac rehabilitation while they are in hospital.
Commissioners commission services that have the capacity and expertise to refer adults admitted to hospital with an MI for cardiac rehabilitation while they are in hospital.
Adults who are admitted to hospital with a heart attack are referred to a cardiac rehabilitation programme while they are in hospital. A cardiac rehabilitation programme includes exercise sessions, information about health and lifestyle changes and how to cope with stress. This helps to slow down or stop heart disease and to reduce the risk of a heart attack or stroke in the future.
Source guidance
Acute coronary syndromes. NICE guideline NG185 (2020), recommendations 1.8.1 and 1.8.13
Definitions of terms used in this quality statement
Cardiac rehabilitation
Cardiac rehabilitation is a coordinated and structured programme designed to remove or reduce the underlying causes of cardiovascular disease. It provides the best possible physical, mental and social conditions so that people can, by their own efforts, continue to play a full part in their community. A healthier lifestyle and slowed or reversed progression of cardiovascular disease can also be achieved. [NICE's full guideline on acute coronary syndromes]
Cardiac rehabilitation programmes should include a range of interventions with health education, lifestyle advice, stress management and physical exercise components. [NICE's guideline on acute coronary syndromes, recommendations 1.8.1 and 1.8.19]