Surgical pre-operative information day (phase 0)
All patients waiting for bypass grafts, valve surgery or any other cardiac surgery are invited to attend our information day.
The day, which runs from 9:30 am to 1:30 pm, is facilitated by a member of the cardiac rehabilitation team. Patients are welcome to bring along one family member/friend if they wish.
Several members of our multidisciplinary team, including pharmacist, blood transfusion nurse, physiotherapist, dietitian and tissue viability nurse, give talks and offer advice with the aim of providing education and relevant information to the patient to prepare them for their surgery.
Medical and surgical patients (phase I)
Both elective and emergency admissions are seen on the ward prior to discharge by a member of the cardiac rehabilitation team. Those who are going home over the weekend are seen on a Friday where possible and if patients are discharged suddenly over a weekend there are copies of our information packs and our contact details on each ward and these should be given out by the ward staff before a patient goes home.
All of the following patients benefit from cardiac rehabilitation:
- Primary angioplasty
- Myocardial infarction
- Unstable transfers
- Elective angioplasty +/- stents
- Medical therapy
- Heart failure
- Transplant
- Coronary artery bypass grafting (CABG)
- Valve replacement/repair
- Aortic root repairs
- Transplant
- Any other cardiac surgery (ASD closure, pericardectomy etc.)
All patients receive appropriate advice on their recovery period which is accompanied by an information pack. Risk factors are identified and addressed on an individual basis. All patients are encouraged to attend a cardiac rehabilitation programme at their local centre and are referred on with their consent.
Early discharge period (phase II)
Harefield cardiac rehabilitation patients are invited to attend weekly education/health promotion classes. These talks are facilitated by the cardiac rehabilitation team with support from members of the multidisciplinary team. Sessions offered include medication, risk factors for heart disease, surgical talk, medical talk, benefits of exercise, healthy eating, coping and adjusting to a cardiac diagnosis, stress management and relaxation.
Following a primary angioplasty procedure, patients are telephoned at one week and four weeks post-discharge irrespective where they live. All patients are given contact telephone numbers for any concerns they may have in relation to their health and recovery period.
We have close links with the team at Hillingdon Hospital and we refer patients living in the London Borough of Hillingdon to the community team who work with the Heart Manual (medical patients) and Road to Recovery (surgical patients).
Phase III
Patients attending Harefield for cardiac rehabilitation classes are invited to an assessment appointment two, four or six weeks after their procedure depending on diagnosis.
Patients are assessed on an individual basis and either offered a place in the appropriate class for 12 sessions or given a home programme if they are unable to attend regularly or have difficulty accessing transport.
We run three different levels of classes: routine, intermediate and a dedicated heart failure class. Patients are allocated to a group based on their functional ability and medical status. Classes either run once a week for 12 weeks or twice a week for six weeks dependent on the group.
Home programmes are individually designed for patients who require them, and our physiotherapist contacts them on a regular basis. After an agreed period of time the patient returns to the hospital for a reassessment.
At the end of the course all patients are reassessed and a discharge summary is sent on to the patient's GP and cardiac consultant.
All patient information is entered on the British Association of Cardiac Rehabilitation's (BACR) National Audit for Cardiac Rehabilitation (NACR).
Phase IV
To be effective, physical activity and lifestyle modification need to be maintained for life.
After completing phase III classes patients can be referred onto structured community-based classes, referred to as phase IV classes. Qualified BACR phase IV instructors lead the classes.
We have close links with our local phase IV programmes and refer patients on to these programmes upon discharge from phase III.
In addition
Alongside the work we do in phases 0 to III and the smoking cessation clinic, we are involved in other activities inside and outside the Trust.
These include:
- In-house staff health promotion days
- Health promotion days for the local primary care trust and community
- Presenting on study days and at trust conferences
- Career talks to local senior schools
- Staff teaching
- Research
- Presenting at national and international conferences
Cardiac rehabilitation dept location:
D floor, Harefield Hospital
Contact us:
Email: HHcardiacrehab@rbht.nhs.uk
Telephone: +44 (0)1895 828944
Fax: +44 (0)1895 828944
Availability: Monday to Friday 8am-4pm
An answer phone is available at all other times.