Michigan Medicine Cardiac Rehab embraces Patient-Centered Care by Experimenting with Patients Co-Leading Orientation with Staff
Michigan Medicine is an Academic Medical Center and Patient is Partner is a small LLC that collaborates with health care to solve challenging problems utilizing the patient voice and experience.
In spite of the positive outcomes over the many years, cardiac rehab continues to face challenges such as lack of awareness and underutilization by providers and patients. Studies show that only 20 percent of eligible patients are referred and of those, only 50 percent participate. We wanted to address the following questions:
- How might we increase understanding, enrollment, persistence, graduation?
- What could the new commitment to patient partnerships do to help?
What We Tried
For the past 6 years, Cardiac Rehab at the University of Michigan has had a patient and family advisory board working to solve challenges that affect the program. In particular, in order to understand the “patient perspective” before starting the exercise program, the staff has held a group orientation session. Following feedback from the advisory board, changes were made to assure that rather than simply complete paperwork during the 1-hour orientation time, the focus was shifted to helping the patients develop a community and share their cardiac event stories with others in the room. Moreover, the group orientation extended to the conference room to the floor in order to help patients understand the process (e.g., they hooked an intern up to the monitors to show what the staff would be monitoring and showed the equipment and helped the group to feel comfortable on what to expect in their first session). Finally, after feedback from patients, a slide deck was created (with substantial patient creation) that would work on the social/emotional challenges that face cardiac patients. As the program continues to grow, there is an innovation to see what impact orientation might have if patients co-led orientation collaborating with exercise physiologist. The goal of this initiative is to enhance the satisfaction and understanding of patients but also to see if any of the outcome measures might change. Examples include if patients come back after orientation at higher rate, stay the entire time, graduate, or make any new friends/colleagues.
With this program being in its infancy, we do not yet have data to compare group orientation illustrating data by staff vs. orientation co-led by patients. However, the hope is to be able to compare understanding, enrollment, persistence or graduation when patients were co-leading orientation versus just staff. This article illustrates a commitment, the trust that staff has at cardiac rehab in assuring patient engagement, and involvement runs deep throughout the organization.
It is important to find patient leaders who are dedicated to improving the experience for those who will follow and it is important to think of this as an opportunity to come together as “graduates” who will thrive in their lives after rehab. It is important to have a budget to sustain the program and provide even minor compensation to the patient co-leaders. Remember when starting the program, have patients involved in the process from inception of the idea, to planning, to implementing so that there is buy-in and commitment from start to finish.