Hospitals' cardiac rehab programs to be consolidated

Feb. 25, 2013 @ 08:23 PM

After undergoing open-heart surgery in October, Hillsborough resident Bob Ireland said he wasn’t looking forward to cardiac rehabilitation.

The cardiac rehab program at Durham Regional Hospital’s Wellness Institute, which also offers pulmonary rehabilitation services, combines exercise, diet counseling, education and support for patients referred by their doctors after a heart attack, valve repair or replacement or other heart issue.

Ireland said he thought he would be pushed to do exercises he couldn’t do. But on Monday, he was part of a group that was marching, reaching, stepping, tapping and kicking in time to the beat of Brooks & Dunn’s country song “Boot Scootin’ Boogie.”

After the warm-up, as he quickly walked laps around the second-floor of the hospital, Ireland said he has one more week in the 36-session outpatient rehabilitation program. He said he was “surprised and pleased” with the program. It changed his outlook on his health, he said, and he made friends he plans to stay in touch with.

“I had no idea that on another level – a social level – I’d become so fond of such a group of people in such a short amount of time,” Ireland said. He said he isn’t looking forward to the program’s upcoming move.

Durham Regional Hospital and Duke University Hospital are consolidating their cardiac and pulmonary rehabilitation programs into one location. Duke University Health System operates Durham Regional Hospital through a 40-year lease, said Katie Galbraith, vice president at Durham Regional.

Because the new location at Croasdaile Commons, the shopping center on Hillandale Road in Durham that was previously known as Loehmann’s Plaza, is still under construction, patients at Durham Regional’s Wellness Institute are temporarily moving Monday to the Duke Center for Living Campus, Mary Kate Llamas, a spokeswoman for Durham Regional, said in an email.

The Center for Living Campus is where Duke’s cardiac and pulmonary rehabilitation programs are now, Galbraith said.

Galbraith said the Wellness Institute has outgrown its space at Durham Regional. The program was previously across the street from the hospital in a standalone building, she said, and was moved back into the hospital in 2001.

The program has had about 85 pulmonary patients a year, and 94 to 95 cardiac patients per year, said Pat Lovell, Wellness Institute manager. In comparison, Duke has had 518 cardiac and pulmonary rehabilitation patients annually, Galbraith said.

The Wellness Institute’s space, about 3,000 square feet, is inadequate, Galbraith said. The new space will be about four times as large, she added.

“What we’re doing is building a new space that’s going to be specifically designed for cardiac and pulmonary rehabilitation, which is really exciting,” she said.

The Duke Center for Living Campus will house the program until the new facility is ready in the fall, Llamas said in the email.

Galbraith said historically, services such as cardiac rehabilitation, which are more preventative and wellness-oriented, have not been reimbursed well by payers. Patients come to the program after they’re referred by physicians.

“I think that plays a factor, but it really…this is about how can we get a better location, better environment,” she said. “Really all this is doing is relocating the program, consolidating, and taking (the opportunity) of being able to relocate into (new) space,” she added.

Lovell, who is retiring Thursday, said cardiac rehabilitation is underutilized, especially among women and minorities. She said some have issues with the time commitment, transportation or cost.

An American Heart Association presidential advisory published in the journal Circulation in November 2011 said there has been “dismally low” use of cardiac rehabilitation programs, despite “clear benefits.”

The article cited lack of accessibility to program sites, insurance coverage and low patient referral rates as factors. The article said, however, that provisions of federal health care reform are expected to improve access.

Lovell said key aspects of the rehabilitation programs include education, which she said includes teaching patients how to manage disease, reduce risk factors, and to continue to take care of themselves after they leave. Exercise, another key component, strengthens the body and builds endurance, she said.

She also said it’s different from joining a gym - a team including nurses, therapists and others monitors patients’ heart activity and symptoms, and would act as a safety net if something were to go wrong.

Ireland said he resents having to give up what he believes are the right numbers of patients, the right professional care, and the right setting at the Wellness Institute’s location at Durham Regional.

 “It has changed very much the way I view my health, and my responsibility for my health,” he also said.