Quality Assurance and the Service Domain in Cardiac and Pulmonary Rehabilitation
AbstractBackground: Little is known about the quality assurance methods used on cardiac and pulmonary rehabilitation. Also, little is known as to what extent the service domain is evaluated and what methods are employed. Knowledge of what is being done in these regards may facilitate programs effectively and efficiently measuring these outcomes. Methods: A survey was mailed to 1/3 of the programs (approximately 400) in both cardiac and pulmonary rehabilitation listed in the AACVPR Program Guide 2004. The survey included questions that would add to the knowledge of what is the extent of practice and methods. 12 components of quality assurance were listed and 14 components of patient satisfaction were assessed as to the frequency of use. It was pilot tested and revised. Results: The usable return rate was 48%. Program directors of both types of programs claimed daily formal assessment of most of the 12 areas listed for quality assurance. The three highest being assessment of adverse events, safety, and patient satisfaction. The three lowest use was in the area of efficiency, timeliness and continuity of care. The service domain was assessed as comparable to the other three: health, clinical and behavioral domains. Patient satisfaction was the most commonly assessed component of the service domain with more than 90% of both types of programs measuring program effectiveness, overall program quality and friendliness of the staff. Managers most commonly cited the acquisition of new equipment as the endpoint as the end results of patient satisfaction assessment. Conclusions: There was surprising similarity in results from programs in cardiac and pulmonary rehabilitation. Quality assurance is very frequently assessed in both. Concern for adverse events, safety, and patient satisfaction predominate.