Cardiopulmonary - Cardiac Rehabilitation Program Description
The goal of Burke’s Cardiopulmonary Rehabilitation Program is to help you achieve the most active and productive life possible, despite physical limitations. It is divided into two parts: the cardiac program and the pulmonary program. The cardiac program is tailored for individuals with heart disease and the post-operative cardiac patient. The pulmonary program serves young adult through elderly patients, with diagnoses such as COPD - emphysema, bronchitis, bronchiectasis, chronic and acute respiratory failure, and pulmonary fibrosis.
Whether you are living with a chronic lung disease or have suffered an acute lung condition, we assist your recovery with intensive therapy and we teach you strategies to help you manage your condition.
The Cardiopulmonary Rehabilitation Program provides care to all patients admitted secondary to cardiopulmonary dysfunction leading to limitations in functional capabilities. Patients present post surgically or following an exacerbation of a chronic cardiopulmonary condition and require the level of care provided by an acute rehabilitation hospital. Patients present with various levels of medical acuity which is diagnosis and/or exacerbation based. The patient must be medically stable to be able to be medically managed in the acute rehabilitation environment and to tolerate approximately 3 hours of therapy/day.
Within a safe, secure and structured environment, Burke offers intensive therapy seven days a week. Your schedule will be determined by your individual needs and goals. As a patient in any of Burke's inpatient programs, you will receive up to 3 hours of therapy a day, 5 days per week, generally Monday through Friday, and additional therapy on Saturday and/or Sunday for one hour. Skilled therapy will be provided in a combination of physical therapy and occupational therapy and/or speech therapy as needed. Rehabilitation nursing and access to a physician are available 24 hours a day, seven days a week.
Scope of Services
The Cardiopulmonary Team is committed to ensuring that each individual’s needs are addressed by:
- Providing rehabilitation through an interdisciplinary approach that emphasizes communication, collaboration and cooperation
- Lessening limitations of activities by focusing on the individual’s capabilities and utilizing compensatory strategies and devices
- Providing the highest quality, patient focused rehabilitation
- Removing or lessening restrictions to participation in life situations to the fullest extent possible
- Providing counseling to the individual and family and/or caregiver on alternative possibilities for life participation when necessary
- Preparing the individual, family and/or caregiver to make the transition to the next stage of the rehabilitation process
Cultural and religious needs are respected for each patient by the entire team. Accommodations to the patient’s schedule, dietary needs and requests, and the provision of appropriate equipment are provided to enhance the patient’s experience and support full participation in the rehabilitation program. All staff members participate in annual cultural diversity and sensitivity training.
The diagnoses commonly served in the Cardiopulmonary Program include but are not limited to:
- COPD: emphysema, bronchitis, asthma, bronchiectasis
- Idiopathic Pulmonary Fibrosis
- Restrictive Lung Diseases
- Post-operative Thoracotomy s/p Pneumonectomy, Lobectomy or wedge resection.
- Status Post Lung Volume Reduction Surgery
- Congestive Heart Failure
- Status Post Coronary Artery Bypass Graft
- Status Post Valve Replacement (mitral, aortic)
- Medical debility
- S/P lung; heart transplant
- S/P Left Ventricular Assist Device placement
In 2019, the Cardiopulmonary Program:
- Served 219 patients with cardiac conditions ranging in age from 15 to 98.
- Served 188 patients with pulmonary conditions ranging in age from 26 to 98 years old.
- Discharged patients to the following:
- 76% (167) of the patients with cardiac conditions and 75% (140) of the patients with pulmonary conditions returned home with home care, outpatient, or no further services because services were no longer needed.
- 7% (14) of the patients with cardiac conditions and 5% (9) of the patients with pulmonary conditions went to a sub-acute facility to continue their inpatient rehabilitation.
- 17% (38) of the patients with cardiac conditions and 20% (38) of the patients with pulmonary conditions were transferred to an acute hospital.
- 0% of the patients entered a long-term care facility.
Within the scope of the Cardiopulmonary Program, patient evaluation and care planning are designed around traditional medical disablement models. These models assess three levels of dysfunction which stem from the patient’s admitting diagnosis (pathology).
Impairments: Weakening, damage, or deterioration of function within a specific component of the cardiopulmonary and/or musculoskeletal system resulting from injury or disease.
Examples: Decrease in exercise tolerance, decrease in balance, limitations in pulmonary hygiene, decreased cardiac output, decreased ventilatory capacity, decrease in strength, decrease in active and/or passive range of motion.
Activity Limitations: The inability to perform a specific task as a consequence of the impairments mentioned above.
Examples: Difficulty with ambulation, stair negotiation, dressing, grooming, or self-care.
Participation Restrictions: The cumulative effect of impairments and activity limitations on the ability of a person to participate in life roles.
Examples: Inability to perform duties as a parent, caregiver, employee, or participant in social and leisure activities.
In addition to these medical characteristics identified through the utilization of the disablement model, social barriers to discharge must also be assessed. These factors are societal and environmental by nature and often times they impact the determination of services rendered upon discharge.
These barriers can include but are not limited to:
- Limited transportation
- Inaccessible living environment
- Limited caregiver support
- Financial resources/insurance benefits
The initial assessment performed by each discipline should capture the patient’s most accurate burden of care via GG scoring as well as functional endurance which is measured via 6-minute walk test. Based upon the results of the initial evaluation, each interdisciplinary team member will create a patient-specific plan of care designed to meet each patient’s goals. The team will formally meet twice weekly to discuss discharge planning and treatment progress.
Discharge planning has the potential to begin on the first day of the patient stay with the discussion of outpatient follow up services, patient goals, and patient support base being initiated by social work. The combination of the patient’s medical, physical and social circumstances will dictate the most appropriate discharge environment from the services available.
Led by pulmonologist Richard Novitch, M.D., the professionals on your interdisciplinary care team will assess your medical and rehabilitation needs and work with you to establish your individual goals. In close collaboration, the team designs and implements your treatment program. Throughout your treatment the entire team meets formally once per week to discuss your progress, and Dr. Novitch monitors the overall team process and outcome.
The philosophy of the Cardiopulmonary Program is that the program’s mission can best be accomplished by providing rehabilitative care through an interdisciplinary team approach. Upon admission, each patient will be evaluated and cared for by members of the interdisciplinary team. The interdisciplinary team make up is determined by patient assessment, medical needs, rehabilitation needs and predicted outcomes. Based upon individual patient needs, the team may be comprised of individuals from, but not limited to, the following disciplines:
- Individual with cardiac/pulmonary condition
- Individual’s family and/or caregiver(s)
- Rehabilitation Nursing
- Respiratory Therapy
- Occupational Therapy
- Physical Therapy
- Social Work
- Recreational Therapy
- Speech-Language Pathology
The patient is an integral part of this team and is informed of the interdisciplinary team members’ findings and expected outcomes by individual team members as plan of care is determined.
Support services available include:
- Medical consultation (Psychiatry, ENT, Dermatology, Podiatry)
- Spiritual services
- Orthotic/Prosthetic services
- Complimentary therapy
- Laboratory services
- Pharmacy services
- Driver assessment and education
- Medical nutrition
The overall function of this team is to create the most appropriate patient-centered plan of care. The team’s goal is to help the patient achieve the highest level of independence and education while establishing a discharge plan that keeps the patient progressing within the healthcare continuum. In doing so, the team aims to minimize impairments, reduce activity limitations, lessen participation restrictions and achieve predicted outcomes. The ideal outcome is an independent discharge to the community with follow up outpatient services concurrently arranged.
From admission through the discharge planning process, team members work collaboratively with each other, the individual with the cardiac/pulmonary condition and the family and/or caregiver(s) to ensure that the specific needs of each individual are addressed. Patient and family and/or caregiver involvement and participation is strongly encouraged throughout the entire rehabilitation process.
Based on the results of the initial assessment, goals are determined with the individual and/or family, and a treatment plan is implemented. The individual’s progress is discussed formally once per week at team conference/medical rounds. Team consultation and collaboration occur throughout the treatment program. In addition to speaking directly with members of the team regarding the patient’s medical condition, progress, functional status, participation in therapy, achievement of established goals, family members and/or caregivers are strongly encouraged to attend and participate in treatment sessions and patient care as appropriate.
Patient and Family/Caregiver Education
All cardiac and pulmonary patients will attend daily patient education classes, which are delivered by the interdisciplinary team. This education is open for family and caregiver attendance as well as patient participation. Educational objectives of the patient education classes are based on self care and disease management, resource utilization as well as community re-entry following discharge. Team members provide a series of lectures and discussions on pulmonary wellness daily.
Family members and caregivers are encouraged to attend and participate in treatment sessions and care as appropriate. Comprehensive education for you and your family and/or caregiver is essential to reaching your goals.
Every potential patient who may benefit from our care is discussed with the screening staff, physician, and/or program director. The rehabilitation potential for every patient is evaluated prior to admission.
Referrals to Burke are usually made by physicians, social workers, discharge planners or case managers. A reasonable medical and functional profile must be provided and appropriate sections of the medical record from the acute care process are included. A rehabilitation nurse may also perform a detailed evaluation at the referring institution. Recommendations are then made to the appropriate member of the medical staff who renders a final decision with regard to admission.
The discharge planning process begins when the patient is first admitted to the program. The social worker/case manager leads the planning process, coordinating information from all members of the interdisciplinary team and acting as the primary liaison between the team and the patient and family. Based on the individual’s functional status for self-care, mobility and other daily life skills, family/caregiver support, medical needs, pre-morbid living situation and level of function, and available health insurance, the team, in collaboration with the patient and family, makes recommendations for the most appropriate and suitable discharge plan for the patient. At the team or family’s request, a meeting with the team and patient/family is scheduled to discuss available discharge options. The patient’s and family’s preferences are of primary concern and the team will make recommendations for a safe discharge when options for continued care and rehabilitation are considered.
Recommendations may include, but are not limited to:
- Home with home care services
- Home with outpatient services
- Sub-acute rehabilitation services
- Long term care services
- Hospice services
For information regarding fees and insurance, please click here.
Located in White Plains, New York, Burke Rehabilitation Hospital's Cardiopulmonary Rehabilitation Program attracts cardiopulmonary patients from Westchester County, New York City, Long Island, Northern New Jersey, and Connecticut. Burke also welcomes cardiopulmonary patients from across the country and around the world.