Cardiac+Rehab

John Muir Health in collaboration with CCHP has agreed to offer a home-based secondary preventive program for cardiac patients called Cardiac Out-Patient Education (COPE). The COPE program components includes:


 * Establishing a therapeutic alliance with the patient,


 * Collaborative goal setting and assistance with risk factor modification


 * Initial appointment which includes review of medications, education, goal setting and a fitness evaluation


 * Telephone follow-up every 2 weeks for 12 weeks


 * Exit evaluation, which includes review of medication, evaluation of goals and fitness evaluation


 * Report to referring physician (PCP)


 * Six-month and one-year follow-up phone call

This program is available to all Medi-Cal and HCCI patients at no charge to the patient or to CCHP. Eligible patients include patients who in the last 6 months have had any of the following diagnoses:


 * MI


 * CABG


 * Stable Angina


 * Status post PCI/Stent


 * AVR/MVR (repair or replace)


 * Status post Cardiac Arrest

Referrals can be made by utilizing the referral form and patient brochure information listed under COPE in the Medical Records Gold star icon sections: cardiopulmonary requisitions or referrals section. Laurie Crider, RN, CCHP Case Management, will be helping to coordinate patients from our system who are referred and any questions can be directed to her.

Please feel free to start referring appropriate patients now. Also, you may receive primary patients back into your clinics who were already referred upon discharge from the hospital if they were hospitalized with an eligible diagnosis. The intent is to coordinate the services with the PCP so all communications and reports from the program will be sent to the PCP of record. I am very excited about this collaboration and I hope it will bring important and much needed positive life-changing services to our patients with cardiac disease.

[|Cardiac Rehab Referral JMMC.DOC]

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