Improving cardiac rehabilitation services - challenges for cardiac rehabilitation coordinators

Background: Cardiac rehabilitation (CR) is a long term multifactorial rehabilitation program aimed at the secondary prevention of cardiovascular events. However, delivery of CR services is less than optimal. Aim: This study explored the perceptions of cardiac rehabilitation (CR) coordinators relating to challenges for improving the delivery of CR services. Methods: The study design used qualitative, semi-structured in-depth telephone interviews with 20 CR coordinators from NSW Australia. Interviews were transcribed verbatim and thematic content analysis was undertaken to identify common themes. Results: Twenty CR coordinators participated in the study. Three major themes including obstacles to delivering cardiac rehabilitation services, challenges in achieving continuity and coordination, and complexities in delivering evidence-based health care were identified. Study findings indicate that limited service capacity due to a lack of investment and planning, rurality, lack of knowledge, and communication difficulties, are major challenges that CR coordinators need to overcome to provide effective services. Conclusions: The experiences of participants provide some detailed insight into the barriers encountered in providing CR services. The main message from this study is that providing CR services is a complex process and is collectively influenced by the health care system; professional and provider issues; and program characteristics.