Last updated on March 26, 2004

Overview

We get a lot of questions on outcomes as programs attempt to be certified by AACVPR.   Here we have gathered resources to help you complete the outcomes portion of your certification application.  Feel free to comment on our message boards if you have other tips on certification.  Orion is working closely with the AACVPR certification committee to be sure our outcomes program meets and exceeds the requirements for program certification.

AACVPR Requirements

In the September 2002 AACVPR Certification Application, under Required Documentation for Program Certification for Cardiac Rehabilitation, Tab 13, are the outcome requirements.  They are:

Tab 13. Outcomes: Clinical, Behavioral, Health (GCR p. 116, 183-187)

For each outcome category above, provide the following for at least a three-month period:

1. number of participants (i.e. N=90)
2. pre-program data
3. post-program data
4. change between pre and post measurements (Examples of change include but are not limited to: percent change, mean unit change, percent of goal reached, etc.)

Submit only mean or cumulative data – do not send individual patient data.

AACVPR Guidelines

AACVPR has published a list of acceptable and unacceptable documentation for sections of the application. Here the excerpt from the section on outcomes.

Acceptable

• Must include 1 outcome from each category: health, behavioral, and clinical (GCR 116, 183-187/ GPR 84-95, 189-237, 244, 245).
• Health: measures change in health or health status, i.e. morbidity, mortality, or quality of life.
• Behavioral: changes in behavior (i.e. change in weight is a clinical outcome – change in dietary habits is a behavioral outcome).
• Clinical: any measurable clinical indicator.
• For each outcome must show:
• 3 months data (indicate dates of data collection).
• Number of patients included ("N" = ?).
• Pre/post mean data (average of all patients).
• Percent change – units of change – or change towards goal.
• These must be quantifiable measures.

Unacceptable

• Less than 3 months data
• Missing any of the criteria mentioned in "acceptable".
• Individual patient data without program summary data.

Data is on very small number of patients in 3 months for a large program (less than 75% of stated census) -- committee will ask for more information.

Using Orion Outcomes for Your Application

Outcome Data to Collect in Advance of Application

• Need to collect data in 3 domains.  Make sure you have at least one data point in behavioral, clinical and health domains.  Popular choices are:
• Behavioral:  exercise frequencies
• Clinical:  Six Minute Distance Walk, which produces blood pressure, distance walked and more
• Health:  SF-36

Reports to Include

• Average Patient Profile Report
  • Gives number of samples/patients
  • Gives pre-program and post-program averages
• Program Change Summary Report
• Gives number of samples/patients
• Gives average/mean in units of change

Suggestions

• Don't spend time trying to explain the math/formulas
• Do spend time explaining what the data means.  Orion Outcomes produces great reports and graphs but if you can't explain what the data means, you are not getting the value from it.
• Example:  If the change in patient weight averages a loss of say 10 pounds between pre-program to post-program, is that a good thing?  Why or why not?  That is the more interesting question, versus how did you come up with negative 10 pounds mathematically.

Frequently Asked Questions

Q:  Do I have to explain all these statistics on the Program Change Summary Report?
A:  No.  AACVPR only requires the Count and Mean columns.  You can selectively turn the other columns off when you generate the report if you prefer.

More Information

Post your questions or tips to our message boards.