The percentage of eligible inpatients referred to a Cardiac Rehabilitation (CR) Program.

A subset of the denominator representing a number of inpatients who were referred to a CR Program prior to hospital discharge. A referral is deemed being made if both of the following criteria are satisfied: 1. There is an official written or electronic communication on behalf of the health care provider for referral to CR and 2. The referral information has been received by the CR program

The number of eligible inpatients in the reference period with any of the conditions or interventions listed below: • Acute coronary syndrome; o Acute Myocardial Infarction (STEMI, non-STEMI); o Unstable angina; • Chronic stable angina; • Stable heart failure; • Percutaneous coronary intervention; • Coronary artery bypass surgery; • Cardiac valve surgery

Denominator exclusions: • CR eligible inpatient with a documented medical reason for non-referral, such as comorbid life-threatening condition, serious mental illness, or inability to ambulate. • CR eligible inpatient with a documented patient-centred reason for non-referral. • CR eligible inpatient discharged to long-term care facility or inpatient rehabilitation. • CR eligible inpatient who died prior to discharge.

Method of Calculation: Numerator / Denominator * 100. Sources of data: Electronic medical records, retrospective chart review, prospective flow sheets, Provincial and territorial hospital discharge abstract databases, CIHI hospital database, and/or cardiac registries

Canadian Cardiovascular Society. The Canadian Cardiovascular Society Quality Indicators E-Catalogue, Quality Indicators for Cardiac Rehabilitation and Secondary Prevention, A CSS Consensus Document. 2013 Accessed May 2023:[5 p.]. Available from: ccs.ca/app/uploads/2020/12/Indicator_CR.pdf. Grace SL, Poirier P, Norris CM, Oakes GH, Somanader DS, Suskin N. Pan-Canadian development of cardiac rehabilitation and secondary prevention quality indicators. Can J Cardiol. 2014;30(8):945-8. Somanader DS, Chessex C, Ginsburg L, Grace SL. Quality and Variability of Cardiovascular Rehabilitation Delivery. Journal of cardiopulmonary rehabilitation and prevention. 2017;37(6):412-20.

The Canadian Cardiovascular Society Quality Indicators E-Catalogue Top 5 QIs developed Page 5. ccs.ca/app/uploads/2020/12/Indicator_CR.pdf Grace 2013 (research paper on development process of indicators reported on e-catalogue) www.sciencedirect.com/science/article/pii/S0828282X14002335?via%3Dihub#sec1 Supplement to Grace 2013 paper ars.els-cdn.com/content/image/1-s2.0-S0828282X14002335-mmc1.pdf Further research on functional change on Canadian Cardiovascualr Society QIs www.cjcopen.ca/article/S2589-790X(21)00132-3/fulltext No public information on registry and website posts are back from 2014: cacprcacpr.wordpress.com/2014/04/25/data-dictionary-2-0/ Suggest that QIs are likely collected via a registry that requires a paywall: www.corhealthontario.ca/Quality-Indicators-for-Virtual-Cardiovascular-Rehabilitation-during-COVID-19-and-Beyond-(May-22-2020).pdf

Canadian Association of Cardiovascular Prevention and Rehabilitation Registry (Cardiologica) (Not publically available and likely used via pay wall. )