Adapting to a changing context with Prevention and Rehabilitation
Over the last few months, the Division of Prevention and Rehabilitation team at the University of Ottawa Heart Institute has adapted in innovative and creative ways to continue supporting patients in the context of the COVID-19 pandemic. The variety of programs and services offered to patients, such as exercise programs, cardiac rehabilitation and women’s heart health services typically happen in person and onsite. With many onsite services cancelled due to the pandemic, many of these programs have taken advantage of technology to continue supporting patients through their recovery and rehabilitation.
The Women@Heart Program provides a caring environment for women with heart disease to access emotional support and education for a better recovery. The 6-month program consists of 12 sessions held bi-weekly and run by Peer Leaders – women who have themselves had a successful recovery from heart disease. While – with the exception of a pilot project held last fall – these groups were held in person in communities across the region, they are now being offered virtually due to the pandemic.
This new approach has provided some unique advantages. For example, physical distance is no longer a barrier – rural participants as well as those living in other cities and/or provinces are now able to join, and participants can attend from any location – while spending time at the cottage, for example. While establishing in-person connections with other group members has always been a big draw and benefit of the program, many virtual group members have been grateful for the opportunity to meet via videoconference. This is a vulnerable period for women with heart disease and the sessions empower women to take charge of their heart health and develop better coping mechanisms to reduce risk of isolation. And, the connections are still going strong within these virtual sessions. To quote one participant: “My most sincere thanks for running this wonderful program. It is truly so important. (The Peer Leaders were) fantastic, and everyone in our group has become soul heart sisters!”
Given the success of these sessions, the plan is to offer the online option as well as in-person groups once pandemic restrictions are lifted. For more information, visit the Women@Heart Program and Virtual Groups pages.
Over the past few months, the Prevention and Wellness Centre (PWC) has been offering weekly webinars on a variety of topics – answering concerns related to COVID-19 as well as covering topics that were previously offered through in-person presentations. Patients and family members can participate in real time when the sessions are delivered or can listen to the recorded sessions online.
The webinars are part of a larger wellness initiative that the PWC team has been developing for over a year, and the pandemic provided a timely launch point for them: the webinars were both necessary and well received by clients. They have averaged about 100 participants per session with over 1,500 signing on in May and June and hundreds more watching the recorded sessions on-demand afterwards.
There have been many benefits to offering these online: as with the Women@Heart virtual groups, online programming can reach a wider audience – even province-wide, nationally and internationally. Having a recorded session is another benefit: allowing participants to watch again, share with someone, or watch it later. Another more surprising advantage to this format is increased participation: organizers have noticed that participants seem to be just as, or in some cases more comfortable asking questions and participating when online compared to the participation at onsite presentations.
Given the interest and participation to date, the online webinars will continue to be offered based on topics of interest to participants as well as important information practitioners want to share with their patients (at a somewhat slower pace during the summer months). The plan is to offer a combination of in-person and online options once onsite programming resumes.
To watch a past session or register for upcoming talks, visit the HeartWise Webinars page. If you would like to propose a webinar topic, please share your suggestions through: firstname.lastname@example.org.
Cardiac rehabilitation (cardiac rehab) has been delivered to recovering patients virtually for some time – through the Virtual Care computer platform and health coaching program over the past 4 years and over the phone through the case-managed home program since 2001. But due to the pandemic, since mid-March, all cardiac rehab services are now being offered virtually, mostly over the phone.
This was a major transition for the cardiac rehab team and participants: group exercise classes, nutrition workshops, stress management workshops as well as other aspects of service went from being offered in-person and often in a group setting to one-on-one care over the phone. Almost all aspects of the services are still being provided with this approach: for example, patients self-report their own blood pressure and weight now, instead of being assessed by a physiotherapist at the hospital.
The reactions to this change were varied: some were relieved to not be risking exposure to COVID-19 or are happy to skip the commute, while others were disappointed to lose the in-person care and miss the peer support and camaraderie from being in a group activity. Fortunately, the phone is a comfortable tool for just about everyone. Again, this approach has advantages including savings from transportation and parking costs and being able to participate from anywhere. As well, participants are receiving a bit more one-on-one time from their care providers in this model as opposed to the group setting, and family members can join the call with them. Another advantage is that it encourages self-management of one’s health program right from the beginning which can help with maintaining healthy habits long-term.
It will be a slow return to group and in person support onsite at the Heart Institute, however future options will also include many new exciting programs in virtual care for cardiac rehab patients. Plans are currently in place to start bringing patients back to Cardiac Rehabilitation who would benefit from an in-person assessment or counselling type of visit. For more information on cardiac rehab services, visit the Cardiac Rehabilitation Outpatient Program page.
Congratulations and thanks to all the teams mentioned in this article, for their swift response to the rapidly evolving circumstances of this pandemic. Thanks to their flexibility, resilience and hard work, patients have continued to receive excellent care and these unforeseen circumstances have given rise to some new and exciting service offerings.