Generic Cardiac Rehabilitation Roles: Expanding and Securing the Occupational Therapy Role in a Heart Failure Cardiac Rehabilitation Programme Sarah Quinlan, Occupational Therapist, Cardiac Rehabilitation: sarahquinlan@nhs.net Rationale: Occupational Therapists (OT) are a core member of a multidisciplinary cardiac rehabilitation programme (BACPR 2012). As an allied health professional, OTs should be working to support integration and challenge historical service boundaries (Chief Allied Health Professions Team, 2017). Purpose: To integrate the OT role into a Heart Failure (HF) Cardiac Rehabilitation Team. To challenge the boundaries of practice by developing generic competencies within a multidisciplinary team, alongside the delivery of OT specific interventions. Method: Establish the OT as a ‘trusted assessor’ (shadowing/joint working/training/competencies) Integration of specific OT therapeutic interventions: fatigue management, activity analysis, relaxation, stress management, anxiety management Offer home based programme: to include therapeutic interventions alongside clinical checks and provision of strength and balance exercises Outcome measures: Hospital Anxiety and Depression Scale (HADS), Dartmouth COOP Quality of Life Scale (QOL), self rating scale (0-10) of goal achievement, Short Falls Efficacy Scale-1 (FES-1), Timed Up and Go (TUAG), Tinnetti gait and balance scale Intervention: The OT role Generic Cardiac Rehabilitation Roles: Clinical assessment: blood pressure monitoring, ECG recording/ basic interpretation Pre-exercise suitability checks Strength and balance functional assessments Exercise intensity monitoring- pulse checks/RPE scale Home Visits: Equipment provision Adaptations Falls prevention home environment assessment Strengthening exercises Clinical review: blood pressure/ECG/oedema/oxygen saturations (may reduce need for HF nurse home visit) OT clinics: Fatigue management Activity pacing Task modification Energy conservation Goal setting Group well-being sessions: anxiety management, thinking styles, problem solving Home and clinic based appointments Results Outcome measures: TUAG reduced from 18 seconds to 14 seconds (high falls risk over 15 seconds) FES-1 reduced from 11 to 9 (indicating reduced psychological fear of falling) Tinnetti increased from 20 to 22 (changing from high/mod falls risk to mod falls risk) HAD scores; Anxiety reduced from 10 to 7/ Depression reduced from 9 to 7 (score of 7 or below is ‘normal’) COOP score reduced by 18% (indicating improved QOL) Self rated goals; 80% achieved goal 1 and 70% achieved goal 2 (functional individual goals) Conclusion: This approach has enabled an OT to become a fully integrated and integral member of the HF cardiac rehabilitation team: In order to ‘increase the value’ of therapy positions it may be necessary to develop wider competencies with appropriate training The development of extra skills should not be seen as a challenge to OT identity References British Association for Cardiovascular Prevention and Rehabilitation. (2012) Standards and Core Components. BACPR:London. Chief Allied Health Professionals Team (2017). AHPs into Action: Using Allied Health Professionals to Transform Health, Care and Wellbeing. London.