Texas Association of Cardiovascular and Pulmonary Rehabilitation

1. President’s Message By: Marilyn Burwitz, RN, TACVPR President Welcome to the Spring edition of the TACVPR newsletter. Although we’re officially still in Winter, the weather is certainly moving rapidly toward warmer temperatures. I’m starting to see evidence that Spring is just around the corner---flowers are blooming and trees in my front yard are starting to bud out. I hope you enjoy this time of year as much as I do. It’s almost conference time! I hope you are making concrete plans to attend the 19th annual TACVPR conference. I think you will really enjoy everything about the conference. The hotel is beautiful. At our original site visit to this hotel, the Crowne Plaza was under a multi-million dollar renovation. It was difficult to get a good idea of what the hotel would look like when we were literally stepping over toilets in the middle of the floor during our tour. I went back in January and it looks great! The area where we will be holding our social this year is near the pool, and if the weather cooperates we will be able to spill out onto the outdoor area. Hopefully, you will enjoy all the speakers as much as you do the social aspects of the conference! I would urge you to invite others to the conference. If you know someone new to the cardiac and pulmonary rehabilitation field, this is the perfect place for them to network with others. Encourage your program’s medical director to attend as well. We would love to have more physicians in attendance. We have talked about having a special workshop or Q&A session in the future for medical directors if we have enough interest. Enjoy this newsletter and I hope to see you in Houston! Marilyn Burwitz, RN TACVPR President Texas Association of Cardiovascular and Pulmonary Rehabilitation Don’t forget TACVPR membership expired December 31st, 2008! To join or renew your TACVPR membership you may sign up online or download a printable membership application at www.tacvpr.org Annual dues are $40/person

2. TACVPR Conference 2009 We Struck it Big…It’s Now Law! Cardiac & Pulmonary Rehab Act of 2008 The 2009 TACVPR annual conference is right around the corner so if you haven’t registered yet make sure you go online to www.tacvpr.org and register ASAP. Onsite registration will be available but we encourage everyone to register prior to the conference if possible. This year’s meeting is set for April 3rd & 4th in Houston at the Crown Plaza Hotel located in the Houston North Greenspoint area.It is a short 7-mile drive from George Bush Houston Intercontinental Airport and 17 miles from Houston Hobby Airport. We have a great venue for the meeting and are fortunate to have some wonderful speakers lined up. Whether you’re a RN, RT, EP, PT, OT, RD or MD attending the annual TACVPR conferenceis one of the best waysto network with your colleagues and keep up to date with all of the important issues happening in the field of cardiac & pulmonary rehabilitation. Go to www.aacvpr.org to register today!!! WIN A FREE AACVPR MEMBERSHIP AT THE CONFERENCE!!! Visit with all the Exhibitors/Vendors at the 2009 TACVPR state conference and get registered to win a free AACVPR Membership. More details at the conference!

3. Submission Instructions for Poster Presentations The TACVPR Board of Directors is interested in displaying clinical pathway/QI projects, and/or clinical/scientific abstracts at the annual meeting. The board wants to both acknowledge “work well done” and share the information with all Texas members. Please see the following criteria for help in the development of your poster presentation. Criteria: Please submit your information, poster title and brief summary content on the bottom of this page and email the form to tacvpr_2005@yahoo.com. Once your poster is accepted for display, the title will be included in the TACVPR conference syllabus. Your poster title will appear as originally submitted, so please check spelling and grammar for accuracy. Submission of a poster or abstract constitutes commitment of the author to be present at the TACVPR conference. Please prepare a poster no larger than 47 by 70 inches for display. The poster will be displayed in the exhibit area on Friday and Saturday. For those posters displayed on cardboard, there will be easels available for appropriate presentation. Non stand-alone posters will be placed on an available presentation board. Please specify at the bottom of this form which type of poster (cardboard/non stand-alone) you will be submitting. Please come to the registration desk on the day of conference for instructions on how and where to display your poster. The TACVPR board enthusiastically welcomes all your ideas as we look forward to the development of the poster presentation process in years to come! Contact Information (please print as you want listed in the conference materials) Print Name and Title____________________________________________________________ Program Name ________________________________________________________________ Poster Title __________________________________________________________________ Phone Number ______________ Email _ ________ _____________ Summary ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Call for Abstracts & Posters Do you have a quality improvement project you would like to share with other professionals in the field? Are you working on a research protocol to improve care for your patients? We would like to share your knowledge with other professionals at the TACVPR Conference. For more information about how to submit a poster at the conference please contact Poppy Patterson at ppatterson@hillcrest.net.

4. On March 4th and 5th, TACVPR board members Erika Abmas with Baylor Dallas Pulmonary Rehab, Dean Diersing with University Medical Center-Lubbock and Cardiac Rehab, Twyla Selvidge with ETMC Cardiac Rehab and former TACVPR board member Mary Hart also with Baylor Dallas Pulmonary Rehab traveled to Washington D.C. to visit our legislators regarding health reform. You may recall last year four TACVPR board members went to “Capitol Hill” seeking legislators to sign on for our bill. That trip proved successful as The Cardiopulmonary Rehabilitation Act of 2008 was passed last July. This year, our goal was to speak with our legislators about health reform. The bill, “American Recovery and Reinvestment Act” recently signed by President Obama, has $650 million set aside for prevention and wellness. Our talking points with our legislators drove home the point that the AACVPR has been organized for close to 25 years and is the model for prevention and wellness within the rehabilitation health care delivery format and can also address chronic disease management that is so costly to our nation. When addressing our legislators regarding healthcare reform, the current vernacular used is “Comparative Effectiveness”. This means legislators want to know how government dollars that are paid for your program compare to another comparative delivery of care that might be more effective and cost saving. We believe our rehabilitation services are genuinely low tech services that have excellent peer reviewed documentation in terms of improving actual health indicators and quality of life. As the AACVPR has stated “We’re effective, and we’re not worried about being compared to other treatment modalities. Just a few notes of other interest the AACVPR is working on now: Pulmonary Rehab: the AACVPR is working closely with all the other pulmonary societies to assist CMS in crafting regulations in time for the January 1, 2010 implementation. These professional societies, ATS, ACCP, AARC, NAMDRC jointly met with CMS late last fall and submitted a lengthy set of recommendations regarding development of a NCD. The AACVPR stated they are confident that “we will see a proposed NCD this Spring/Summer. On the Cardiac Side: the AACVPR has joined with the ACC and also met with CMS to discuss changes in the existing NCD that are required by law. For example, the current NCD does not address outcomes assessment and the new provisions require it. What’s New on the Reimbursement Front?By: Twyla Selvidge, M.S. What’s That? NCD National Coverage Determination LCD Local Coverage Determination CMS Centers for Medicare and Medicaid Services ACC American College of Cardiology ATS American Thoracic Society ACCP American College Chest Physicians AARC American Assoc Respiratory Care NAMDRC National Assoc for Medical Direction of Respiratory Care

5. Get to know your referral sources – If you don’t know them, how do they know you and the quality of your program? Without this relationship what obligates them to you? 2.Develop a Team Resume – Show your highly qualified staff off! Give this resume out during community health fairs, marketing luncheons, or give it directly to your referral sources (you might get lucky and they post it in their waiting room!). Do whatever you can to sell your program! (Feel free to email me for a Team Resume example/template.) Develop a Marketing Leadership role – Allow one of your high performing staff members to take on this role and be responsible for regularly scheduled marketing visits. This can simply be visiting the clinic to get to know the staff and building relationships. Feel free to take them a fruit tray or some sort of goodie to enhance your experience. 4. Become a Member of the AACVPR – The AACVPR recently developed a “Referral Enhancement Toolkit” and they have marketing presentations already put together that you can edit to match your program. This is a member’s only benefit. The work is already done. (see #7 below) Establish relationships with Social Services or Case Workers within your hospital – especially the ones that assist with the care of cardiac/pulmonary patients. Request to give an in-service to them. If they understand your program, they can better explain the importance to your potential patients. 6. Market in the good times – Make it a priority. You don’t want this picture painted “Oh great I guess Cardiac/Pulmonary Rehab must need referrals. THEY’RE BACK!!!” Make sure they see you there because of the benefit to the patient not your program. 7.Develop a Marketing Presentation – Find out when your Cardiology or Pulmonary Doctors regularly meet. Request to get on there agenda to deliver a in-service/presentation about cardiac/pulmonary rehab services. (Sometimes buying lunch works too depending on your budget and the size of the group.) 8. Get on pre-printed/standing orders – Discuss with your administration the process of getting on certain pre-printed/standing orders if you are not already. For example, your hospital will more than likely have a pre-printed/standing order for Acute MI. Is Cardiac Rehab an option on that order? Does the Doctor have to remember to write it in the discharge orders? SIMPLIFY THE PROCESS! 9. Reward your top referral source – This shows your appreciation for the dedication they have to your program. It is also a way to market in the good times! Give this top referral source and his staff lunch or give that doctor a gift card to a place where he can spend it on himself! This gives you a reason to be in their clinic again, MARKETING! 10. Make rounds with your Physicians – Set up a time to allow a staff member (or you) to make rounds with one of your physicians or shadow their clinic. It won’t take but a few times with you in their back pocket saying, “Would that patient benefit from Cardiac/pulmonary rehab services?” before they get use to referring to your program! *Recommendation: Develop a Marketing Log to track your progress and hold your program accountable to marketing. I would also recommend tracking your referrals through a Referral Log. This log should be updated monthly and include who is referring, as well as, total referrals. 10 Ideas to Enhance Referrals By: Dean Diersing, MS, ACSM-HFS, TACVPR President Elect

6. The TACVPR Board of Directors WANT YOU!!! • The TACVPR is looking for interested Cardiac and/or Pulmonary Rehab professionals to run • for a position on the board. The election will be held at the annual meeting on April 4th, • 2009. Attendance at the conference is not mandatory, but please make sure you submit the • requested information by the deadline to ensure inclusion. • Board nomination requirements include: • Serving a 2-year term • Must be an active and participating TACVPR member at least one year prior to the time of the election. • Total of 11 Board Members, so every member must be ready to work and make sure that the members of this state are cared for • Required to attend 4 meetings per calendar year (typically June, August, November, January) and a teleconference (typically in March) • Meetings scheduled from ~9am–3pm to allow travel to & from meetings for each board member that day • Travel paid for by TACVPR, pending most cost effective travel secured • Members will represent the membership and communicate with members of the association to bring issues and concerns to the board meetings. • Members will be expected to contribute articles and/or information for publication in the quarterly newsletter • Members of board receive a complimentary TACVPR membership & conference registration • Commitment/Confidentiality/Conflict of Interest Form will be signed by all board members upon election. • Must serve on a committee and/or hold office on the board (it is preferable to hold an office in the second year on the board). • Board members with minimum of 1 year tenure are eligible for Executive Board positions of President, President Elect, Treasurer, or Secretary. • Please complete the Nomination Form on the next page and email to Julie Hartman at • julie.hartman@baylorhealth.edu. Faxed copies are acceptable if email not possible to469- • 814-3528. Feel free toemail us at tacvpr_2005@yahoo.comif you have any questions or • need additional information.

7. Texas Association of Cardiovascular and Pulmonary RehabilitationBoard Nomination FormIf you are interested in running for the TACVPR board, please complete the form below and send it to Julie Hartman at julie.hartman@baylorhealth.edu. You will also need to email or mail a picture (3x5 or 4x6) of yourself for us to post on a board near conference registration. No scandalous photos please! Our Question Your Info I am interested in serving on and working for the Board of the Texas Association of Cardiovascular and Pulmonary Rehabilitation. I understand the construct and requirements of this Board position and submit my information as nomination for the April 4, 2009, election.    Printed Name: ___________________________________________ Signature: ___________________________________________ (Email will suffice for signature if sent electronically)

8. Is Your Program Certifiable? For those who either applied for certification in December or recertification in February, you may feel like you and your staff are certifiable… certifiably nuts that is! The worst is over. You may have some tweaking to do after the committee meets for its initial review in Chicago on April 16 – 19th but hopefully all of us will ultimately find that our programs are indeed certifiable. You can expect to hear from AACVPR by the first week of May. You will either be notified that your program has met the requirements on the first review or that you need to send additional documentation for the final review in July. In years past the State review committee would review the first time certification applications and possibly ask for additional documentation before sending it to National for the second review. This year there was no State review so there may be an increase in programs who are asked for additional information in order to have a clear picture of your policies, procedure, and daily practice. If you get a letter requesting additional documentation, DON’T PANIC!! You will receive information on what tabs need clarification and a contact committee member that is responsible for your application. DO CALL OR EMAIL THEM!! Make sure you utilize your committee member. They are there to ensure you send back what is needed to successfully complete the application process. Even if you think you have everything correct I would encourage you to pass it by your contact person or someone on the committee for verification. Poppy Patterson and Barbara Flato currently sit on the Recertification Committee and Laura Raymond begins her first year on the Certification Committee in April. For those of you who are still contemplating whether your program is certifiable, I extend a special invitation to you and your colleagues to attend the “Is Your Program Certifiable” breakout session at the TACVPR Annual meeting next month. That will be a first step in development of an action plan to prepare your application for a December 2009 delivery to AACVPR. Completed Certification and Recertification documents will be available for review. See you in Houston!! Certification CornerBy Barbara Flato MSN, RN-BC, FAACVPR TACVPR Members Only Section Have you had the chance to check out the new “Members Only” section of the TACVPR website? If you answered “no” to this question, take a minute to log on to www.tacvpr.org to see what it has to offer. For questions on how to log-in to the website, please e-mail Dean Diersing at MichaelDean.Diersing@umchealthsystem.com

9. Update Your Information for the 2009 TACVPR Program Directory We are currently updating the statewide program directory which is available to all current TACVPR members. In order to make sure your facility’s information is included and accurate, please answer the following questions and return this form as soon as possible by email or fax. Hospital/Facility Name:_______________________________________________________ Hospital/Facility Address:_____________________________________________________ __________________________________________________________________________ City:_____________________________________ Zip Code:_______________________ Department (Cardiac, Pulmonary or both): ________________________________________ Department Phone Number: ___________________________________________________ Department Fax Number: _____________________________________________________ Program Director/Coordinator’s Name: ___________________________________________ Program Director/Coordinator’s Email: ___________________________________________ Cardiac Rehab Program AACVPR Certified? Yes No Pulmonary Rehab Program AACVPR Certified? Yes No Do you know of any programs in your area that have closed in the last 1-2 years? Please list program names: _____________________________________________________________ ___________________________________________________________________________ There is no cost to have your program listed in the directory, but if you do not want your program listed, please let us know. We will let you know when the 2009 directory is completed and available. TACVPR members can view the current directory online at www.tacvpr.org in the “member’s only” section. Upon completion, please email to llee@christushealth.org, fax to 830-606-3657or mail to: Lorri Lee 750 Landa Street, Suite A New Braunfels, TX 78130

10. IN OTHER NEWS… What is the RAP Program? The Recruit–A–Pal program starts on January 1st each year and continues to the start of TACVPR annual conference. For each new person you recruit to join the TACVPR or to attend the conference you earn points. You may also earn points for an approved poster presentation. (A new person is someone who was not a member over the past year nor attended the previous conference). The Point System: 1 point: Each new member recruited between Jan 1 & the conference 2 points: Each new person brought to conference 1 point: An approved poster presentation The AWARDS: 5 points: Earns a free membership for a year 7 points: Earns a free conference fee for the following year IMPORTANT: Make sure to have your name filled in the “RAP Program Referral” section as the referring person on the membership form and the conference registration form. Job Openings If you have a job you would like posted in the quarterly newsletter, please email Julie Hartman at julie.hartman@baylorhealth.edu. Is Your AACVPR Membership Up to Date? Don’t forget to renew AACVPR membership if yours has expired! Annual membership fees: $185 Member/Associate Member; $75 Student (AACVPR is currently offering a special rate for an 18-month membership for only $250) Go to www.aacvpr.org to join or renew your membership. Nutty Salmon Pocket 4 oz canned salmon or albacore tuna (in water) 2 Tbsp. unsalted chopped walnuts 2 Tbsp. diced green onions 2 Tbsp. diced red bell pepper 2 Tbsp. light mayonnaise ( or try using fat free, plain yogurt) 1 tsp Dijon mustard ½ cup romaine lettuce 1 med. Whole wheat pita pocket Mix salmon with nuts and veggies, add mayo and mustard. Place in pita pocket with lettuce. 465 calories, 19 g fat (2 g saturated fat, 14 g poly, 3 g mono), 30 g protein. To reduce sodium, look for low sodium fish.

11. Meet Your 2008-2009 TACVPR Board Dean Marilyn Julie Poppy Lorri Not Pictured: Erika Abmas Tresa Anderson Barbara Nita Twyla Danielle Marilyn Burwitz, RN President East Texas Medical Center Fairfield Julie Hartman, MS, FAACVPR Immediate Past President THE HEART HOSPITAL Baylor Plano Twyla Selvidge, MS Treasurer East Texas Medical Center Nita Pack, RRT Secretary Charlton Methodist Hospital Dean Diersing, MS President Elect University Medical Center Poppy Patterson, RN, MBA Past President Hillcrest Health System Getterman Wellness Center Lorri Lee, BS, RCEP Past President McKenna Memorial Hospital Barbara Flato, MSN, RN-BC, FAACVPR CHRISTUS Spohn Cardiac Rehab Danielle Strauss, BSN, RN-BC, BS Baylor Heart & Vascular Hospital Erika Abmas, RRT Baylor University Medical Center Tresa Anderson, RRT Shannon Medical Center If you are interested in serving on the TACVPR Board of Directors, please contact Julie Hartman at julie.hartman@baylorhealth.edu.