Toronto Heart Attack Collaborative: an administrative model that facilitated a successful city-wide integration initiative.

This article provides a description of the administrative model that enabled a city-wide integration effort between Greater Toronto Area hospitals and Toronto Emergency Medical Services in the care of patients within the city of Toronto with ST elevation myocardial infarction (STEMI). This administrative structure, known as the Toronto Heart Attack Collaborative (THAC), enabled universal 24/7 access to primary percutaneous coronary intervention within Toronto, improving patient efficacy and outcomes. The lessons and administrative enablers from this experience may be useful for regions that are embarking on multi-centre integration efforts.

How do hospital administrators perceive cardiac rehabilitation in a publicly-funded health care system?

Background: Patient and provider-related factors affecting access to cardiac rehabilitation (CR) have been extensively studied, but health-system administration factors have not. The objectives of this study were to investigate hospital administrators' (HA) awareness and knowledge of cardiac rehabilitation (CR), perceptions regarding resources for and benefit of CR, and attitudes toward and implementation of inpatient transition planning for outpatient CR.

Methods: A cross-sectional and observational design was used.

The two-minute walk test as a measure of functional capacity in cardiac surgery patients.

Objective: To examine construct validity and sensitivity of the two-minute walk test (2MWT) in cardiac surgery patients.

Design: Measurements were made in patients preoperatively, during the postoperative in-hospital stay, and 6 to 8 weeks after discharge from hospital.

Setting: Ambulatory and hospitalized care.

Discharge criteria from perioperative physical therapy.

Objectives: To develop valid and reliable hospital discharge criteria and a scoring system that would be used to assess when a patient should be discharged from perioperative physical therapy (PT) care.

Design: We developed the postoperative physiotherapy discharge scoring tool (POP-DST), a tool composed of objective criteria and a scoring system that would be used to determine when a patient should be discharged from perioperative PT. It is a composite score of the following five subcategories: mobility; breath sounds; secretion clearance; oxygen saturation; and respiratory rate.