North Carolina Cardiopulmonary Rehabilitation Association www nccraonline org

North Carolina Cardiopulmonary Rehabilitation Association www. nccraonline. org PULMONARY REHABILITATION IN NORTH CAROLINA Connie Paladenech, RRT, RCP, FAARC

Pulmonary Rehabilitation • Comprehensive intervention • patient assessment • patient tailored therapies including but not limited to: • exercise training • education • behavior change • psychosocial support • Promote long-term adherence to healthenhancing behaviors Exercise Nutrition Psychosocial Oxygen Assessment Other Core Components Outcomes

American Thoracic Society Documents An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation Martijn A. Spruit, Sally J. Singh, Chris Garvey, Richard Zu. Wallack, Linda Nici, Carolyn Rochester, Kylie Hill, Anne E. Holland, Suzanne C. Lareau, William D. -C. Man, Fabio Pitta, Louise Sewell, Jonathan Raskin, Jean Bourbeau, Rebecca Crouch, Frits M. E. Franssen, Richard Casaburi, Jan H. Vercoulen, Ioannis Vogiatzis, Rik Gosselink, Enrico M. Clini, Tanja W. Effing, Franc¸ois Maltais, Job van der Palen, Thierry Troosters, Daisy J. A. Janssen, Eileen Collins, Judith Garcia-Aymerich, Dina Brooks, Bonnie F. Fahy, Milo A. Puhan, Martine Hoogendoorn, Rachel Garrod, Annemie M. W. J. Schols, Brian Carlin, Roberto Benzo, Paula Meek, Mike. Morgan, Maureen P. M. H. Rutten-van. Mo¨lken, Andrew L. Ries, Barry Make, Roger S. Goldstein, Claire A. Dowson, Jan L. Brozek, Claudio F. Donner, and Emiel F. M. Wouters; on behalf of the ATS/ERS Task Force on Pulmonary Rehabilitation THIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY (ATS) AND THE EUROPEAN RESPIRATORY SOCIETY (ERS) WAS APPROVED BY THE ATS BOARD OF DIRECTORS, JUNE 2013, AND BY THE ERS SCIENTIFIC AND EXECUTIVE COMMITTEES IN JANUARY 2013 AND FEBRUARY 2013, RESPECTIVELY Pulmonary rehabilitation has been clearly demonstrated to reduce dyspnea, increase exercise capacity, and improve quality of life in individuals with chronic obstructive pulmonary disease (COPD)

Pulmonary rehabilitation initiated shortly after a hospitalization for a COPD exacerbation is clinically effective, safe, and associated with a reduction in subsequent hospital admissions. Health behavior change is vital to optimization and maintenance of benefits from any intervention in chronic care, and pulmonary rehabilitation has taken a lead in implementing strategies to achieve this goal.

NCCRA North Carolina Cardiopulmonary Rehabilitation Association • NCCRA is the oldest state affiliate of the American Association for Cardiovascular and Pulmonary Rehabilitation • Founded in 1984 as a nonprofit organization dedicated to the mission of reducing disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management. • The multidisciplinary organization includes physicians, exercise physiologists, registered nurses, dietitians, respiratory therapists, physical therapists, mental health professionals, and vocational rehabilitation counselors.

NC Pulmonary Rehabilitation Programs … dedicated to improving the quality of life for our patients and their families

Coastal - 20 Sampson Regional Medical Center Pulmonary Rehab 607 Beaman Street Clinton, NC 28328 Sampson County (P) 910 -590 -8754 (F) 910 -596 -4242 Harnett Health System, Inc. Betsy Johnson Regional Hospital Pulmonary Rehab 800 Tilghman Drive Dunn, NC 28335 Harnett County (P) 910 -892 -1000 ext. 4627 (F) 910 -891 -6027 Vidant Medical Center Pulmonary Rehab 2470 Stantonsburg Road Greenville, NC 27835 (P) 252 -847 -2376 (F) 252 -847 -7337 Outpatient Carolina East Pulmonary Rehab 1001 Newman Road New Bern, NC 28560 Craven County (P) 252 -633 -8613 (F) 252 -634 -6235 Johnston Health Pulmonary Rehab 514 N. Bright Leaf Blvd. Smithfield, NC 27577 Johnston County (P) 919 -938 -7127 (F) 919 -989 -6420 Vidant Health-Chowan Pulmonary Rehab 211 Virginia Road Edenton, NC 27932 Chowan County (P) 252 -482 -6232 (F) 252 -482 -6662 Bladen County Hospital Pulmonary Rehab Hwy 701 South Elizabethtown, NC 28337 Bladen County (P) 910 -862 -5135 (F) 910 -862 -1239 Sentara Albemarle Medical Center Pulmonary Rehab 1144 North Road Street Elizabeth City, NC 27909 Pasquotank County (P) 252 -384 -4450 (F) 252 -384 -4237 Outer Banks Hospital Pulmonary Rehab 4800 S. Croatan Hwy Nags Head, NC 27959 Dare County (P) 252 -449 -5930 (F) 252 -449 -4528 Vidant Health Beaufort Pulmonary Rehab 1375 Cowell Farm Road Washington, NC 27889 Beaufort County (P) 252 -975 -4236 (F) 252 -948 -4837 Cape Fear Valley Health System Pulmonary Rehab 1638 Owen Drive Fayetteville, NC 28314 Cumberland County (P) 910 -615 -4469 (RT) 910 -615 -6577 (F) 910 -6155397 Wayne UNC Healthcare – Pulmonary Rehab 2700 Wayne Memorial Drive Goldsboro, NC 27533 Wayne County (P) 919 -731 -6304 (F) 919 -731 -6439 Nash Healthcare System Health. First Wellness Center 1051 Noell Lane Rocky Mount, NC 27804 Nash County (P) 252 -962 -3468 (F) 252 -962 -3485 Vidant Edgecombe Hospital CVPR 111 Hospital Drive Tarboro, NC (P) 252 -641 -8668 email: sherry. bridgers@vidanthealth. com New Hanover Health Network Heart Center Outpatient Services (Pulm Rehab) 1415 Physicians Drive Wilmington, NC 28401 -9000 New Hanover County (P) 910 -662 -9901 (F) 910 -662 -9946 Scotland Memorial Hospital, Inc. Pulmonary Rehab Program 500 Lauchwood Drive Laurinburg, NC 28352 Scotland County (P) 910 -291 -7409 (F) 910 -291 -7429 Southeastern Regional Medical Center 4895 Fayetteville Road Lumberton, NC 28359 Robertson County (P) 910 -738 -5403 (F) 910 -739 -4027 Carteret Health Care Pulmonary Rehab 3500 Arendell Street Morehead City, NC 28557 Carteret County (P) 252 -499 -6616 (F) 252 -808 -6908 Columbus Regional Healthcare System Pulmonary Rehab 500 Jefferson Street Whiteville, NC 28472 Columbus County (P) 910 -640 -4611 (F) 910 -641 -8242 Wilson Medical Center Pulmonary Rehabilitation 1705 Tarboro Street SW Wilson, NC 27893 Wilson County (P) 252 -399 -8448 (F) 252 -399 -7303

Piedmont - 27 Carolinas Healthcare System (Atrium) Stanly 301 Yadkin Street Albemarle, NC 28001 Stanly County Pulmonary Rehab Program held at local YMCA (P) 980 -323 -4193 or 980 -323 -4586 (F) 704 -982 -8449 Randolph Health Cardiopulmonary Rehabilitation 364 White Oak Street Asheboro, NC 27205 Randolph County (P) 336 -633 -7752 (F) 336 -633 -7750 Carolinas Healthcare System (Atrium) Pulmonary Rehab 4525 Cameron Valley Parkway Charlotte, NC 28211 Mecklenburg County (P) 704 -512 -2401 (F) 704 -512 -2474 Alamance Regional Medical Center Pulmonary Rehab Program 1240 Huffman Mill Road Burlington, NC 27215 Alamance County (P) 336 -538 -8120 (F) 336 -538 -7529 Carolinas Healthcare System (Atrium) – North East 1090 NE Gateway Ct NE Suite 102 Concord, NC 28025 Cabarrus County (P) 704 -403 -9250 (F) 704 -403 -9251 Carolinas Medical Center (Atrium) – Pineville Pulmonary Rehab 10650 Park Road Suite 480 Charlotte, NC 28210 Mecklenburg County (P) 704 -667 -6010 (F) 704 -667 -6011 Duke Cardiopulmonary Rehabilitation at Crossdaile 1821 Hillandale Road Durham, NC 27705 Orange County (P) 919 -660 -6673 (F) 919 -681 -4517 Rowan Regional Medical Center Pulmonary Rehab Program 612 Mocksville Avenue Salisbury, NC 28144 Rowan County (P) 704 -210 -5412 (F) 704 -210 -5428 Thomasville Medical Center Pulmonary Rehab 207 Old Lexington Road Thomasville, NC 27360 Davidson County (P) 336 -476 -2539 (F) 336 -277 -9328 Maria Parham Hospital, Inc. Breathwise Pulmonary Rehab Program 566 Ruin Creek Road Henderson, NC 27536 Vance County (P) 252 -436 -1570 (F) 252 -436 -1472 High Point Regional Health System Pulmonary Rehab Program 601 North Elm Street High Point, NC 27261 Guilford County (P) 336 -878 -6914 (F) 336 -878 -6026 Novant Health Huntersville Wellness Center 10030 Gilead Road, Suite 380 Huntersville, NC 28078 Mecklenburg County (P) 704 -316 -5655 (F) 336 -316 -5522 Novant Health Matthews Wellness Center 1500 Matthews Township Parkway Suite 150 Matthews, NC 28227 Mecklenburg County (P) 704 -316 -3990 (F) 704 -384 -6664 Rex Hospital Pulmonary Rehabilitation 4420 Lake Boone Trail Raleigh, NC 27607 Wake County (P) 919 -784 -3756 (F) 919 -784 -3442 Presbyterian Medical Center Novant Health Heart and Vascular Institute 125 Baldwin Avenue Suite 200 Charlotte, NC 28204 Mecklenburg County (P) 704 -384 -5031 (F) 704 -384 -8895 Moses H. Cone Memorial Hospital Pulmonary Rehab 1200 North Elm Street Greensboro, NC 27401 Guilford County (P) 336 -832 -7700 (F) 336 -832 -8572 Moses H. Cone Memorial Hospital Annie Penn Hospital Pulmonary Rehab 618 S. Main Street Reidsville, NC 27320 Rockingham County (P) 336 -951 -4837 (F) 336 -951 -4558 First. Health of the Carolinas Pulmonary Rehab 925 Long Drive Rockingham, NC 28372 Richmond County (P) 910 -417 -3351 (F) 910 -417 -4359 Duke Specialty Rehab Services Midtown 5920 Sandy Forks Road Suite 200 Raleigh, NC 27609 Wake County (P) 919 -954 -3174 (F) 919 -954 -3177 Central Carolina Hospital Pulmonary Rehab Program 235 Fields Drive Sanford, NC 27330 Lee County (P) 919 -774 -2384 (F) 919 -774 -2397 Wake Forest Baptist Health – Winston Campus Pulmonary Rehabilitation 1 Medical Center Blvd Winston-Salem, NC 27157 Forsyth County (P) 336 -713 -8855 (F) 336 -713 -8856 Novant Forsyth Medical Center Pulmonary Rehab 3333 Silas Creek Parkway Winston-Salem, NC 27103 Forsyth County (P) 336 -718 -5748 (F) 336 -718 -5721 Northern Hospital of Surry County 830 Rockford Street Mount Airy, NC Surry County (P) 336 -783 -8448 (F) 336 -786 -3771 Wake Forest Baptist Health Lexington Medical Center 250 Hospital Drive Lexington, NC 27292 Davidson County (P) 336 -238 -4864 (F) 336 -238 -4810 Chatham Hospital Pulmonaary Rehab 163 Medical Park Drive Suite 120 Siler City, NC 27344 Chatham County (P) 919 -799 -4650 (F) 919 -799 -4651 First. Health of the Carolinas, Inc. – Moore Regional Pulmonary Rehab 205 Davis Road Southern Pines, NC 28387 Moore County (P) 910 -692 -9103 (F) 910 -692 -2103 First. Health of the Carolinas, Inc. – Troy Montgomery Memorial Hospital 520 Allen Street Troy, NC 28371 Montgomery County (P) 910 -571 -5277 (F) 910 -572 -2478

Mountain - 23 Mission Hospital Pulmonary Rehab 5 Vanderbilt Park Drive Suite 301 Asheville, NC 28801 Buncombe County (P) 828 -213 -7977 (F) 828 -213 -7178 Appalachian Regional Medical Center Pulmonary Rehab 232 Boone Heights Drive Boone, NC 28607 Watauga County (P) 828 -268 -9492 (F) 828 -268 -9055 Hugh Chatham Memorial Hospital Pulmonary Rehab 180 Parkwood Drive Elkin, NC 28621 Surry County (P) 336 -527 -7523 (F) 336 -527 -7537 Angel Medical Center Cardiac and Pulmonary Rehab 120 Riverview St Suite 100 Franklin, NC 28734 Macon County (P) 828 -349 -8290 (F) 828 -349 -8291 Gaston Memorial Hospital Pulmonary Rehab 2525 Court Drive Gastonia, NC 28054 Gaston County (P) 704 -671 -7932 (F) 704 -671 -7940 Carolinas Healthcare Systems (Atrium) Cleveland Pulmonary Rehab 201 East Grover Street Shelby, NC 28150 Cleveland County (P) 980 -487 -3659 (F) 980 -487 -3085 Blue Ridge Regional Hospital Pulmonary Rehab 125 Hospital Drive Spruce Pine, NC 28777 Mitchell County (P) 828 -765 -7901 (F) 828 -766 -3065 Harris Regional Hospital Pulmonary Rehab 68 Hospital Road Sylvia, NC 28779 Jackson County (P) 828 -586 -7645 (F) 828 -586 -7646 Iredell Memorial Hospital Pulmonary Rehab 557 Brookdale Drive Statesville, NC 28677 Iredell County (P) 704 -878 -4558 (F) 704 -878 -4951 Valdese General Hospital Pulmonary Rehab 720 Malcolm Boulevard Valdese, NC 28690 Burke County (P) 828 -879 -7528 (F) 828 -580 -7739 Cannon Memorial Hospital Pulmonary Rehab 434 Hospital Drive Linville, NC 28646 Avery County (P) 828 -737 -7069 (F) 828 -737 -7509 Alleghany Health Pulmonary Rehab 233 Doctors Street Sparta, NC 28675 Alleghany County (P) 336 -372 -3244 (F) 336 -372 -2089 Catawba Valley Medical Center Pulmonary Rehab 810 Fairgrove Church Road SE Hickory, NC 28630 Catawba County (P) 828 -326 -2131 (F) 828 -732 -7288 The Mc. Dowell Hospital Pulmonary Rehab 1633 Sugar Hill Road Marion, NC 28752 Mc. Dowell County (P) 828 -659 -5401 (F) 828 -652 -8365 Ashe Memorial Hospital Pulmonary Rehab 200 Hospital Avenue Jefferson, NC 28640 Ashe County (P) 336 -846 -0820 ext. 3 (F) 336 -846 -0780 Grace Anne Dorney Pulmonary Rehabilitation Program 1345 Hwy 268 Lenoir, NC 28645 Caldwell County (P) 828 -754 -6850 ext. 218 (F) 828 -757 -3214 Rutherford Regional Health System Pulmonary Rehab 288 South Ridgecrest Road Rutherfordton, NC 28139 (P) 828 -286 -5053 (F) 828 -286 -5060 Frye Regional Medical Center-Tenet Pulmonary Rehab 420 North Center Street Hickory, NC 28601 Catawba County (P) 828 -315 -3563 (F) 828 -326 -9281 Murphy Medical Pulmonary Rehab 3990 East US HWY 64 Alternate Murphy, NC 28906 Cherokee County (P) 828 -835 -7656 or 828 -835 -7615 (F) 828 -835 -7614 Wake Forest Baptist Health - Wilkes Medical Center 1370 West D Street North Wilkesboro, NC 28659 Wilkes County (P) 336 -651 -8106 (F) Transylvania Community Hospital Pulmonary Rehab 260 Hospital Drive Brevard, NC 28712 Transylvania County (P) 828 -883 -5322 (F) 828 -883 -5180 Park Ridge Health 50 Hospital Drive Suite 3 A Hendersonville, NC 28792 Henderson County (P) 828 -681 -6809 or 828 -681 -2713 (F) 828 -650 -6811 Mangum Memorial Hospital Pulmonary Rehab 520 Allen Street Troy, NC 28371 Montgomery County (P) 910 -571 -5277 (F) 910 -572 -2478

NCCRA Resources • Annual meeting • Regional Meetings • Pulmonary Discipline Committee • Consultation • Education • Sharing of best practices • Legislative and Reimbursement Advocacy

NCCRA Pulmonary Discipline Meeting • Best Practices • COPD Navigators • Fast Track • Historically Low Participation Rate (<20% of eligible patients) • Identification of Barriers • Transportation • Parking • Payment/Co-payments • Low self-efficacy • Fear of infection • Coverage for maintenance programs

AACVPR Program Certification The AACVPR Cardiac and Pulmonary Rehabilitation Program Certification process is the only peer-review accreditation process designed to review individual facilities for adherence to standards and guidelines developed and published by AACVPR and other professional societies.

AACVPR Outpatient Pulmonary Rehabilitation Data Registry • Patient outcomes and program performance tracking • Provides national outcomes data for benchmarking • Instant access to program and patient data reports • Benchmark individual results against national averages

PR Outcomes Resource Guide Also known as the Pulmonary Outcome Toolkit Updated February 2017 The PR resource guide was developed by Chris Garvey, FNP, MSN, MPA, MAACVPR, Gerene Bauldoff, RN, Ph. D, FAACVPR, Eileen Collins, Ph. D, RN, FAACVPR, Dor. Anne Donesky, RN, Ph. D, Kent Eichenauer, Psy. D, FAACVPR, Connie Paladenech, RRT, RCP, Charlotte Teneback, MD, FAAN, Maria Buckley, Ph. D, FAACVPR and colleagues to provide AACVPR members with information regarding the available, evidence-based PR outcome measures and resources. Expert opinion and input was sought from volunteers of AACVPR, ATS, ACCP, APTA and AARC. The intent of the tool kit is to offer resources for program quality improvement, AACVPR certification/recertification, AACVPR registry use and ultimately National Quality Forum Performance Measures for PR.

Non Traditional Models Lift Pulmonary Rehab is a homebased, comprehensive pulmonary rehabilitation program Cost is $9. 99/month paid monthly www. liftpulmonaryrehab. com/ COPD Self-management program Free http: //www. livingwellwithcopd. com/en/about. html • • • Alternative scheduling Telemedicine Home Care

Thank You cpaladen@wakehealth. edu www. nccraonline. org