The care and rehabilitation of cardiac patients and their families: a report of a study tour of the USA

I visited four centres of clinical cardiac care and rehabilitation to examine, compare and discuss the development of nursing research and practice and the application of this knowledge to patients and their families after a heart attack or cardiac surgery. The key areas examined were the organisation of services, specific interventions, and outcome and evaluation criteria. American care and rehabilitation services generally appear to be more directed towards the family and involve a wide range of health professionals from different discipline. The systems, when compared to their British counterparts, are more structured in terms of organisation, coordination and evaluation, and are more geared towards cost-containment, effectiveness and efficiency. However, although British systems are increasingly emulating the American ones, they are in many respects more innovative, flexible and tailored to individual needs.