Preparation of a comprehensive customized dossier

It's indispensable to prepare a comprehensive customized dossier on the advantages and benefits of establishing a pulmonary rehabilitation program in your institution or in your region.

Identify the needs and profile of your clientele

Determine the profile of your potential clientele. For example, in your region, how many people have COPD? How old are they? etc. To this end, get hold of statistics on the number of COPD-related hospitalizations from the regional authorities (agency, CSSS or your institution).
Take inventory of the pulmonary rehabilitation programs that already exist in your region or Province and try to make use of their experience.
From the statistics you acquire, determine who your target patients should be based upon their condition (moderate-severe COPD, pulmonary fibrosis, etc.).
Find out the priorities that your public health agency has established, so as to align your objectives with those in your region. For example, if a priority involves reducing the COPD-related morbidity rate, establish your goals accordingly.

Determine the program's overall objectives

Identify your goals for the program. For example, it could by the benefits reaped by the patient and by the health care system.
Ideally, incorporate a temporal dimension and set realistic expectations.

Determine specific goals

Determine a target number of patients to register in the program, for example, during the first year and then the second year. More precisely, to see 50 patients in groups of four during the first year.
Select the benefits that you seek to have the patients enjoy as a result of the program (See: The goals of the program section) or the impact it should have upon the health care system.
Don't forget to choose measurable goals so that you can document the results of your program. To this end, determine the clinical benchmarks (e.g.: decrease in the number of exacerbations experienced by the patient over the course of one year) and the administrative benchmarks (e.g.: decrease in the number of hospitalizations or visits to the emergency room due to COPD).
Give yourself the time to properly set up the program and achieve results, for example, over a five-year period.

Appoint a medical director

This person must be involved in the process right from the beginning. This key person must necessarily be:

A pneumologist, physician internist or general practitioner.
Functions: to be available in a timely manner to meet with the pertinent health and social services agency or CSSS in order to demonstrate the importance and merit of establishing a pulmonary rehabilitation program in the region; to act as the program's spokesperson.

Learn all you can about the process to be engaged, locally, with an eye towards advocating a pulmonary rehabilitation program in your community

Identify who the key decision-makers are. For example, is it the Director General, the Program Manager, the Head of Rehabilitation, etc.?
Consider setting up a rehabilitation advisory committee that could help position pulmonary rehabilitation as a priority in your institution or in your community.
Ensure that your goals are aligned with those of the decision-makers.

Establish a strategic plan

Link up with other existing rehabilitation programs (e.g.: cardiac rehabilitation) or propose an eventual alliance with them.
Consider approaching certain community organizations in your community to solicit their help and support (e.g. offices, transportation assistance, funding, etc.)
Determine the cost of operations and the funding formula.
Determine the kind of pulmonary rehabilitation program that should be established based upon the goals that exist in your community, but also based upon the reality and particularities that characterize your region (access to facilities, public transit, etc.)

Plan a pulmonary rehabilitation program pilot project

Don't neglect to establish measurable and realistic goals, taking into account how the existing decision-makers view the situation.