Daryl Buchanan | News & Views

The first cohort of AACVPR’s Leadership Development Academy (LEAD) graduated from the coaching program during the 40^th Annual Meeting in September. Fifty cardiac and pulmonary rehabilitation professionals sharpened their skills and knowledge over the course of the 8-month curriculum and will now apply what they have learned in their own workplaces.

A requirement of all participants was completion of a capstone project that developed solutions for a real-world problem. AACVPR’s News & Views followed three participants on their journey through the program.

Vanessa Pahlad-Singh, MS, CCRP, CRPR; Gregory Scharf, BS, CEP, CCRP; and Kasey Jepsen-Large, MA, CEP, CCRP, FCSCR, shared insights into their capstone projects and what they have gained from participating in LEAD.

Vanessa Pahlad-Singh, Program Director – Lead Clinical Exercise Physiologist at Montefiore Medical Center, completed a capstone project that addressed stubbornly low referral and enrollment rates in the cardiac and pulmonary rehabilitation programs at her workplace, despite the expansion of both services in 2024.

“My intervention focused on strengthening referral pipelines, reducing time from referral to enrollment, and optimizing scheduling and staffing. Drawing from the LEAD principles — particularly strategic planning, data-driven decision-making, and effective communication and marketing — I developed SMART goals and implemented several key initiatives,” said Pahlad-Singh when describing her capstone project.

Her work contributed to an increase in referrals from 1,169 in 2024 to 1,837 by mid-2025, surpassing an annual goal of 1,300. In addition, time from referral enrollment decreased from 88 days to 43, which represents a major improvement in process efficiency. Speaking on the larger benefits of her work, she adds, “This project has the potential to benefit the broader cardiopulmonary rehabilitation community by providing a scalable framework for improving referral communication, interdisciplinary collaboration, and patient access. Implementing streamlined referral processes and proactive outreach can be replicated in other health care systems facing similar barriers.”

Pahlad-Singh says participation in LEAD has bolstered her leadership and analytical skills. “This experience has enhanced my confidence as a leader and equipped me with the tools to drive sustainable improvements that will ultimately expand access to our cardiac and pulmonary rehabilitation services,” she attests.

Gregory Scharf, Cardiopulmonary Rehab System Manager at MyMichigan Health, set the goal of developing a new tool that can better predict staffing needs for health care systems. He says his capstone project addresses the growing importance of increased efficiency and productivity, while also overcoming the many variables that arise in the areas of operation for cardiac and pulmonary rehabilitation programs.

Scharf reports, “Unfortunately, limited and inconsistent staffing benchmarking tools, along with no standard patient-to-staff ratios, leave many programs in a potentially unsafe situation. Since there is no acceptable limit to the number of patients staff can treat, the efficiency always has the opportunity to improve.” He adds, “If we do not have guardrails in place that help us to validate the correlation to negative patient outcomes and patient staff safety, we may expect to operate too “lean” for us to consistently deliver comprehensive high-quality care.”

He concludes, “As health systems continue to find opportunities to improve ‘productivity,’ we need to be able to provide some clinical validation to prevent unrealistic efficiency targets; and if we do not have effective ways to measure productivity, we will continue to struggle to correlate to other program key drivers.”

Kasey Jepsen-Large, Supervisor of Cardiopulmonary Rehab at NorthBay Health, focused her capstone project on reducing the time from referral to enrollment and increasing patient volume through the creation of a group orientation process. “One of the main challenges was maximizing efficiency without compromising quality. To address this, I drafted a comprehensive intake questionnaire that patients completed before orientation and turned in at their first session,” she shares.

“The process evolved over time, as reflected in my mid-point report. A key improvement was learning to use the EMR more effectively — allowing the ITP to be prepped and signed before orientation, which made the very first encounter billable,” Jepsen-Large adds. “Minor adjustments followed, and we successfully began billing for group orientation intakes.”

She notes that input from LEAD course directors helped guide her approach. Early into the work, Jepsen-Large focused on process redesign; but feedback pushed her to place greater scrutiny on the root causes, set more impactful goals, and highlight key performance metrics. She states, “As a result, the project yielded success in the areas we targeted, but also revealed larger system issues that could not be resolved at the program level. The success of the project was not sustainable with the resources allocated to us.”

Jepsen-Large continues, “This revealed broader systemic gaps. It reaffirmed that the organization lacked structured resources for compliance, billing, budgeting, and program management. I could not fix these issues from the bottom up.”

Nevertheless, she did discover ways to help address the gaps and challenges her program faced. She explains, “My contribution was keeping quality data, advocating for resources, and implementing change within the scope I could control.”

During her time in LEAD, Jepsen-Large also transitioned to the role of Supervisor of Cardiopulmonary Rehab in a different health system. Despite this, she says she takes pride in what she was able to accomplish and provide her former colleagues. “Although they were less engaged while I was there, they are now exploring AACVPR membership and resources to support success,” she adds.

The timing of LEAD and her new job proved fortuitous for Jepsen-Large. She says, “In just the first weeks, I have applied many skills from the LEAD Academy: giving feedback, assisting with the 2026 budget, drafting a QI presentation with registry data, supporting program certification remediation, making connections with outside departments, and writing a new EP job description.”

Jepsen-Large believes LEAD has positively impacted her new career role and laid the groundwork for a bright future. “My project not only improved outcomes in my former program (temporarily) but also equipped me with tools I am now applying daily. My new manager and I are even exploring whether group orientations could improve our intake process here. I look forward to continuing this leadership journey and building programs that balance efficiency, quality, and teamwork,” she says.

You can find more coverage on the learning experiences of Vanessa, Gregory, and Kasey as they progressed through different phases of LEAD on the News & Views website. Type LEAD in the website’s search bar. More information about the 2025 LEAD cohort and the upcoming 2026 LEAD cohort can be found here.