THE heart rate is rising at Swan Hill District Health ahead of tonight’s Victorian Public Healthcare Awards.
SHDH is a finalist in the partnership in healthcare category for I-HEART – a virtual regional heart failure service in partnership with Austin Health.
The awards celebrate and acknowledge the achievements of healthcare workers, public health services and health volunteers.
Heart failure is a life-threatening disease with frequent hospitalisations and low survival rates.
It is one of the most common causes of hospitalisation in the elderly.
The aim of this partnership between SHDH and Austin Health is to improve access to specialist heart failure services and facilitate care closer to home.
The partnership co-developed several clinical decision tools to support patients during their hospitalisation, and a virtual clinic after discharge for follow up with heart failure specialists.
SHDH executive director of medical services Associate Professor Rex Prabhu said the project had been running for two years.
“We collaborated with Austin Health’s cardiology department, as well as Deakin University, to look at translating the new heart failure guidelines into practice in regional and rural areas,” Prof Prabhu said.
“That involved patients diagnosed with new heart failure or existing heart failure, getting the same care that they would get in a metropolitan setting.”
Prof Prabhu said that involved “tweaking” because SHDH could use telehealth and technology to enable patients in Swan Hill to get access to a cardiologist on the first week of discharge.
“We know from our data, patients with heart failure and newly diagnosed heart failure tend to relapse back into hospitals because of their lack of knowledge of the medications and lack of knowledge of the disease,” he told The Guardian.
“Every time they are hospitalised, it increases their risk of death over time – not immediately – because the heart gets decompensated and that complication is better avoided.
“So the outcome of the program was to give these patients up to six months of tailored support to first make sure they they were well cognisant of their disease, understood how to manage their disease with medications and went to seek help, monitor their fluid intake, monitor their weight, their drugs and give them the wrap-around support of specialist care.”
Although it started as a pilot program, SHSH has continued to embed it into its practice with the hospital’s avoidance team.
“The support from Austin Health is ongoing with the nurse practitioner and cardiologist, giving us access to them through telehealth on a regular basis for patients who’ve come here to Swan Hill internally,” Pof Prabhu said.
“For the medical teams here, we developed a pathway, which means somebody that comes to the emergency department with heart failure, we make the treatment very streamlined like checklist of boxes, what they need, what investigations they need, what medications they need to be put on, what education is given on the bedside to improve that.
“Care outcomes, which means by implementing a streamlined pathway, you get faster discharge and better compliance from patient.
“We know that patients get educated on the pathway … there is an exercise undertaken that the staff need to make sure the patient understands the disease, gives them the resources they require.”
Prof Prabhu said for SHSH, it was about delivering care closer to home.
“So that patients don’t have to travel, and it’s getting that specialist access to care closer to home, rather than a day lost in travel, another non-productive day for the family,” he said.
“What we learned was that access of specialists was really difficult, so people actually didn’t bother accessing that care because it was too hard, too difficult, in the too-hard basket.
“So by introducing the program, we saw a lot of people get access to specialist care earlier.”
Prof Prabhu said the Mallee had a high rate of chronic disease, including heart failure and respiratory illness.
“I remember in my first year here in 2019, I was asked by the board why our heart failure presentation was higher than average in 2019,” he said.
“That allowed me to study a bit more on the population and demographics here.
“And then when this opportunity came up with I-HEART program to streamline and provide specialist care, I thought it was a win-win situation to improve that indicator.”
