Key result
Collaborative care model linked to ~105% increase in cardiac rehab referrals for Aboriginal ACS patients.
Why the study?
Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome, contributing to the life expectancy gap with non-Aboriginal Australians.
Does a collaborative care model involving an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse improve referral and attendance at cardiac rehabilitation for Aboriginal patients with acute coronary syndrome?
Does a collaborative care model involving an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse improve referral and attendance at cardiac rehabilitation for Aboriginal patients with acute coronary syndrome?
A collaborative care model involving an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse improved cardiac rehabilitation referral and attendance rates for Aboriginal patients with ACS.
Answers are grounded in this paper and cite their sources.
May support coordinated care models to boost rehabilitation uptake in Aboriginal ACS patients; leaves open effects on outcome disparities.
Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients' admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. WHAT IS KNOWN ABOUT THE TOPIC?: Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome. This may contribute to the life expectancy gap between Aboriginal and non-Aboriginal Australians. WHAT DOES THIS PAPER ADD?: This paper describes a model of care involving an Aboriginal Hospital Liaisons Officer and a specialist cardiac nurse working together to improve hospital care and attendance at cardiac rehabilitation services for Aboriginal Australians with acute coronary syndrome. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS?: The working together model of care could be implemented across mainstream health services where Aboriginal people attend for specialist care.
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Daws et al. (2014) studied Acute coronary syndrome (n=83). Working together model of care (Aboriginal Hospital Liaison Officer and specialist cardiac nurse) vs. Standard care (retrospective baseline) was evaluated on Referral to cardiac rehabilitation. Implementation of a working together model of care increased cardiac rehabilitation referrals for Aboriginal patients with acute coronary syndrome from 42% to 86%.
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