Health Sciences

'Working together model’ to improve attendance at cardiac rehabilitation by Aboriginal patients

SVCNR Team Chairmans Award

(From L-R) Mr Paul Robertson AM (St Vincent’s Health Australia Board Director), Ms Karen Daws, Ms Amanda Punch and Professor Linda Worrall-Carter.

Researchers from St Vincent’s Centre for Nursing Research (SVCNR) at ACU received the St Vincent’s Hospital Chairman’s Award for Excellence for their project ‘Implementing a working together model for Aboriginal patients with acute coronary syndrome’. This included a model of close collaboration between an Aboriginal Hospital Liaison Officer (AHLO) and a specialist cardiac care nurse to provide coordinated care of Aboriginal patients with the aim of increasing typically low rates of attendance at cardiac rehabilitation.

The study was supported by and conducted at St Vincent’s Hospital Melbourne. It had three main components. Firstly, the development of the working together model which recognised that two-way learning would occur between the AHLO and the cardiac nurse – both contributing knowledge and learning from one another. Secondly, analyses of database to explore cardiac rehabilitation attendance among Aboriginal patients. The retrospective analysis showed that, prior to the implementation of the working together model, 42% of Aboriginal patients with acute coronary syndrome (ACS) received a referral to cardiac rehabilitation but none actually attended. Thirdly, fifteen Aboriginal patients with ACS were recruited to a prospective study and received co-ordinated care according to the working together model. Of these, thirteen (87%) were referred either for cardiac rehabilitation or heart failure rehabilitation programs, more than twice as many as before the working together model was implemented. Even more importantly, close to two-thirds (61%) of those referred did actually attend cardiac rehabilitation.

The AHLO and cardiac nurse model of working together engenders a culturally safe environment, which in turn enables and facilitates the delivery of optimum specialist clinician care and leads to greater patient engagement with follow-up rehabilitation. This is considered the most significant achievement of the project, since attendance at cardiac rehabilitation has been demonstrated to reduce the risk of subsequent cardiac mortality. Furthermore, effective working relationships have been established and nurtured with other health professionals in the hospital; and strong collaborative foundations have been laid within the cardiac ward at St Vincent’s Hospital. The working together model offers further potential for other hospitals and patient groups.

Karen Daws was the specialist cardiac nurse and Mandy Punch worked as an AHLO for this project. If you would like to know more about this project or other research conducted by SVCNR, please look at our website http://www.svcnr.edu.au/ or contact Professor Linda Worrall-Carter via email to linda.worrall-carter@acu.edu.au.