title: Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.
abstract: 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.
authors.affiliation: St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;
authors.forename: Karen
authors.initials: K
authors.lastname: Daws
authors.affiliation: St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;
authors.forename: Amanda
authors.initials: A
authors.lastname: Punch
authors.affiliation: St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;
authors.forename: Michelle
authors.initials: M
authors.lastname: Winters
authors.affiliation: St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;
authors.forename: Sonia
authors.initials: S
authors.lastname: Posenelli
authors.affiliation: St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;
authors.forename: John
authors.initials: J
authors.lastname: Willis
authors.affiliation: St Vincent's Hospital, Melbourne, Vic., Australia. Email: ; ; ; ;
authors.forename: Andrew
authors.initials: A
authors.lastname: MacIsaac
authors.affiliation: St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Vic., Australia. Email: ;
authors.forename: Muhammad Aziz
authors.initials: MA
authors.lastname: Rahman
authors.affiliation: St Vincent's Centre for Nursing Research (SVCNR), Australian Catholic University, Melbourne, Vic., Australia. Email: ;
authors.forename: Linda
authors.initials: L
authors.lastname: Worrall-Carter
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D003299:Cooperative Behavior; D006740:Hospital Administrators; D006801:Humans; D008485:Medical Audit; D008962:Models, Theoretical; D009720:Nurse Clinicians; D009741:Nursing Staff, Hospital; D058996:Quality Improvement; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014739:Victoria