Sliding doors: The journey of one cardiac rehabilitation patient through system roadblocks and delays compared to ideal care. How a specialist allied health team in rural Victoria facilitated system change and life saving patient outcomes.
Fiona Miller1, Roslyn Bloomer2, Julie Blake3, Leeah Cooper41Kiewa Valley Sports & Spinal Physiotherapy, Mt Beauty, VIC, Australia2Alpine Health, Mt Beauty, VIC, Australia3Ovens Valley Physio & Pilates, Bright, VIC, Australia4Equilibre Health, Wandiligong, VIC, Australia
Abstract
The PACE (Pulmonary and Cardiac Exercise and Education) Team is a multidisciplinary team delivering cardiopulmonary rehabilitation across three sites in the Alpine Shire in northeast Victoria. The team consists of a nurse coordinator (3 days per week) along with two physiotherapists and one exercise physiologist who each work one day per week. PACE is a partnership between the public sector (Alpine Health who employs the Nurse Coordinator) and the private sector (three private allied health services based in three different towns).
We follow the journey of one PACE patient who experienced an emergency event during the program and will illustrate their journey through the healthcare system at various points compared with ‘ideal care’. Using this case study we will show the value of a highly skilled multidisciplinary team in creating systemic improvements and enhancing communication pathways which create lasting benefits extending to a broad cohort of patients in the future.
So what key factors do we believe sit behind our capacity to make a difference at both patient and system level?
PACE has dedicated permanent staff not rotating team members, retaining experience and skills and consolidating relationships.
Holistic assessment and intervention framework.
A high degree of practitioner independence and self determination means we can allocate time flexibly based on patient needs and acuity.
Team members value and have confidence in each other’s assessment skills and professional opinion and work effectively together.
Management which understands and fully supports and endorses the PACE approach.
Biography
Biographies to come.