The clinic keeps the heart beating - Golden Plains Times

HEART FAILURE is one of the top conditions that result in the most visits to the emergency department, including at Ballarat Health Services.

BHS cardiac nurse practitioner Linda Macaulay said it was a “huge burden” in more ways than one.

“Besides the burden of disease and people’s lack of quality of life, heart failure is also a huge burden on our health system,” he said.

Aiming to reduce the readmission rate of heart failure patients in hospital, with evidence-based care, personalized care, and targeted treatment, BHS has its own heart failure clinic.

“Re-admission rates are enormous, and not only for patients who are re-admitted with heart failure, but with various co-morbidities that impair the heart, such as diabetes, cognitive impairment, or respiratory disease,” Macaulay said.

“Our clinic is running to provide consistent care for every patient at all times, because our patients we see are our friends, family members, relatives, work and schoolmates.

“We care for people in our community, so we want to give them the best possible care so they can live their best lives, rather than be burdened with co-morbidities, and die early.”

Ms Macaulay said people with heart failure are referred directly to clinics, but her team is also working to identify patients who come to the hospital with other problems, but who may also have heart failure.

“We work hard with pharmacists and doctors, and have several IT tools to help identify them, so every heart failure patient can be identified at any time.

“They get a specific package of evidence-based care, such as targeted education to help them understand their condition, understand their treatment, and the signs that they are sick,” he said.

Once a heart failure patient leaves the hospital, the clinic has a role in supporting them in the long term.

Nurses call regularly, clients get a medical review within seven days of discharge, they can call the helpline for timely advice, access health independence programs, or cardiac rehabilitation, and home care from the BHS@Home program.

“People in the Grampians area don’t have good access to GPs, so how they are sent home, and what their follow-up is, is very important,” Macaulay said.

The role of Adam Livori, a cardiology pharmacist, is to make sure these people have evidence-based medicine, which “saves lives, reduces death and disability,” and if they need help, they can get in touch.

“We know when patients have a proper pharmacological review with a pharmacist, they are much more likely to take their medication consistently because they really understand what they’re doing,” Macaulay said.

“Continuity of care between practitioners is key in Ballarat. Connecting community programmes, we can reduce gaps in care.”

Barry Nixon has been a heart patient since February 2006 and says navigating heart failure for the first time can be very “confusing.”

“Heart failure clinics, and other patients through peer support, are very helpful to new patients and empower them through discussion,” he said.

“It’s great to share the journey with other people. You gain a lot of confidence, and your fear lessens.

“This is also the first time there is a dedicated clinic helpline. New patients have a lot of questions and fears, and that number is a valuable and useful resource.”

Mr Livori said the internal partnership between the BHS cardiology department, heart failure service and pharmacy was “innovative.”

“You don’t see this kind of collaboration in the big metro health services. Ballarat is a true challenger,” he said.

The BHS heart failure clinic is part of a wider Heart Failure Collaboration with 19 other healthcare services across Victoria that aims to improve patient safety.

“The strong thing about all of this is that everyone is aware of their own successes, and learns from them,” said Livori.

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