Victorian Cardiac Clinical Network (VCCN) Activities

Building Capability in Regional Services

In September 2011a number of cardiac clinical facilitators  were appointed at regional health services to enhance cardiac service capability across the state. The role of the facilitator is to support cardiac service provision and coordination. The initiatives undertaken at each service are tailored to local needs with a focus on reducing variation in care .and improving coordination.

Facilitators are located at: Bendigo Health Care group, Ballarat Health Service, Goulburn Valley Health, Shepparton, Albury Wodonga Health, Latrobe regional Hospital and South West Healthcare, Warrnambool.

Introduction of Point-of-Care Tests for Serum Troponin to Rural Emergency Departments/Emergency Stabilisation Units.

This initiative aims to streamline the early management of patients presenting with acute chest pain utilising bedside point-of-care troponin testing.

The initiative is being piloted in 7 health services in the Barwon South West region and encompasses the introduction of guidelines-based strategies to assist in risk stratification and early management of patients presenting with chest pain or suspected acute coronary syndrome.. It is envisaged that, if successful, point-of-care testing of troponin will be extended to other rural emergency departments across the state.

Participating services are South west healthcare, Warrnambool, Heywood Rural health, Terang and Mortlake Heath Service, Portland District Health,

“Snapshot” of Acute Coronary Syndromes

This project is an Australasian initiative to explore and evaluate the incidence, in-hospital patient care and outcomes of patients presenting with an acute coronary syndrome. Structured as a prospective registry of patients admitted to hospital with a suspected acute coronary syndrome during a 2-week period in May 2012. All states in Australia will be participating and this project is supported by the Australian Commission on Safety and Quality in Healthcare, Cardiac Society of Australia and New Zealand and the National Heart Foundation.

Victorian Directory Cardiac Rehabilitation Services

A directory of cardiac rehabilitation services in Victoria has now been completed. The directory comprises a comprehensive listing and location of cardiac rehabilitation services across the state, including dedicated Aboriginal Community Services. The directory can be accessed on the VCCN website. Victorian Cardiac Rehabilitation Directory

Audit of Pre-Hospital Notification of ST Elevation Myocardial Infarction (STEMI) Patients to Emergency Departments

This clinical audit records and tracks the outcomes of patients presenting with acute ST elevation myocardial infarction (STEMI), who have the details of their cardiac condition, including a 12 lead ECG, transmitted to their receiving hospital before the patient  arrives. This strategy of “pre-hospital notification” allows the hospital’s emergency department to activate emergency treatment as early as possible, thus ensuring rapid delivery of emergency and potentially life saving treatment with minimum delay. This strategy of pre-notification was pioneered by MonashHeart and Ambulance Victoria (known as the MONAMI project)

This is a been conducted by a collaboration between VCCN, Acute Coronary Syndromes (ACS) sub-committee of the (Department of Health), the Victorian Ambulance Service and all public hospitals in Victoria (Alfred, Austin, Box Hill, Frankston, Geelong, Monash Medical Centre, Northern, Royal Melbourne, St Vincent’s and Western) and one private hospital (Epworth, Richmond) who are participating in the pre-notification of a heart attack (STEMI) by Ambulance Victoria.

The results will be presented at the annual scientific sessions of the Cardiac Society of Australia and New Zealand in Brisbane in August 2012.

Interactive Electronic “Heat” Map for Coronary Heart Disease and Heart Failure Incidence

The VCCN, in partnership with the Heart Foundation, Victoria, is assisting in the development of an interactive electronic map, outlining the regional incidence of coronary heart disease and heart failure incidences and risk factor prevalence in Victoria. Planned completion of this project is in early 2012.

Minimum Standards for Delivery of Cardiac Rehabilitation Services

The VCCN through its Cardiac Rehabilitation Subcommittee, is developing a set of minimum standards, for Victoria, to assist Health Services and health professionals in establishing and maintaining cardiac rehabilitation programs. There are currently no universally accepted guidelines within Victoria and there is wide variation in the type, scope and quality of services currently being supplied. A set of minimum standards will provide a framework for the design of future programs and allow existing services to benchmark their programs to guide improvement in service quality and delivery.

Standardised Cardiac Rehabilitation Referral Form

In conjunction with the Victorian Cardiac Rehabilitation Association (VCRA), the VCCN has supported the development of a standardised form for cardiac rehabilitation referrals. The form is intended to facilitate the efficient and effective communication of patients’ clinical history and details to the rehabilitation service.

The standardised cardiac rehabilitation referral form has now been completed and is available on the VCCN website at the following link:
http://health.vic.gov.au/clinicalnetworks/downloads/cardiac/cardiac_rehabiliation_referral_form.doc

Strengthening Cardiac Care for Aboriginal and Torres Strait Islanders with Acute Coronary Syndromes

A partnership model of care is being developed involving St Vincent’s Hospital, Melbourne Cardiology, the hospital’s Aboriginal Health Team and Aboriginal Community Controlled Health Organisations (ACCHO’s). This 12-month project that began in late 2011, followed the appointment of a cardiac rehabilitation nurse and cardiac Aboriginal Liaison Officer at St Vincent’s Hospital. The aim is to foster better cardiac health care delivery to Aboriginals and Torres Strait Islanders and reduce gaps in treatment and improve health outcomes in this patient group.

Victorian Cardiac Outcomes Registry (VCOR)

The Department of Health is supporting the development and implementation of a cooperative cardiac registry with the aim to support quality improvement. This registry will focus on percutaneous coronary interventions (PCI) in its initial phase, with the hope that it can expand to other important areas in cardiology including reperfusion therapies for ST elevation myocardial infarction, implantable devices and anticoagulation therapy for atrial fibrillation

It is anticipated that the scope of the PCI component will also included referrals to cardiac rehabilitation and discharge medications.

This registry is being coordinated by Monash University School of Public Health & Preventive Medicine and has the support of the Cardiac Society of Australia and New Zealand.