Key activities for Better Cardiac Care in NSW

NSW is progressing a range of activities for each of the 5 priority areas:

Priority 1: Early cardiovascular risk assessment and management

• NSW is conducting a data linkage study in collaboration with the ACT and QLD to better understand the patient health journey by examining primary and secondary preventive care activities, access to services and referral patterns for patients with cardiac conditions and other chronic diseases. This study will link Medicare benefits schedule and national death index data with state based data on hospital admissions and emergency department presentations.
• A pilot project is planned to support care for chronic disease patients in Aboriginal Community Controlled Health Services by enhancing clinical quality improvement activities.
• NSW is developing a number of Aboriginal-specific smoking cessation programs including a quit smoking app to bolster existing strategies including the ATRAC Framework, Aboriginal Quitline and Quit for New Life.

Priority 2: Timely diagnosis of heart disease and heart failure

• Development of educational videos to improve health literacy for Aboriginal people on understanding the signs and symptoms of heart disease, the importance calling an ambulance if experiencing chest pain, and the care pathways into and out of hospital.

Priority 3: Guideline based therapy for acute coronary syndrome (ACS)

• NSW is developing a state-wide electronic chest pain pathway in the electronic Medical Record (eMR) to better equip services to deliver high quality care.
• NSW is working on better understanding access to cardiac procedures. This is important to ensure all patient who have a heart attack in NSW have timely access to the best care possible.

Priority 4: Optimisation of health status and provision of ongoing preventative care

• Aboriginal people have higher rates of cardiovascular disease than non-Indigenous Australians but participate in cardiac rehabilitation at a much lower rate. NSW is developing a set of tools for patients and health care providers to help improve the uptake of cardiac rehabilitation.
• The data linkage study described in priority 1 will help identify any gaps in post-discharge care and inform improvement in the delivery of services.

Priority 5: Strengthen the diagnosis, notification and follow up of rheumatic heart disease (RHD)

• Acute rheumatic fever, also known as rheumatic fever or ARF, is caused by bacteria called group A streptococcus, commonly called the strep germ. The strep germ causes an infection that normally presents as a sore throat. It can also affect joints, the heart, skin and brain - this reaction is called rheumatic fever. While rheumatic fever leaves no lasting damage to the brain, joints or skin, it can cause permanent damage to the heart. This is known as rheumatic heart disease (RHD). ARF and RHD can cause irreversible damage to the valves of the heart and have a significant impact on morbidity and mortality. Both ARF and RHD disproportionately affect Aboriginal people in Australia.
• To assist in improving care for patients, NSW has made ARF and RHD in people <35 years of age notifi​able. An electronic register is being developed to help manage patient care and support long term models of care coordination for patients. NSW Health is developing tools and resources for communities, patients and health care providers to support these RHD activities.