1. Engaging community in care

2. Background CA Regional Cardiac Strategy -2010 to 2015 development and delivery of integrated cardiac services in Central Australia. optimise the care of patients with or at risk of cardiovascular disease within Central Australia.

3. Background The major gaps were identified as relating to service provision in the Barkly region, local diagnostic services capacity, cardiac rehabilitation, local cardiology presence and specialist cardiac nursing personnel.

4. Way forward 27 recommendations ASH establish a coordinated Cardiac Service across Central Australia That ASH establish a Cardiac Coordinator position.

5. Way forward A full suite of non-invasive diagnostic facilities are available at ASH Establish, supports, and routinely conducts Holter monitoring and EST lists at Tennant Creek Establishes a coordinated cardiac specialist outreach.

6. Way forward That ASH ensures that all available clinical and diagnostic results, from inpatient, outpatient and outreach cardiology services are available to clinicians involved in the care of cardiac patients through existing or newly established clinical information systems.

7. Case Study JL (07/08/90) ARF 2001 – Mild (3) April 2006 – admitted to ICU 2010 – 1 st baby

8. Case Study 2012 – pregnant second baby. August 12 – 26 weeks gestation transferred to FMC to assess need for balloon valvuloplasty Remains in Adelaide for delivery October 12 – delivers at 35 weeks

9. Case Study June 2013 – admitted with rapid AF Class 11 to 111 heart failure symptoms Reviewed by cardiologist with plan for transoephageal echo

10. Case Study August 2013 – TOE done FMC cardiac surgical meeting – accept for MVR and TVR Dental fitness obtained in November 2013

11. Case Study January 2014 admitted with rapid AF and decompensated heart failure FMC advises surgery date of 5 th March 2014 Surgery cancelled due to UTI. JL in Alice Springs when advised

12. Case Study FMC unwilling to give new surgery date until dental fitness for surgery updated. Dental fitness – July 2014 Numerous emails to FMC asking for surgery date. Dental fitness expires again Dental fitness – April 2015

13. Case Study April 15 – FMC advise cardiac surgery date 22 nd July 2015 MVR and Tricuspid annuloplasty done on 22/07/15 Uncomplicated recovery – returned to home community with 2 weeks

14. Case Study Small children Long wait time for cardiac surgery date Remoteness of community – cross border issues