watto purrunna rheumatic heart disease management cqi project june 20… · sa health watto...
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Watto Purrunna Rheumatic
Heart Disease Management
CQI Project
Damian Rigney, Aboriginal Health Worker
Dr Penny Silwood, Senior Consultant
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SA Health
Acknowledgements
Mark McMillian, CQI Coordinator
Teresa Branson, Clinical Services Coordinator
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Watto Purrunna Aboriginal Primary Health Care Service
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SA Health
Watto Purrunna
Three service delivery teams:
Kokotina Tappangga – Clinic team – Multi-disciplinary
Purrunna Waiingga – wellbeing and health promotion
Kanggawodli – sub acute inpatient facility
Operate from three sites:
Muna Paiendi (Elizabeth Vale)
Maringga Turtpandi (Gilles Plains)
Kanggawodli (Dudley Park)
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SA Health
Watto Purrunna Aboriginal
Primary Health Care Service
Who are we?
>Watto Purrunna provides culturally specific primary health care services
>Multi-disciplinary team approach, including Aboriginal Clinical Health Workers
>ACHW, GP, Podiatrist, Nutritionist, Social Worker, RN, Speech pathologist, Occupation Therapist, Diabetic educator Visiting specialists
>Groups programs, Community information and education, Social support
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SA Health
Overview of current RHD patients
> 16 Current RHD patients
> 2 severe (priority 1)
> 3 moderate (priority 2)
> 11 mild (priority 3)
> 7 patients receiving regular penicillin
prophylaxis
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SA Health
Why did we do the CQI Project?
Describe how the decision was made to do
the CQI project…
> Acknowledge Mark and Teresa
> RHD wasn’t a priority for the organisation
> Low awareness about what RHD is
> Patients weren’t being managed
according to the RHD guidelines
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SA Health
Evidence of a problem (2012)
> Recommended services received
• 14% of clients had evidence of a dental check
within 2 years
• 14% had a record of having an echo within 3 years
• 28% had a record of seeing a cardiologist within 2
years
• 57% had an influenza vaccination in the last 12
months
> Medical information missing
• 14% had a priority classification document
• 0% were on the RHD Register (new to SA)
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SA Health
What did we do?
> Aim: Improve staff knowledge of ARF/RHD
Strategies:
> RHD Coordinator deliver training to staff
> Clinic team to complete training package
> RHD guidelines made available in all clinics
and online
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SA Health
What we did Cont’d
> Aim: Provide more accurate and timely
recall of our RHD/ARF clients
Strategies:
> Develop standard recall for our clinical
software
> Get codes approved by MD working group
> Ensure every RHD client has a priority
classification
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SA Health
What we did cont’d
> Aim: Further investigate barriers from a
clients to follow-up care of RHD.
Strategies:
> Interview with RHD clients to get an
understanding of the barriers from their
perspective
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SA Health
What we did cont’d
> Aim: Increase the clients understanding of
ARF/RHD and the recommended
management
Strategies:
> Make current educational materials
available to client with RHD
> Hold information session at service for
RHD client
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SA Health
Implementing care plans and
recalls
> Making sure that people had a priority classification
• Send them to the cardiologist
> Making sure recalls were set
> 6 monthly program reviews to check recalls and
follow-up
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SA Health
Barriers
> Difficulties in getting to see the specialist
(Transport etc)
> People moving between Adelaide and
home communities
> Knowledge about why they need to have
injections or see a specialists
> (Examples: Ray, Brent, Mark, Natasha)
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SA Health
Education
> Education for staff
> Education for patients
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SA Health
Why are we better now (2014)?
> Confident that new clients will be identified,
the process for recalls and follow-up will be
implemented
> Skilled ACHWs
> RHD co-ordinator
> Organisation: core business
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SA Health
How can you help each other?
> Clear recommendations following
guidelines
> Ensuring patients have a priority
classification
> Good communication between all health
providers
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SA Health