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A program of research to improve ACCESS to cardiovascular care

Professor Robyn Clark, Institution: Flinders University

2015 Future Leader Fellowship

Years funded: 2016-2020

Outcomes of the Future Leader Fellowship
Prof Clark has earned international recognition for her research into the most effective management of Australia’s most disadvantaged populations (the elderly, rural and remote, low literacy, English as a second language and Aboriginal and Torres Stait Islander people).

Geographical Access to services
One of the focus projects of Prof Clark’s Future Leaders Fellowship was to apply geospatial science to inform efficient and effective geographically targeted service provision for cardiac and stroke services to all Australians. Results showed
  • Approximately 71% or 13.9 million people lived within 1 hour of a category 1 hospital (7 million outside the 1-hour range)
  • Only 40% of indigenous people lived within 1 hour of the category 1 hospital
  • 16% (74000) of indigenous people are 3 or more hours from any hospital
  • 90,000 people >65 years of age live more than 3 hours from any hospital
  •  96 % of the total population and 75% of indigenous people lived within 1 hour of aftercare services.

“…What we found was there is a need for innovative service delivery to meet Australia’s health care needs was identified 25 years ago and still exists today. Despite recognising the urban and non-urban health disparity, there are no nationally based health service models to help understand this disparity. We presently group all rural and remote locations into "poor health"; little effort is expended on identifying areas with better health and using these to improve rural and remote health. It is important to identify what is working in rural and remote areas and use this as a base for policy. This work has been translated in the Heart Foundation heart maps projects epidemiology/service maps that are extensively used by communities’ policy makers and researchers. We have also partnered with the Stroke Foundation to extend to work to include Stroke services and stroke care and will be applying for further funding for this next phase of research….”

Improving access to evidence-based cardiac rehabilitation for rural and remote
As a result of the Heart Foundation Future Leaders Fellowship our team was successful in being granted an NHMRC Partnership grant entitled: The Country Heart Attack Prevention (CHAP) Project: A four step model of care and clinical pathway for the translation of cardiac rehabilitation and secondary prevention guidelines into practice for rural and remote patients. 

Our legacy from the CHAP project will be:

  1. Better Care and Better outcomes for rural and remote cardiac patients through improved access, attendance, and completion of cardiac rehabilitation.
  2. Australia’s largest, internationally recognized CR dataset with live linkage for continuing quality and outcomes research on the effectiveness of cardiac rehabilitation in rural and remote Australia.
  3. A clinical service that is co-designed, evidence-based, and person centered that tailors to a person’s needs with 4 options (or choice) of delivery (Including CR Especially for Women-CREW)
  4. ACCREDITED CR Programs that meet international and national standards for patients and providers.
  5. Heart Health for Life: A sustain model of care which is integrated into primary care.
  6. A team of ECRs / MCRs with outstanding and competitive track records.

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