Management of Osteoarthritis
Arthritis is a chronic disease of the joints estimated to affect over five million Australians. Over two million of these have osteoarthritis (OA) which is the most common form of arthritis , though it is known that many go unreported as it is a common misguided belief that joint pain is a part of the normal process of ageing.
Osteoporotic Re-fracture Prevention
An osteoporotic fracture (commonly known as a minimal trauma or fragility fracture) is a fracture that is sustained through falling, tripping or slipping from a standing height or less, or a trauma of lesser impact. Having an underlying condition, such as osteoporosis, predisposes a person to osteoporotic fracture.
Diabetes High Risk Foot Services
Diabetes related foot complications occur mainly as a result of diabetes-related impacts on the nerves, joints and blood vessels. Most foot ulcers occur because there is reduced or absent sensation whereby patients do not feel their injuries and as a consequence delay seeking treatment, continuing to walk on their ulcerated or fractured foot. People with diabetes have more frequent and earlier progression to blockages of the arteries which affects blood flow and ability to heal. Under these conditions, minor injuries (cuts and bruises) and stress fractures can progress to ulcers, infections and amputation.
Inpatient Management of Diabetes Mellitus
Diabetes is a chronic condition marked by high levels of glucose in the blood. It is caused either by the inability to produce insulin (a hormone produced by the pancreas to control blood glucose levels) or by the body not being able to use insulin effectively. Diabetes can lead to acute and chronic complications. In an acute hospital setting, hyperglycaemia can increase risk or infection and other adverse outcomes. Chronic high blood glucose levels are associated with long-term damage, dysfunction and failure of virtually every organ, especially the heart and blood vessels, eyes, kidneys and nerves. As a result people with diabetes are predisposed to comorbidities, including cardiovascular disease, visual loss, amputations and renal failure.
Renal Supportive Care
The ACI Renal Network is supporting the implementation of a Renal Supportive Care (RSC) Model across NSW. RSC involves an interdisciplinary approach that integrates the skills of renal medicine and palliative care to help patients with chronic kidney disease (CKD) and end stage kidney disease (ESKD) to live as well as possible by better managing their symptoms and supporting them in living with advanced disease. It is a program that is embedded in usual renal care. The ACI support model includes a gap analysis, patient mapping, service utilisation, and redesign of existing services.
Falls in Hospitals – driving improvements in care
The Clinical Excellence Commission (CEC) NSW Falls Prevention Program is supporting the implementation of system improvements in the care of older people in hospital and will provide strategic coordination and practical support for action across NSW. The CEC, NSW Ministry of Health, ACI and LHDs are working together to prevent falls and fall injuries through the implementation of evidence–based best-practice, strategic leadership and practical support for implementation of local initiatives.
Patient Reported Measures
Patient Reported Measures (PRMs) are a critical component in supporting Leading Better Value Care across NSW; shifting our focus from measuring just volume to measuring value – value in terms of the outcomes and experiences that matter to patients.
Hip Fracture Care
Hip fracture is the most serious and costly fall related injury in older people. There is a high risk of post-operative complications, within a year approximately 20-25% of patients will no longer be alive and less than half return to their previous function. Collaboration and communication within the multidisciplinary team is necessary to ensure that all patients receive the best value and evidence-based care.
Acute bronchiolitis is a common viral chest infection. It frequently affects infants aged one or younger, and is most often occurs in autumn and winter. The infection causes the small tubes in the lungs (bronchioles) to become inflamed and narrowed by swelling and mucus, leading to difficulty breathing, fast breathing, wheezing and poor feeding.
Chronic Heart Failure
Chronic heart failure (CHF) is a complex clinical syndrome caused by structural or functional abnormalities in the heart which result in shortness of breath, fatigue, and oedema. It is a severe, disabling condition, which negatively impacts on quality of life. The ACI Cardiac Network published the NSW Clinical Service Framework for chronic heart failure in 2016, which provides best practice guidance for CHF across nine key standards. These guidelines can be used to provide a benchmark for optimal care delivery, reduce unwarranted clinical variation and improve outcomes for people with CHF across NSW.
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a progressive and disabling condition that limits airflow in the lungs. People with COPD experience increasing shortness of breath, a persistent cough with phlegm or mucus most days and a limited ability to complete everyday activities due to poor exercise tolerance. The incidence of COPD increases with age. COPD is an area of significant healthcare variation, with high associated healthcare costs. In an effort to improve clinical best practice for people with COPD, the Australian Lung Foundation published The COPD-X Plan: Australian and New Zealand guidelines for the management of chronic obstructive pulmonary disease in 2016. These best practice guidelines aim to broaden treatment of COPD from a pharmacological focus to an emphasis on patient education, chronic disease self-management and pulmonary rehabilitation.