Wellness @ Heart Pilot Program
The Wellness @ Heart pilot program aims to support people from culturally and linguistically diverse backgrounds (CALD) with heart conditions and/or risk factors to stay well, manage their health and avoid unnecessary presentations to hospital. The program receives referrals from the PA Hospital to work intensively with people to ensure they are linked to essential primary health services, understand their medications, receive health education and cultural support and support to access the services they require to stay well and manage their health. The objectives of the Program are:
- Strengthen engagement with appropriate primary health services for CALD consumers with heart health conditions
- Provide a care coordination service to maximise engagement and follow-up with appropriate primary health services
- Provide best-practice medication support to CALD consumers to improve consumer knowledge and adherence to treatment and management plans
- Provide cultural support to complex consumers to better engage with primary health care and the hospital services.
- Develop agreed protocols for referral, discharge planning and collaborative care arrangements between PA Hospital and World Wellness Health and Medical Clinic for people from CALD backgrounds with heart disease risk factors and conditions.
- Evaluate the proposed model for CALD populations to improve primary health service engagement and improved health indicators for heart health
The Pilot Program will achieve this by providing consumers:
- Care coordination
- Cultural support
- Health education
- Supported referral
- Medication review and reconciliation
- Follow up
The program takes referrals from PA Hospital to work with adults from a non-English speaking background who meet eligibility criteria and the program is delivered by a multidisciplinary team comprising:
- Nurse Care Coordinator
- Community Pharmacist
- Bilingual/Bicultural Workers
- Health Promotion Officer
The University of Queensland is a partner for the evaluation framework of the program. The program will run from October 2018 to May 2019 and is funded by Metro South Health.