1. Service Name (Mandatory)
2. Primary Coordinator (Mandatory)
3. Secondary Coordinator
4. Street Address (no P.O. boxes) (Mandatory)
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5. Street Number
6. Street Name
7. City
8. State
9. Postcode
10. Country
11. Building Name
12. Phone 1 (Mandatory)
13. Phone 2
14. Phone 3
15. Fax 1 (for referrals)
16. Fax 2
17. Primary Service Email (Mandatory)

    We strongly encourage Services to have generic Service emails rather than individual work emails for each Service

18. Secondary Service Email
19. Service Description (Mandatory)

1. Cardiac Rehabilitation – Inpatient What is this?

   Cardiac Rehabilitation - Inpatient

   A service that ensures every patient has access to structured discussions with health educators about their condition and recovery while in hospital. This includes every eligible patient receiving an individualised discharge management plan and referral to cardiac rehabilitation - outpatient. Discussions may be delivered to the patient and family members and/or in group education sessions.

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2. Service Description

   Example Service Description:
   Monday to Friday. Education to all STEMI, NSTEMI, PCI, High Risk Factors and patients referred for cardiac surgery. Access to multidisciplinary allied health teams.

3. Cardiac Rehabilitation – Outpatient What is this?

   Cardiac Rehabilitation - Outpatient

   A structured education and/or exercise service that begins when referred patients have an initial assessment to identify their goals and develop an action plan that empowers them to adopt self-management strategies to:

   • make changes in their lifestyle
   • adhere to prescribed medications
   • return to, or to improve on, baseline everyday functioning
   • develop coping strategies
   • maximise psychological and social parameters
   • develop a life-long approach to prevention

   These can be facility-based, home-based, phone-based or web-enabled.

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4. Service Description

   Example Service Description:
   10 Session program. Tuesday & Friday 7.15-09.30am; Monday & Thursday 7.15-09.30am.

5. Cardiac Rehabilitation – Maintenance What is this?

   Cardiac Rehabilitation - Maintenance

   An ongoing structured education and/or exercise service to help sustain activities and behaviours to realise long-term health benefits and decrease the risk of future cardiovascular events.

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6. Service Description

   Example Service Description:
   2 x week. Mondays/Fridays (6:00 – 11:00am) and Tuesdays/Thursdays (4:00 – 6:30pm). Patients must have completed the Outpatient program (offered for up to six months)

7. Heart Failure Management What is this?

   Heart Failure Management

   A dedicated multidisciplinary program of care for patients with chronic heart failure following hospitalisation. This involves:

   • patient education and counselling
   • promoting self-care behaviours
   • intensive follow-up to proactively detect and address clinical problems
   • applying evidence-based medications and improving adherence
   • fluid and electrolyte management and physical activity programs
   • developing coping strategies
   • maximising psychological and social parameters

   Priority should be given to face-to-face management of patients, but remote management assisted by structured telephone support and telemonitoring should be considered for patients with limited access.

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8. Service Description

   Example Service Description:
   Heart failure patients receive education on the benefits of exercise, managing of their condition (diet, sodium restrictions, fluid management, action plans) and access to a staged exercise rehabilitation program.

9. Chronic Disease Management (that caters for cardiac patients) What is this?

   Chronic Disease Management

   A service that provides care coordination and self-management support to help people with a range of chronic diseases (including cardiac patients) to better manage their condition and access appropriate services in order to improve health outcomes, prevent complications and reduce the need for hospitalisation.

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10. Service Description

    Example Service Description:
    The program offers a broad range of services including healthy eating plans, tailored exercise programs, stress management, adopting a safe home environment aimed at improving quality of life.

1. Face-to-face – group-based
2. Face-to-face – home-based
3. Face-to-face – individual
4. Phone-based
5. Web-enabled
6. Other home-based

1. Aboriginal and Torres Strait Islander Peoples
2. Culturally and Linguistically Diverse

Diagnosis Options (Mandatory)

1. Acute coronary syndrome: acute myocardial infarction (heart attack) & stable or unstable angina (chest pain)
2. Coronary heart disease
3. Heart failure
4. Cardiomyopathies
5. Arrhythmia (abnormal heart rhythm) - Atrial fibrillation, atrial flutter, supraventricular tachycardia (SVT)
6. Adult congenital heart disease, pulmonary hypertension, peripheral vascular disease

Procedure Options (Mandatory)

1. Re-vascularisation - coronary angioplasty or stenting
2. Coronary artery bypass graft (CABG) surgery
3. Valve surgery
4. Cardiac Transplant
5. Defibrillator or pacemaker implantation
6. Cardiac surgery: AAA repair, congenital, LVADS, Arrhythmia Surgery or combination