Connecting with Community – Champions4Change

Ms Diana Mosca1, Ms Vicki Wade1

1RHDAustralia, Darwin, Australia


Health care systems built on western ideologies and constructs, are multidimensional and fragmented making it difficult for many people to navigate. People with a lived experience of acute rheumatic fever (ARF) rheumatic heart disease (RHD) are well placed to provide comfort to people experiencing social and emotional hardships throughout their very complex health journey.

Many factors contribute to the higher prevalence of RHD in Aboriginal and Torres Strait Islander populations including, underlying economic and social disadvantage, delayed access to care, cross-cultural miscommunication, racism and discrimination. These factors present challenges in providing optimal health care for people most in need of early detection and prevention, secondary care, tertiary and ongoing management.

Aboriginal people with a lived experience of RHD and a desire to share their knowledge and experience have designed the RHDA Champions4change program.  Roles like these are not new to Aboriginal people, passing on and sharing knowledge is a part of traditional Aboriginal culture based on the kinship system. Mothers and grandmothers had a shared responsibility to look after all children in the community. Elders helped children grow into adults often in sacred ceremony. The RHDAustralia champions are encouraged to tap into their Aboriginal ways of knowing and being to help breakdown structural and cultural barriers in care. They can provide comfort to people who are experiencing social and emotional hardship throughout their often very complex health journey.

This presentation provides an overview of the Program and how it helps build the knowledge required to ensure Aboriginal and Torres Strait Islander peoples have the tools to live a good life by reducing the impact of RHD in their communities. It will explore the support and resources required for the champions to successfully develop a Champions4change program in their own community.


Diana commenced as the Senior Nurse Advisor at RHDAustralia in January 2018 and is enjoying working in Darwin after 20 years.

She has held clinical nursing and education positions around Australia since the 80s, mostly in rural and regional areas. Her nursing experience spans education, paediatrics, public health and perioperative nursing. This range of nursing experience has been invaluable to inform projects and programs including education programs and quality improvement in acute and chronic health.

As well as being a registered nurse, she has qualifications in Public Health, Education, Perioperative nursing, Leadership, and Business Analysis.

The Joy Project – getting people to smile!

Ms Xaviera Farrell1

1Prison Health Darwin, Darwin , Australia



Demonstrate how colour in the workplace can change the way we connect with our patients and our colleagues.

Nature and Scope:

By examining how colour can effect mood and behaviour I explore how this has transferred into the design of our clinic by adding colour to moving works of art- staff, and how this has far reaching effects.

The issue under consideration:

Our community members at Darwin correctional precinct have complex behaviours,  are culturally diverse, have individual health needs and are generally suspicious of people in uniforms – and that’s just us health care professionals!  We wanted to make our space, for all the people within it, a place of healing and happiness.  The reality is that we are in a prison and we wanted to make the clinic a place of true rehabilitation.

Staff were not micromanaged on how they wanted to add some colourful ‘frosting’ to their uniforms.

We celebrated days of inclusion and recognition such as ‘Harmony day and NAIDOC week’ and included the inmates in the decorating of the clinic.

We also commissioned local artists to add colour to our clinic.

The outcome;

We have  reduced episodes of anti- social behaviour in the clinic.  We have a reduced amount of inmates ‘leaving against medical advice’.  We have a higher rate of smiles.  We have fewer staff sick days, improved retention and overall improved staff satisfaction.

Most important – when you enter our clinic you can not help but smile!  And when we smile we relax- the healing begins with colour!


Xaviera Farrell RN, BA, BS (nursing), Grad Cert Clinical Nursing, Grad Dip Emergency Nursing.

Clinical Nurse Specialist and Patient Feed Back Coordinator.

Darwin Correction Precinct.

NSW Retrieval Transfusion

Mrs Sophie Shand1

1NSW Ambulance Aeromedical, Australia



Catastrophic haemorrhage is identified as the leading preventable cause of death. Rural and remote communities are particularly challenged by their distance to definitive care. NSW Ambulance has developed and introduced a Retrieval Transfusion Protocol to facilitate the delivery of blood products to pre-hospital scenes, during extended transfers and to hospital facilities.

Your Project:

There is limited evidence for transfusion specific to the pre-hospital environment however recent robust studies in hospitals broadly supports mixed transfusion in 1:1:1 ratios (Shand et al., 2018). NSW Ambulance Aeromedical services currently routinely carry only Packed Red Blood Cells and there are limited facilities which have access to additional products, particularly in rural and remote areas. With approximately 35 per cent of the NSW population residing beyond the boundaries of the greater Sydney area, NSW Ambulance has developed and introduced a retrieval transfusion protocol which facilitates the provision and delivery of additional blood products from existing blood bank facilities to patients in need across the state. This process is the first of its kind worldwide.


The development and processes of the NSW Ambulance Retrieval Transfusion Protocol will be discussed and demonstrated with the presentation of specific case studies. A clinical overview of the approximately 100 patients who have received extended blood product transfusion with NSW Ambulance will be presented.


Shand, S., Curtis, K., Dinh, M., & Burns, B. (2018) What is the impact of prehospital blood product administration for patients with catastrophic haemorrhage: an integrative review. Injury.


Sophie is a Clinical Coordinator at NSW Ambulance Aeromedical Operations. This CNS role is responsible for triage, coordination and clinical oversight of aeromedical transfers and medical retrievals throughout NSW/ACT, also providing telephone clinical support.

The position combines Sophie’s previous experiences in UK Critical Care and Emergency Nursing and as a Paramedic with London Ambulance Service before her search for warmer climates brought her to Australia in 2013.

Sophie has completed a BN(Hons) Nursing, FdSc Paramedic Sciences and GradCert Emergency and is currently undertaking post-graduate research studies with the University of Sydney relating to pre-hospital blood transfusion in NSW.

Coordinated Veterans’ Care: A collaborative approach to managing chronic conditions

Ms Carolyn Campbell1, Ms Anna Polson1

1Department Of Veterans’ Affairs


The Department of Veterans’ Affairs Coordinated Veterans’ Care (CVC) Program is a team-based program encouraging partnership and collaboration between the participant, GP, nurse coordinator and a wide range of health professionals and community supports. CVC involves a proactive approach to improve the management of participants’ chronic conditions and quality of care for eligible Gold Card holders at risk of unplanned hospitalisation.

CVC Care Teams use a person centred approach to care planning, coordination and review, as the model to support better outcomes and self-management of the veterans’ health. The program emphasises a coordinated approach, partnering and utilising a multidisciplinary team to provide tailored and flexible support based on an individual’s goals.

The coordination of care for those living with chronic conditions is pivotal in the empowerment of participants by promoting self-management, providing education and linking participants with other health providers for a holistic approach.

Through the CVC Program and the coordination of the care plan, participants can access a wide range of health services to assist in the management of their chronic conditions. The sharing of health information amongst all partnering health care providers enables better health outcomes for participants. Regular communication, empowerment and coaching are key to the success of the team.

The CVC Program has proven to be effective in reducing hospitalisations and is considered to be a leading practice approach to the coordination of health care services facilitating and promoting partnerships to support health outcome. Amid the changing landscape of health care and the emergence of different chronic conditions, the CVC Program will continue to lead the way in delivering high quality coordinated care to the veteran population.


Carolyn Campbell and Anna Polson are in the Nursing Programs and Operations section at the Department of Veterans’ Affairs and oversee the Coordinated Veterans’ Care (CVC) Program.

RHDAustralia in 2019

Ms Diana Mosca1

1RHDAustralia, Casuarina, Australia


RHDAustralia is funded under the Australian Government’s Rheumatic Fever Strategy to support the control of rheumatic heart disease in Australia. The aim of this hotspot is to highlight our work in 2019. Australia has among the highest prevalence of RHD in the world, largely in rural/remote communities. It is important to know what resources and support are available.

What we are doing:

  • The Australian ARF/RHD Guideline is being updated and expanded. The new edition is based on the latest evidence-based research, with a focus on culturally-appropriate practice.
  • RHDAustralia works closely with communities to develop culturally-appropriate information and education. This includes the support for initiatives like the champions4change.
  • In partnership with RHD control programs across Australia, RHDAustralia deliver workshops for the rural and remote health workforce.
  • Free e-learning modules, short movies, and many other resources are available on our website.

Please visit the RHDA booth in the trade displays and let us know how we can support you and your community.


Diana commenced as the Senior Nurse Advisor at RHDAustralia in January 2018 and is enjoying working in Darwin after 20 years.

She has held clinical nursing and education positions around Australia since the 80s, mostly in rural and regional areas. Her nursing experience spans education, paediatrics, public health and perioperative nursing. This range of nursing experience has been invaluable to inform projects and programs including education programs and quality improvement in acute and chronic health.

As well as being a registered nurse, she has qualifications in Public Health, Education, Perioperative nursing, Leadership, and Business Analysis.

Indigenous eye health – diversity and connection will close the gap for vision

Ms Rosamond Gilden1, Mr Mitchell  Anjou1, Mr Nick  Schubert1, Mrs Carol Wynne1, Mrs Tessa Saunders1, Professor Hugh  Taylor1

1Indigenous Eye Health, The University of Melbourne, Carlton, Australia



Initiatives and activities to close the gap for vision by 2020 are currently being implemented across Australia. Aboriginal and Torres Strait Islander people still (2015) have three times more blindness and vision loss compared than other Australians but this has been significantly reduced since 2008 when there was six time more blindness. The Roadmap to Close the Gap for Vision (Roadmap, 2012) proposed 42 sector-endorsed and evidence-based recommendations necessary to close the vision gap. The Roadmap identified that the eye care pathway was like a leaky pipe. To successfully navigate the patient pathway and tackle the ‘leaks’, the whole-of-system, collaborative approach proposed by the Roadmap connects diverse organisations within geographic regions who work together to close the gap for vision.

What is happening in your project/ health service/or what has been your experience:

Roadmap recommendations have been progressively implemented at national, jurisdictional and regional levels since 2012. Regional eye health stakeholder groups have been established, comprising members from various organisations involved in the patient journey. The diverse nature of these groups has been critical in identifying local barriers and determining solutions to address inequities and reform approaches.

Over 50 regions across Australia are now engaged in this way, representing urban, regional and remote areas. To 2018, 19 of the 42 Roadmap recommendations are completed and over 75% of intermediate activities commenced. Through regional collaborative processes, we have seen improved eye health outcomes for Indigenous Australians. This is reflected in national surveys (2015) and measures (2018) which show improved screening, examination and surgery rates and reduced blindness


This paper will consider the impact of embracing diversity through regional eye health stakeholder networks and how this has built stronger connections between patients, providers and services resulting in better eye health outcomes for Aboriginal and Torres Strait Islander people.


Rosamond Gilden started in the role of Research Assistant with Indigenous Eye Health (IEH), University of Melbourne in June 2016. Upon completion of her masters in Orthoptics, Rosamond worked as an Orthoptist in both the public and private sector. Rosamond joined the Centre for Eye Research Australia in 2014 as Clinical Coordinator for the National Eye Health Survey. In her role with IEH, Rosamond is part of the Roadmap team that helps to support implementation of the Roadmap to Close the Gap for Vision.