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Chronic Disease
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Chronic Disease

2020-12-03 09:37:13

Chronic Disease Unit

The Community and Primary Health Care, Chronic Disease Team provide an integrated, interdisciplinary range of specialist services throughout the North West Queensland Hospital and Health Service region.  The team deliver culturally appropriate primary and secondary interventions to improve disease management and quality of life, with a patient and family centred care management approach.

Services provided:

  • Cardiac Service
  • Cardiac Rehabilitation
  • Diabetes Service
  • Renal Health Service
  • Rhematic Heart Disease Service
  • Respiratory Service
  • Respiratory Rehabilitation
Cardiorespiratory Service

Cardiorespiratory services encompasses four services under one banner this includes:

  • Rheumatic heart disease service
  • Heart failure service
  • Respiratory
  • Cardiac/pulmonary rehabilitation

The client care strategy is self-management, patient and family education for primary and secondary prevention of cardiovascular and respiratory disease to avoid hospital admittance. The model of care incorporates telehealth, home visits, group consultation, group gym programs and nursing presence medical clinics.

Smoking Cessation

The clinic is proactive in its approach to smoking cessation. Individuals over the age of 18 can self-refer into the clinic. The clinic provides education in primary and secondary prevention of cardiovascular disease and disease prevention in general. The clinic offers individual consultations and clients are followed up regularly throughout the 8-12 week individualised program.

Diabetes Service

The Diabetes Service focus on hospital avoidance by screening and early identification, management and health education/promotion utilising evidence based best practice, to optimise individual self-management of diabetes in pregnancy and type 1 and type 2 diabetes across all ages. The model of care incorporates telehealth, home and outreach visits, group consultations and individual consultations, education advice to schools and community-based health care providers.

Renal Service

The Renal Service provide a coordinated interdisciplinary approach to focus on prevention, early identification and management of people with all stages of chronic kidney disease (CKD) within a primary and community healthcare framework to optimise their health outcomes. The model of care consists of telehealth, home visits outpatient consultations, outreach visits and education programs.