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Title: Implementing guideline based heart failure care in the Northern Territory: challenges and solutions.
Authors: Iyngkaran, Pupalan
Harris, Melanie
Ilton, Marcus
Kangaharan, Nadarajan
Battersby, Malcolm
Stewart, Simon
Brown, Alex
Affiliation: Consultant Cardiologist, Senior Lecturer Flinders University, Royal Darwin Hospital, Rocklands Drive, Tiwi, PO Box 41326, Casuarina NT 0811. Electronic address:
Senior Research Fellow, Flinders Human Behaviour and Health Research Unit, Flinders University, GPO Box 2100 Adelaide SA 5001. Electronic address:
Director of Cardiology, Royal Darwin Hospital, Rocklands Drive, Tiwi, PO Box 41326, Casuarina NT 0811. Electronic address:
Director of Medicine/Consultant Cardiologist, Royal Darwin Hospital, Rocklands Drive, Tiwi, PO Box 41326, Casuarina NT 0811. Electronic address:
Flinders Human Behaviour and Health Research Unit (FHBHRU), Margaret Tobin Centre, Flinders University, Bedford Park, South Australia, Australia 5001. Electronic address:
Director NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC, 3004, Australia. Electronic address:
Professor of Population Health and Research Chair Aboriginal Health School of Population Health, University of South Australia & South Australian Health & Medical Research Institute, Adelaide. Electronic address:
Issue Date: May-2014
Citation: Heart, lung & circulation 2014-05; 23(5): 391-406
Abstract: The Northern Territory of Australia is a vast area serviced by two major tertiary hospitals. It has both a unique demography and geography, which pose challenges for delivering optimal heart failure services. The prevalence of congestive heart failure continues to increase, imposing a significant burden on health infrastructure and health care costs. Specific patient groups suffer disproportionately from increased disease severity or service related issues often represented as a "health care gap". The syndrome itself is characterised by ongoing symptoms interspersed with acute decompensation requiring lifelong therapy and is rarely reversible. For the individual client the overwhelming attention to heart failure care and the impact of health care gaps can be devastating. This gap may also contribute to widening socio-economic differentials for families and communities as they seek to take on some of the care responsibilities. This review explores the challenges of heart failure best practice in the Northern Territory and the opportunities to improve on service delivery. The discussions highlighted could have implications for health service delivery throughout regional centres in Australia and health systems in other countries.
DOI: 10.1016/j.hlc.2013.12.005
Type: Journal Article
Research Support, Non-U.S. Gov't
Subjects: Heart Failure
Nurse led care
Delivery of Health Care
Guideline Adherence
Heart Failure
Northern Territory
Practice Guidelines as Topic
Appears in Collections:NT Health digital library

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