CURRICULUM VITAE

Name: John N. Hill A/Prof, MBBS, CertAvMed, FRACP, FCSANZ, FHRS, DDU

Date of Birth: 1 July 1959 Marital Status: Married - May 1985 to Deborah Marie

3 children - Sean, born 1987 - Christopher, born 1993 - Cailin, born 2000

Interests: Tennis, cars, aircraft

COMMENTARY Timeline

1980–1981: Student Elective in Radiology, McGill University - Jewish General Hospital Montreal Canada (8 weeks)

1983: M.B., B.S. (Adel)

1983: Internship Royal Adelaide Hospital

1984: Residency Royal Adelaide Hospital

1985: Certificate of Aviation Medicine, RAAF Point Cook

1985: Prize for Best Officer Qualities, RAAF Officer Training School o The only RAAF Medical Officer to complete this 10 week course o The only RAAF Medical Officer to obtain this prize

1985–1988: Medical Officer to RAAF Chief of Air Staff

1987: Senior Medical Officer, Joint Services Health Centre Canberra

1989-1997: RAAF General Reserve Member

1989-1990: Basic Medical Trainee, Royal Canberra and Woden Valley Hospitals

1991-1992: Advanced Trainee in Cardiology, Royal Canberra and Woden Valley Hospitals

1992: Medical Registrar, Box Hill Hospital, Melbourne

1993: Advanced Trainee in Cardiology, The Alfred Hospital, Melbourne

1993: Diploma of Diagnostic Ultrasound (Echocardiography) First registrar to obtain DDU during advanced training at the Alfred Hospital, Melbourne

1993: F.R.A.C.P.

1994-1995 Fellowship in Cardiac Electrophysiology and Pacing, St. Vincent’s Hospital, Indianapolis USA – Prof. Eric N. Prystowsky

1995: Appointed Full-Time Staff Cardiologist, Princess Alexandra Hospital, Brisbane

1996: Appointed Visiting Cardiologist, Mater Hospitals Brisbane

1997-2002 Specialist Reserve Member

1999: Appointed Visiting Cardiologist, Redlands Hospital Brisbane

2003: Appointed Senior Staff Consultant Cardiologist Princess Alexandra Hospital

2005: Sabbatical Study, 10 weeks June – August 2005: Focus on role of cardiac electrophysiology in heart failure and atrial fibrillation, deployment and operation of non-fluoroscopic imaging and cryo-ablation systems

ESC Heart Failure Symposium, Lisbon, Portugal – 1 week

EP laboratory Dr. Carlo Pappone, Milan, Italy – 1 week

ESC Europace Scientific Sessions, Prague, Czech Republic

EP laboratory Dr. Michel Haissaguerre, Bordeaux, France – 2 weeks

EP laboratory Dr. Wyn Davies, St. Mary’s Hospital, London, England – 1 week

EP laboratories D. Richard Schilling, St. Bartholomew’s and London Bridge Hospitals, London, England – 1 week

EP laboratory Dr. George Klein, London, Ontario, Canada – 1 week

EP laboratory Dr. David Wilber, Chicago U.S.A. – 1 week

EP laboratory Dr. Eric Prystowsky, Indianapolis U.S.A

2005-current: Appointed Director of Clinical Cardiac Pacing and Electrophysiology Princess Alexandra Hospital

2009: FCSANZ

2014 appointed Associate Professor, University of Queensland School of Medicine

2014 appointed FHRS

Teaching Commitments 1996-2000: Annual lecture in cardiology to medical students of University of Queensland, ECG, Herston campus, Brisbane 1996-1999: Annual tutorial series with foreign medical graduates (AMEC candidates), 2-3 sessions, ECG/Arrhythmia, Royal Brisbane Hospital, Brisbane 1996-2006: Annual lecture/tutorial series during intern training, Princess Alexandra Hospital, 3-4 sessions, ECG/Arrhythmia/Resuscitation/Cardiological Emergencies/Angina 1995-2014: In-Service tutorials for residents on Cardiology rotation, 8-10 sessions per year, Princess Alexandra Hospital 1996-2014: In-Service tutorials for Cardiology nurses, 1-2 sessions per year, Princess Alexandra Hospital 1995-2014: Annual lecture/tutorial series with advanced trainees in Medicine, 2-3 sessions, Advanced ECG Interpretation/Arrhythmia, Princess Alexandra Hospital 1995-2014: Short and Long Case practice examinations with advanced trainees in Medicine, 6-10 sessions per year, Princess Alexandra Hospital 2000-2006: Clinical Teaching sessions for medical registrars every fortnight at Redland Hospital, Brisbane 1998-2014: Continuous training responsibility for Cardiac Scientists involved in cardiac electrophysiological studies, ablation procedures, pacemaker implantation and pacemaker clinic follow-up activities, Princess Alexandra Hospital. 7 cardiac scientists obtained IHBRE certification in Cardiac Pacing 2008-14 1995-2014: Continuous training responsibility for advanced trainees in Cardiology, Princess Alexandra Hospital 2001-2014: RACP Clinical Supervisor, Princess Alexandra Hospital 2007-2012: Lecturer to CEPIA National Scientific Programme for Cardiac Scientists: Complex arrhythmia diagnosis and ablation

Publications Bibliography

1. Fogel R.I., Chamberlain-Webber R., Hill J.N., Evans J.J., Johnson S., Prystowsky E.N.:

"Intravenous Amiodarone: Acute Efficacy Predicts Long Term Success."Circulation 1994; 90 Vol.4 Pt2:I-546 (abstract)

2. Hill J.N., Chamberlain-Webber R., Prystowsky E.N. et al: "Long RP Tachycardia: Can

Mode of Termination By Adenosine Differentiate Atrial from Atypical AV Node Re-entrant Tachycardia?" JACC Feb 1995: 129A (abstract)

I presented this abstract at the ACC Meeting in New Orleans on March 20th 1995. 3. Chamberlain-Webber R., Hill J.N., Prystowsky E.N. et al: "Characteristics of Successful

Posterior Septal Sites to Cure AV Node Re-entry Using a Thermistor-Controlled Catheter System." JACC Feb 1995: 128A (abstract)

4. Wharton J.M., Hill J.N., Freedberg N.A., Prystowsky E.N.: "Disopyramide" chapter in

"Cardiovascular Drug Therapy" ed. Messerli F.H., 2nd. edition, W.B. Saunders 1995 5. Freedberg N.A., Hill J.N., Evans J.J., Fogel R.I., Prystowsky E.N.: "Patients with Initial

Appropriate Defibrillator Therapy: Are Subsequent Therapy and Symptoms Predictable?" PACE 1995; 18(4)Pt2: 944

6. Hill J.N., Freedberg N.A., Wharton J.M., Prystowsky E.N. et al: “Are Atypical and Typical

AV Node Re-entry “Mirror-image” Tachycardias? Response to Adenosine suggests Otherwise” Circulation 1995; 86: 919-25

7. Hill J.N., Chamberlain-Webber R, Zimerman L, Shenasa H, Fogel, Wharton M,

Prystowsky EN: Long RP tachycardia: “Can mode of termination by adenosine differentiate atrial from atypical AV node reentry tachycardia?” J Am Coll Cardiol, 1995;25:129A

8. Freedberg NA, Hill JN, Evans JJ, Fogel RI, Prystowsky EN: “Spontaneous sustained ventricular tachycardia: Mechanisms of initiation.” J Am Coll Cardiol 1996;27(2):349A

9. Freedberg N.A., Hill J.N., Fogel R.I., Prystowsky E.N.: “Recurrence of Symptomatic

Ventricular Arrhythmias in Patients With Implantable Cardioverter Defibrillator After the First Device Therapy” JACC 2001; 37:1910-17

10. Meulet J., Pavia S., Doneva S., Hill J.N.: “Impact of RV Pacing Site on Development of Atrial Tachyarrhythmias in Patients with Dual Chamber Pacemakers” PACE 2005, 28(4)

11. Hill J.N.: “Amiodarone for Atrial Fibrillation: Comfort for the Afflicted and Affliction for the

Comforted.” J Cardiovasc Electrophysiol 2007, 18(7): 719-21 (Editorial)

12. Hill J.N.: “Detection of Thrombus Before Ablation for Atrial Fibrillation: Focus Determines Reality”” J Cardiovasc Electrophysiol 2008 (published online Feb 5 2008, Editorial)

13. Hunt B.J., Dauber K.M., Gould P.A., Hill J.N.: “No Difference in Defibrillator Lead Integrity

or Efficacy with Right Ventricular Outflow Tract Placement Compared to Right Ventricular Apical Placement: A Single Centre Experience” Heart Rhythm 2009, 6(5S): 439

14. Stanton T., B. Haluska, R. Leano, K. Dauber, S. Doneva, P.A. Gould, G. Kaye, J.N. Hill, et al:“Improvement of Mechanical Synchrony by Echocardiographic Optimization of CRT and its Role in Improving Response” Heart, Lung and Circulation, 2009,(18),16–17

15. Stanton T., Haluska B., Leano R., Dauber K.M., Doneva S., Stafford W., Gould P.A., Kaye G., Hill J.N., Marwick T.H.: “Echocardiographic Optimisation of Cardiac Resynchronisation Therapy: The Importance of Mechanical Synchrony” Heart Lung Circ 2009, 18(S3): 33-34

16. Dauber K. M., Gould P.A., Jenkins C., Doneva S., Kaye G., Hill J.N., Marwick T.H.:

“Regional Variations Seen in Left Ventricular Electro-Mechanical Activation” Heart Lung Circ 2009, 18(S3): 136-137

17. Dauber K.M., Gould P.A., Doneva S., Hill J.N., Kaye G.: “Primary Prevention ICD Therapy

Rates in a Single Centre Cohort” Heart Lung Circ 2009, 18(S3): 157

18. Hill J.N., Korczyk D., Denaro C., Finn H.: “Enzyme Replacement Therapy in a Case of Anderson–Fabry Disease with Advanced Cardiac Involvement and Malignant Ventricular Arrhythmias” Heart Lung Circ 2012, 21(S1): S5

19. T. Stanton, B. Haluska, K. Dauber, S. Doneva, W. Stafford, G. Kaye, P. Gould, J. Hill, et al, “Cardiac Resynchronisation Therapy Optimisation at Rest but not on Exercise Produces Significant Improvement in BNP: Results of a one Year Randomised, Double-Blind Clinical Trial” Heart, Lung and Circulation, 2012, (21), S74

20. Eng L., Peters N., Hill J.N.: “Dofetilide—Anti-arrhythmic Therapy: First Australian Experience” Heart Lung Circ 2012, 21(S1): S101

21. Moore P.T, Kaye G.C., Hamilton M., Slater L., Gould P.A., Hill J.N.: “Seven Years Experience of a Nurse-Led Elective Cardioversion Service in a Tertiary Referral Centre: An Observational Study” Heart Lung Circ 01/2014

22. Moore P.T, Kaye G.C., Hamilton M., Slater L., Gould P.A., Hill J.N.:”The Safety of a Nurse-Led Day-Case Cardioversion Service in a Tertiary Referral Center: A Single Centre Experience” Heart Rhythm 2014, 11(5S): S176

23. Moore PT, Kaye GC, Hamilton M, Slater L, Gould PA, Hill JN. “Seven years experience of a nurse-led elective cardioversion service in a tertiary referral centre: an observational study.” Heart Lung Circ. 2014 Jun;23(6):555-9. doi: 10.1016/j.hlc.2014.01.014. Epub 2014 Feb 6. 24. Kaye GC, Eng LK, Hunt BJ, Dauber KM, Hill J, Gould PA: “A Comparison of Right Ventricular Non-apical Defibrillator Lead Position with Traditional Right Ventricular Apical Position: A Single Centre Experience.” Heart Lung Circ. 2014 Sep 1. pii: S1443-9506(14)00661-1. doi: 10.1016/j.hlc.2014.08.008. [Epub ahead of print] PMID:25224461 [PubMed - as supplied by publisher]

Invited lectures

To General Practitioners and local community hospital Medical Staff, on subjects of general cardiological interest including arrhythmia, 2-3 events per year, 1996-2008

To The Annual Scientific Sessions of the North American Society for Pacing and Electrophysiology (NASPE, now “HRS”, Heart Rhythm Society – the pre-eminent international group of specialists in heart rhythm disorders), 1-2 Clinical Tutorials as Faculty member:

1999 – Ablation of Complex Accessory Pathways:

This presentation marked international recognition of knowledge and capability in this field

2000 – ECG in Ablation of Accessory Pathways: Advanced intracardiac and surface ECG interpretation in the therapy of Wolff-

Parkinson-White Syndrome

2001 – Automatic External Defibrillators (AEDs) in Aircraft: Tracing the development and utility of AEDs pioneered in commercial aviation

resuscitation, presaging the wider usage of AEDs in hospitals and other institutions

2001 - Non-Anti-Arrhythmic Drugs and Implantable Cardioverter/Defibrillators: Integration of pharmacotherapy for mechanical and ischaemic factors with device

and Anti-arrhythmic therapies in the prevention of sudden cardiac death

2002 – Prevention of Sudden Cardiac Death Beyond the implantable defibrillator

2002 - Practical Management of Atrial Fibrillation

Expert Panel

2012 - Provocative Cases in the Management of Ventricular Arrhythmias

Session Chair

Involvement in Clinical Trials

TRIAL NAME # RECRUITED COMMENCED CEASED PI Sub-

I

AS OF 1997 Gusto III 25 Aug-97 Jan-99 Hill

Val-Heft 22 Oct-96 May-00 Hill

Alive 5 Dec-97 Jun-00 Hill

Assent-II 25 Sep-97 Nov-98 Hill

Bosentan 2 Jan-97 Feb-98 Hill

Capricorn 31 May-97 May-00 Hill

Fraxis 17 Jan-97 Aug-97 Hill

Guardian 25 May-97 Aug-98 Hill

Hero-2 Transfer site only Dec-97 NA Hill

Nicorandil 3 Jan-97 Apr-97 Hill

Open-Label Bosentan

1 Nov-97 Feb-06 Hill

Posicor 0 (Study ceased by sponsor)

Cancelled by sponsor

Cancelled Hill

Symphony-I 7 Dec-97 Oct-98 Hill

COMMENCED IN 1998

Copernicus 1 Apr-98 Mar-00 Hill

Cure 23 Nov-98 Dec-00 Hill

Dronedarone 1 (Study ceased by sponsor)

Cancelled by sponsor

Cancelled Hill

Moxcon 2 (Study ceased by sponsor)

Cancelled by sponsor

Cancelled Hill

Symphony-II 1 (Study ceased by sponsor)

Cancelled by sponsor

Cancelled Hill

COMMENCED IN 1999

Valiant 37 Aug-99 Feb-06 Hill

Overture 7 Aug-99 Feb-06 Hill

Pacific 9 Jun-99 Jun-00 Hill

COMMENCED IN 2000

Sportif-III 4 11-00 Feb-06 Hill

Ivadbradine 1 11-00 Jan-06 Hill

Gusto-V 4 6-00 Feb-06 Hill

Presto 20 3-00 Jan-06 Hill

Carissa 0 (Study ceased by sponsor)

Cancelled by sponsor

Cancelled Hill

COMMENCED IN 2001

Prove-It 7 Jun-01 Apr-06 Hill

Oat 4 (closed recruitment)

Nov-01 Oct-10 Hill

Expedition 31 Nov-01 Feb-06 Hill

COMMENCED IN 2002

Open-Label Overture

7 Feb-02 Mar-06 Hill

Adonis 1 Feb-06 Feb-06 Hill

Interheart 7 Feb-02 Feb-06 Hill

On Target 45 May-02 Jul-08 Hill

Transcend 2 May-02 Mar-09 Hill

Synergy 11 Apr-02 Apr-06 Hill

I-Preserve 4 Aug-02 Jul-08 Hill

COMMENCED IN 2003

Extract Transfer site only Jun-03 NA Hill

HAT 49 Jul-03 Sep-07 Hill

Oasis 5 11 Jan-04 May-06 Hill

Active 31 Jul-03 May-09 Hill

Phase I 0 (Study ceased by sponsor)

Cancelled by sponsor

Cancelled Hill

COMMENCED IN 2004

Revive 1 Mar-04 Apr-06 Hill

Universe 4 May-03 Apr-06 Hill

Chablis 6 Mar-04 May-06 Hill

COMMENCED IN 2005

Apex 6 Jan-05 Aug-06 Hill

Early ACS Transfer site only May-05 May-06 Hill

MAIA 6 Jun-05 Jun-06 Hill

Beautiful 5 Aug-05 Aug-09 Hill

TIMI 38 8 Aug-05 Sep-07 Hill

Adduce 4 Aug-05 Apr-06 Hill

COMMENCED IN 2006

Acacia 45 Feb-06 Aug-07 Hill

ZoMax II 13 Jan-06 Dec-11 Hill

Freedom 4 Aug-09 May-12 Hill

COMMENCED IN 2007

Champion 19 Jan-07 Jul-09 Hill

Plato 21 Apr-07 Jun-09 Hill

Red-HF 0 May-07 Mar-09 Hill

Cardiome 0 Sep-07 Aug-09 Hill

Protect 35 Aug-07 Ongoing Hill

Freedom 2 0 Oct-07 Oct-08 Hill

Shift 0 Oct-07 Aug-09 Hill

Rocket 1 Aug-08 Jun-09

Dionysos 0 Mar-08 Jul-08 Hill

COMMENCED IN 2008

Roche 18 Dec-08 May-12 Hill

COMMENCED IN 2009

Atlas 2 16 Apr-09

Jun-11 Hill

Alphee 1 Sep-09 Apr-11 Hill

Averroes 2 Mar-09 Ongoing Hill

COMMENCED IN 2010

Artemis 0 Jun-10 Oct-11 Hill

COMMENCED IN 2012 Respond CRT 4 Sep-12 Ongoing Hill

Committee Membership, Professional Recognition 1998-2006, 2011-12: Abstract Review Panel, Heart Rhythm Society 2001-2003: Abstract Review Committee, Cardiac Society of Australia and New Zealand 2004-2014: Literature Review Panel, Journal of Cardiovascular Electrophysiology 2004-5: Medical Advisory Panel to MSAC for generation of appropriate HIC item number listings in relation to Implantable Loop Recorders 2013: Literature Review Panel, Heart Lung and Circulation

Leadership

1. RAAF Officer Training and Service experience as a uniformed then reservist military doctor was preparation for and remains background to managerial service contribution to Princess Alexandra Hospital.

2. Since appointment to Princess Alexandra Hospital in October 1995, the role of de

facto deputy director of the Cardiology Department has required administrative, teaching and counseling activities additional to expanding clinical activities. This supporting role has facilitated the considerable growth of the Department commensurate with the requirements of Cardiac Surgery which commenced at Princess Alexandra Hospital in 1998.

3. Although I have considerable experience with all types of cardiac procedures

(excluding only coronary angioplasty and stenting), the purpose of my employment as a trained cardiac electrophysiologist was to bring to Princess Alexandra Hospital the specialized skills and technology required for the modern management of heart rhythm disorders. Since the patient with a heart rhythm disorder often has other serious cardiological problems, including especially heart failure and coronary artery disease, their care is necessarily wide in scope. After expending much effort in planning and organization, I commenced permanent pacemaker implantation at Princess Alexandra Hospital in April 1998, together with pacemaker outpatient clinic activity. In May of the following year, I commenced implantations of automatic cardioverter/defibrillator devices (ICDs). Initially, considerable time, effort and patience were invested in assuring the cohesion of operating theatre staff, radiographers, anaesthetists, cardiac scientists, device manufacturers and coronary care nurses. Ultimately this produced educational opportunities for all concerned, and impressive experiences for the patients. This type of integrated activity required for pacemaker services at Princess Alexandra Hospital can serve as a paradigm for co-operation between medical disciplines.

My loyalty and patience were tested severely under conditions of irregular financial support, by accounting variables and by ideological differences in some areas. However, the pacemaker service continued to operate and grow beyond these problems. Responsibility is now assumed by that service for the large catchment of patients including the southern half of Queensland and extending to parts of northern New South Wales. Trans-telephonic pacemaker checks extended from Princess Alexandra Hospital to regional hospitals in all of these areas, including the Gold Coast Hospital, in 2001. Remote monitoring of pacemakers and ICDs by internet (“telehealth” par excellence) commenced under my direction in 2011. The pacemaker follow-up clinic is now supervising over 4000 patients, in-person, by internet or by telephone. The pacemaker service has complication rates as low as any in the world and has been subject to continuous financial audit. Its cardiac scientists have been trained to a high standard coveted internationally. I constantly encourage them to maintain their enthusiasm and precision.

4. In September 1998, after acquisition of appropriate laboratory equipment and catheter

inventory, I commenced invasive procedures for diagnosis of arrhythmia (cardiac electrophysiological studies – EPS) and for cure of arrhythmia (radio-frequency ablation – RFA, and cryo-ablation). Again, as in the case of pacemaker-related services, this technology and expertise were implemented where none had existed previously, and for the first time a new educational ‘window’ had been opened to mechanisms of arrhythmia, with natural segues to scientific assessment of patients who may require a permanent pacemaker. For all types of arrhythmia treated by RFA at Princess Alexandra Hospital, the overall cure rate has exceeded 90% consistently, with very low complication rates. These results again rank with the best available anywhere.

5. In 2004 I was involved as consultant in the specification and tender processes for new

cardiac catheterisation laboratories at Princess Alexandra Hospital and Gold Coast Hospital. I was also involved in the planning for new electrophysiological monitoring systems, and proposed deployment of the new technologies of 3D mapping and cryo-ablation for arrhythmia procedures at Princess Alexandra Hospital. Development of the Cardiac Electrophysiology and Pacing Service continues. There are now effectively 2.2 FTE consultant staff responsible for:

Approximately 200 ablation cases per year. Cryo-ablation technology has been implemented successfully in 2005, with safety and accuracy benefits for patients requiring ablation near the AV Node. Non-fluoroscopic mapping equipment has been evaluated and deployed, expanding further the scope of ablation procedures to include potentially curative procedures for atrial fibrillation.

Approximately 580 pacing/ICD device procedures per year, including bi-ventricular pacing devices for palliation of heart failure.

Involvement as Principal Investigator in the Micra (sole Australian site) and Leadless II phase II international clinical trials of leadless pacemakers from March 2014, so that by the end of 2014 PAH became the leading Australian centre for application of this technology to patients..

Device Timing Clinic with echocardiographic optimization of pacemaker/ICD AV and V-V timing cycles to maximize cardiac performance established and run by myself since 2005

Outpatient and Inpatient Arrhythmia consultations

6. Clinical Governance of the Arrhythmia Service

7. Critical involvement in the implementation of automatic external defibrillators on Princess Alexandra Hospital wards in 2001, with specialized consultancy insisting on employment of the most efficient and practical devices available. These devices represent the most significant advance in 40 years of external defibrillation technology, and their superiority over older devices is being demonstrated in terms of better survival of cardiac arrest in hospital.

8. From 1999 to 2006, Visiting Cardiologist to Redlands Hospital, cardiological referral

centre for Princess Alexandra Hospital. My work there involved education and maintenance of clinical standards in High Dependency and outpatient settings, with provision of specialised and timely consultations and facilitation of triage and transfer of cardiological patients.

9. In the planning of future projects there is recognition of the importance and interactions

of the dual medical epidemics of heart failure and atrial fibrillation. Elements of this planning include:

growth of the arrhythmia service to address its educational and procedural demands, which are increasing rapidly. This growth includes establishment of an EP-Pacing fellowship. The first such fellowship position was filled at Princess Alexandra Hospital in January 2007.

development of research into selection of candidate patients and techniques for alternate-site permanent pacing, particularly as they apply to heart failure. These pacing procedures commenced in 2002 at Princess Alexandra Hospital.

development of expertise in the management of imaging processes and ablation strategies for atrial fibrillation. Consecutive left atrial ablation procedures designed for cure of atrial fibrillation commenced in October 2006 at Princess Alexandra Hospital.

clinical research focused on new pharmacological approaches for cardiology, arrhythmia and heart failure.

10. Elected Chair of the Queensland Health Southern Clinical Cardiac Network in May 2009. Supervision of the following achievements:

Ongoing decentralisation of cardiac services by implementation of the “Healthy Hearts” budget

development of local leadership

sharing of resources / training

tracking of funding - positions, services, equipment, outcomes

7 SQ Cardiac services upgraded (cardiologist, echo, HF, CR) at Ipswich, QEII, Logan, Redland, Toowoomba, PAH, GCUH

Cardiac Outreach Clinics – monthly visits to Roma, Goondiwindi, Kingaroy and Cherbourg, MSOAP funding

Indigenous Health Worker Education Package development

Adoption of Patient Transfer Criteria to PAH – prioritisation, categorisation

Standardisation of Clinical Competencies for Cardiac Nurses

Implementation of Echo standards for imaging and reporting, now adopted statewide

Site Mapping Report, released 2010, identifying service gaps

2009 formal SQ Cardiology Site Visit Evaluation 2010 Mapping Report released - identifying gaps 2011 audit of ACS resources across all facilities in SQ Improvement of Nursing Clinical Skills promoting evidence-based care

- addressing the learning needs of nurses at all levels and in all working environments

Strategy - Project officer - SQ Nurse Education Working Group - broad consultation across Southern Qld

Outcome

15 Standardised evidence-based Cardiac Clinical Skills Assessments for Registered Nurses, completed in 2009.

Sponsorship of Echo Work Group - Image sharing - improving access / referral system - maintaining standards - sustainability - recruitment / training Education

Heart Failure DVD

Patient education is a vital component of CHF-MPs

What do patients with CHF need to know?

What are patients with CHF preferences for information delivery?

Focus on self-care behaviours

New focus in 2010-2014:

Clinical Practice improvement

1) ACS 1. Pathway promulgation 2. Development of Emergency Coronary Reperfusion Strategy for

Metro South Area 3. Audit of Southern Zone ACS Resources 4. ECG interpretation by doctors

2) Indigenous – Close the Gap 3) EP-Pacing

Satellite Arrhythmia Clinics: inception and ongoing:

• To improve non-metropolitan patient

access to Heart Rhythm procedures which improve quality of life and enhance survival Strategy

• Establish ‘satellite’ outpatient clinics staffed by Cardiac Electrophysiologists from PAH visiting Toowoomba, Ipswich and Logan

• Employ additional 0.2FTE Cardiac Electrophysiologist at PAH Expose more patients to the full range of arrhythmia procedures – - implantation of devices: pacemakers, ‘cardiac re-synchronisation therapy (CRT)’, cardioverter/defibrillators (ICDs), loop recorders (ILRs)

- electrophysiological study (EPS) - potentially curative ablation therapy Other Benefits • Improve collaboration, support local staff • Spread expert knowledge • Develop interest, familiarity and experience • Improve continuity of care • Reduce unnecessary patient travel

Cherbourg Cardiac Outreach Clinic

An investigation of the issues related to service improvement of the clinic. 1) Nurse Education 2) Post-discharge follow-up 3) Rehabilitation: referral KPI, facilitated discharge, COACH

Southern Qld ACS Audit Assessing the ability of all SQ facilities to achieve best practice in Acute Coronary Syndrome management.

ECG interpretation for junior doctors: inception and ongoing - Contribute to the improvement of these vital skills. - 13-week structured course - Developed by cardiac scientists with my support and supervision - 30 minute sessions: first half didactic, second half interactive - Broadcast to all Queensland Health hospitals by videoconference, archived for

later reference

Emergency Reperfusion Strategy for Metro South

Devised the practical architecture and protocols in collaboration with Emergency, Cardiology and QAS at multiple facilities

11. Election to QPACT Committee for statewide evaluation of new health

technologies in March 2009; QPACT has nationwide secretariat in 2011. Facilitated introduction of laser-assisted lead extraction for patients with cardiac pacemakers and ICDs at TPCH.

12. Election to SQACT Committee 2009 for Southern Zone evaluation of new health technologies

13. Election to Chairmanship of the Electrophysiology and Pacing Working Group of the

Steering Committee of the Statewide Clinical Cardiac Network in November 2009. The Group functions to provide Queensland Health (QH) with ongoing direct expert opinion and accurate data concerning management of heart rhythm disorders (arrhythmias), to discuss particular challenges in this field as they relate to QH patients now and in the future, and to serve as a potential structure for collaborative research.

Activity mapping and analysis in its Report of May 2010, of which I am the author, identify the following issues:

1. Infrastructure deficiency; inadequate laboratory time resources

2. Inadequate number of workforce; work practices including duties unrelated to arrhythmia and too few cardiac scientists employed or in training.

The interwoven issues related to present and future funding, technological advances and the increasing requirement for procedures for patients with atrial fibrillation (AF) were discussed in detail. This Report can serve as a reference for statewide planning in relation to cardiac electrophysiology.

14. Election to Novel Anticoagulants (NOACs) multidisciplinary committee (2012) to generate and update guidelines for perioperative usage of these agents at PAH.

15. 2013-4: Chair of ECG Rapid Transmission working group and the Electrophysiology Data working group of the QH Cardiac Information Solutions Program.

27 December 2014