Pulmonary and Cardiac Exercise and Education (PACE): Developing a flexible service model to meet community needs

Ms Emma Ghys1, Ms Roslyn Bloomer1, Ms  Fiona  Miller2, Ms Leeah  Cooper3, Ms Julie Blake4

1Alpine Health, Alpine Shire, Australia, 2Kiewa Valley Sports and Spinal Physiotherapy, Kiewa Valley, Alpine Shire, Australia, 3Equilibre Health, Ovens Valley, Alpine Shire, Australia, 4Ovens Valley Physio and Pilates, Ovens Valley, Alpine Shire, Australia

Background: The Alpine Shire in North East Victoria has heart attack rates double many metropolitan areas and Chronic obstructive pulmonary disease (COPD) is one of the top three causes of hospitalisation. As one of Victoria’s most remote regions, barriers to accessing cardiac and pulmonary rehabilitation includes; accessibility of transport, large travel distances (often >200kms return), unique mountainous geography across the shire, no local service provision, no flexibility in current public rehabilitation services and possible low referral rates.

The solution: Alpine Health, a public health service, collaborated with three private allied health providers and developed the “PACE” program (Pulmonary and Cardiac Exercise and Education).  PACE is a locally responsive model of care that encompasses innovative best practice with an expanded flexible scope, optimising local health practitioners’ expertise. The program is provided three times per week, one day in each town: Myrtleford, Bright and Mt Beauty. The PACE program offers a rolling program i.e a participant can enter at any point and will complete an eight week cycle. This model offers flexibility to clients via location, home or centre based programs. Clear and simple referral pathways were developed, and connecting participants with community based services after discharge is prioritised.

Outcomes: A local combined cardiac and pulmonary rehabilitation program has been established to meet the needs of the local community where there was previously no service. In the first eight months of the program, 130 referrals were received and 70 participants have completed the program between March and December 2018. Key to the success of this model of care has been the public/private partnership. The strength of this approach has been evident in the flexibility offered to participants, continuity of care and good working and personal relationships between professionals. Partnering with private organisations has many benefits including; utilising a highly skilled local workforce, opportunity to continue and expand working relationships, continuity of care with participants and shared vision with a client centred approach. The proven need for locally based solutions for health services in remote communities, is one that the team will continue to advocate for and support other regions in developing.


Roslyn Bloomer started her nursing career in 2 of the major hospitals in Melbourne. Her first few years spent in neurosurgery and cardiothoracics, and then the flowing 8years she worked in Emergency achieving her postgraduate studies in critical care nursing. She and her husband then decided it was time for a tree change to start a family. Following their move to the “country” she continued her role in emergency nursing at Albury Base Hospital, building on her knowledge of emergency health as well as further developing an understanding of the complexities facing rural health. Recently she was afforded the opportunity to be part of a fantastic  team assisting with the development and implementation of The Pulmonary and Cardiac Exercise and Education (PACE) Program. She has loved being part of such an enthusiastic group of health professionals and such a dynamic innovative program that is making such a huge and holistic difference in their patients lives.

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