What is XTend?

‘XTend’ is a pilot project offering patients at Royal Prince Alfred Hospital a new service where community health workers in conjunction with the cardiac chronic care nurses manage the ongoing care of heart failure patients on discharge and link them with their GP and other community services.

The goal is to improve patient health outcomes and reduce readmissions. The service provides home visits on discharge within 2 working days to address the following:

  • Medication confusion/ issues
  • Reengagement with the GP
  • Any issues that can impact patients ability to manage their health at home

Who is eligible?

  • Patients with a diagnosis of heart failure who are discharged home from the cardiology and geriatric services at Royal Prince Alfred Hospital.

What happens during home visits?

  • Conduct a general assessment to identify any issues at home
  • Assist with arranging a GP appointment
  • Make a list of the patient’s current medication to take to the GP for review
  • Record any questions the patient has for the GP
  • Review vital signs

Who performs the home visits?

  • Community health workers (AIN Certificate III) supported by the cardiac chronic care nurses

For any queries please contact the XTend Project Officer, Rachel Thistlethwaite, on 9515 9579 or the XTend Project Manager, Julie Finch, on 9515 9890.