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Heart, Lung and Circulation

The Last Mile: Improving Patient Outcomes within Modern Cardiovascular Medicine

  • Derek P. Chew
    Correspondence
    Correspondence address: Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5042, Australia. Tel.: +61 8 8404 2001; fax: +61 8 8404 2150.
    Affiliations
    Roy and Marjorie Edwards National Heart Foundation Senior Research Fellow, Adelaide, S.A., Australia

    Cardiovascular Outcomes Research, Flinders University, Adelaide, S.A., Australia

    Cardiovascular Medicine, Flinders Medical Centre, Adelaide, S.A., Australia
    Search for articles by this author
      It is now well recognised that, in many areas of medicine, substantial gaps in clinical care exist despite robust clinical trial data and the careful assimilation of this information into clinical practice guidelines. Those at greatest risk are patients presenting with multiple co-morbidities, and those with advanced age in whom the issues of complexity and limited time available for careful assessment, potentially lead to sub-optimal clinical practice and outcomes. Greater efforts are needed to move the acquired knowledge across the “last mile”, that is from clinical guidelines and best practice to nationwide routine practice. This article will discuss some of issues faced in operationalising “clinical effectiveness” in cardiovascular care in Australia.

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