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Lymphoedema physiotherapists shine at awards night

Jennifer Azurin, Director of Physiotherapy, Calvary Public Hospital Bruce
25 July 2016

The ACT Health Allied Health Awards for Excellence are the most esteemed honour for allied health in the territory. In 2016, the Lymphoedema Senior Management and Clinical Team at Calvary Health Care Bruce received not only the Award for Allied Health Team Excellence, but also the Allied Health Professional/s of the Year Award.

The assessment panel noted the longstanding commitment of all team members to developing and evolving the service to where it is today, with the evidence clearly demonstrating the commitment of individual team members to the specialist field of lymphoedema.

Lymphoedema is caused by a failure of the lymphatic system that results in swelling of one or more areas of the body. It usually affects the arms or legs, although it may also involve the trunk, breasts, head, neck or genital area. If left untreated, the stagnant fluid can interfere with wound healing, cause affected areas to increase in size and result in complications such as skin ulcers, cellulitis and sepsis. Much of the team’s work involves preventing lymphoedema severely affecting people’s day-to-day lives.

‘If somebody has very significant swelling in their arm, they may lose dexterity in their hand and may not be able to wear clothing without modification. The weight of a heavy arm can also lead to musculoskeletal issues in the shoulder and neck,’ Gemma Arnold, Lymphoedema Service Coordinator and Senior Clinician, explains.

Many patients report improvements in swelling, reductions in limb size and fewer admissions to hospital for cellulitis after attending the service.

L-R: Karen Murphy (Chief Allied Health Officer, ACT Health) with award recipients, Pip Davies (Senior Palliative Care Physiotherapist), Lizzie Webb (Senior Lymphoedema Physiotherapist), Gemma Arnold (Lymphoedema Service Coordinator & Senior Clinician), Marie Coulombe (Senior Lymphoedema Physiotherapist), Jennifer Azurin (Director of Physiotherapy), Associate Professor David Hardman (Vascular Surgeon), Julie Hearne (Senior Lymphoedema Physiotherapist) and Ingrid The, APAM (Senior Lymphoedema Physiotherapist).

The lymphoedema service in the ACT had humble beginnings with no lymphoedema physiotherapists at Calvary Hospital and three part-time physiotherapists across other services. The hospital’s physiotherapy department submitted a proposal to establish a new lymphoedema service, as approximately 80 per cent of breast surgery, often resulting in lymphoedema, occurred on the Calvary Hospital campus at the time.

There is now a coordinated service with close collaboration between public and private lymphoedema practitioners.

The proposal led to the establishment in 2001 of a small but dedicated lymphoedema team at Calvary Hospital that serviced a multidisciplinary clinic, provided physiotherapy outpatient intervention and delivered monthly education sessions for clients at risk of developing lymphoedema. The team was made up of a vascular surgeon, a dietician, physiotherapists and a social worker or psychologist position. This was the first multidisciplinary service in the ACT with the capacity to manage complex lymphoedema.

After the service at Calvary Hospital reached full capacity, with up to an 18-month waiting list for outpatient services, the physiotherapy department led an ACT-wide Lymphoedema Service Review in 2011, which resulted in an unprecedented model of service delivery across the continuum of care. There is now a coordinated service across the two major public hospitals in Canberra, community health centres in the north and south, a respite facility at Clare Holland House and home-based palliative care, with close collaboration between public and private lymphoedema practitioners.

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Consumers put forward their stories during the service review, a powerful factor in the decision to expand the service.

‘The consumer voice is very important, particularly in lymphoedema where the condition doesn’t fit neatly into one medical specialty. Demonstrating good outcomes can inform and support improved services Australia-wide, as well as ensuring the future of our service,’ Gemma concludes.


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