People who have autoimmune diseases and inflammation related arthritis are getting faster care through a new nurse-led rheumatology clinic at Canberra Health Services.

Prior to the clinic, the longest wait time was 1,875 days, it’s now down to 175 days. This work is so successful other states want a slice of the ‘clinical action’.

As the only rheumatology advance practice nurse working in Australia, Biljana Zeljkovic is key to this success.

Biljana assesses and manages patients who are medically and clinically stable and need regular care, which helps free up the specialist’s time for more complex cases.

‘We needed new ways of assessing and managing chronic disease and long-term conditions, particularly in looking at how nurse expertise can improve access to patient care,’ Biljana said.

‘By doing research like this we can learn about diseases, patients, and treatments. We can also improve the patient and carer experience and provide the best evidence-based care to our patients’.

Biljana has worked with Canberra Health Services for 24 years and has more than 10 years of nursing experience in the field of rheumatology. The best part about Biljana’s collaborative clinical and research work in this field is the significant reduction in waiting times, leading to faster patient access to exceptional health care and achieving high levels of patient satisfaction.

The research and evaluation needed to put this clinic into practice was made possible by being part of an ACT Government investment to reboot rheumatology health services, affected by the impact of COVID-19.

‘Some rheumatology referrals are considered a lower priority over other conditions and there can be long wait times due to a limited number of consulting specialists available. The COVID-19 pandemic exacerbated this challenge with longer waiting times,’ Biljana said.

Over a 12-week period assessing and managing non-urgent rheumatology referrals, 43 patients were discharged and removed from the waiting list. The longest waiting time was reduced from 1,875 days to 175 days. Also, there has been no need to re-refer patients, because of the high rate of satisfaction from patients surveyed* about the quality of care they received.

In fact, the program was so successful, hospitals in Sydney and Hobart have been in touch with Biljana to set up similar nurse-led clinics, and Biljana was also recently recognised for her work at the 2022 Australian Rheumatology Association’s Annual Scientific Meeting Awards.

Biljana said she hoped this work encourages teams across health services to work together to advocate for exceptional health care for our patients.

‘It’s well documented, that patients who have a rheumatology nurse in their care team have improved clinical outcomes and satisfaction with care.

‘In terms of research, my advice is to talk to your team. I’m very lucky to be part of the fantastic rheumatology team at Canberra Health Services.

‘Think about the challenges of your service and don’t forget to ask for help from other colleagues who have already done research.’

Nurse practitioners who specialise in this area are very limited, with only five working in the field and an estimated 50 rheumatology nurses in the country to support an estimated 1.7 million Australians with inflammatory arthritis.

*The patient satisfaction survey was developed in partnership with CHS Patient Experience Survey Coordinator, Karen Ramsden.

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