WFH NETWORK

Australia

Country: Australia
City: Melbourne

IHTC:
Ronald Sawers Haemophilia Centre
The Alfred, Level 1 South Block
Commercial Road
Melbourne Vic 3004
Tel.: (61) 3 9276 2179
Fax: (61) 3 9276 3021
Email: haemophilia@alfred.org.au
Website: www.alfred.org.au 

Director: Prof. Huyen Tran


Medical Associates: Dr Mandy Davis, Dr James McFadyen, Dr Zane Kaplan, Dr Anne Powell, A/Prof. Carolyn Arnold, A/Prof. Edwina Wright, Dental: A. Prof Ian Hewson
Fellowship logistics coordinator: Penny McCarthy / Megan Walsh Clinical nurse consultants haemophilia@alfred.org.au
Year of IHTC designation: 2005

Areas of specialty: Adult hematology; Laboratory Diagnosis and hemostasis; Orthopedic care and surgery; Nursing; Dental care; Blood banking; Psychology; Social work

DESCRIPTION OF IHTC FACILITIES

Location: Melbourne has been voted recurrently as the most livable city in the world. The Alfred Hospital is located close to the central business district (CBD).

Climate: Summers are usually hot and dry while winters are usually cool and wet. Spring and autumn are very pleasant times to be in Melbourne.

Accommodations: Local, good quality student accommodations available. Fellows with special requirements are requested to make this clear before arrival so that we can try to accommodate their needs.

Language: English, Vietnamese, and Hebrew

DESCRIPTION OF TRAINING PROGRAM

Clinical activities: The trainee will be involved with all aspects of our clinical work, including daily ward rounds, weekly outpatient clinics (frequency depends on discipline), case discussions, haemophilia care plans in preparation for procedures, and multidisciplinary clinics. The centre currently cares for 948 patients registered with inherited bleeding disorders, approximately 150 of who are classed as “severe”. Many patients are referred to the centre for evaluation and management of bleeding disorders, including rare types. We have large cohorts of patients with von Willebrand disease, factor XI deficiency, and platelet disorders but also rarer bleeding disorders such as factor VII, factor V and factor XIII deficiency. Our consultative service provide advice for diagnosis and management of acquired bleeding syndromes such as DIC, acquired factor deficiency, pregnancy-, anticoagulant- and liver-related bleeding in the context of a quaternary teaching hospital with numerous subspecialties.

Children and adolescents 18 years and younger with bleeding disorders are cared for by the Royal Children Hospital (RCH), that is co-located in Melbourne (Parkville). A transfer model is being established between our two centres. Arrangements could be made for IHTC fellows to visit RCH during their stay in Melbourne with advance notice if desired.

Laboratory activities/research: The coagulation haematology laboratory is very experienced in the performance of diagnostic tests in the evaluation and management of new and existing bleeding disorders. The blood bank plays a significant role in the management of inpatients including the provision continuous factor concentrate replacement.  The routine haematology laboratory ably supports both of these sections. Clinical and laboratory haematologists interact seamlessly to discuss results of complex cases that are referred to the centre. Advanced trainees in haematology are encouraged to be actively involved in the process.

Multidisciplinary activities/research: We apply the model of comprehensive care to all patients with inherited bleeding disorders. Our team currently comprise of four haematologists, one pain medicine specialist, one rheumatologist, two clinical nurse consultants, one physiotherapist (part-time), one infectious diseases physician, one dentist, two social workers, one data manager, and a secretary.

Medical clinics are conducted separately. The team meets once weekly to discuss inpatient, surgical and outpatient care plans for that corresponding period. Once a month we run a combined multidisciplinary clinic for patients with multiple complex medical issues. The co-location of team members readily facilitate communications thereby enhancing patient care. All team members are able to make direct cross referrals to each other.

Our model of comprehensive care enables patients to receive care from knowledgeable experts, and also enables therapies to be instituted quickly.  We coordinate in- and out-patient care, support home therapy, educate patients, families and communities, and collect data and conduct audits, research to improve care.  All of this improves mortality and reduces hospitalisation rate and cost with aggregation of services. 

Research: The unit encourages research. We have explored the minimal use of factor concentrate in patients with bleeding disorders undergoing dental work and non-high risk endoscopies. We are involved clinical trials that aim to evaluate long-acting factor concentrates in haemophilia, and novel hepatitis C therapy. We are exploring participation in a gene therapy trial for haemophilia B.


Updated July 2014