This article has a correction

Please see: BMJ Open 2014;4

BMJ Open 4:e004137 doi:10.1136/bmjopen-2013-004137
  • Cardiovascular medicine
    • Protocol

Northern Territory Heart Failure Initiative–Clinical Audit (NTHFI–CA)–a prospective database on the quality of care and outcomes for acute decompensated heart failure admission in the Northern Territory: study design and rationale

  1. Alex Brown9
  1. 1Department of Cardiology, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
  2. 2Chronic Disease Coordination Unit, Department of Health, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
  3. 3Flinders Human Behavior and Health Research Unit, Flinders University, Adelaide, South Australia, Australia
  4. 4Heart Failure CNC—Top End, Chronic Disease Coordination Unit, Department of Health, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
  5. 5Division of Medicine, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
  6. 6Department of Cardiology, Darwin Private Hospital, Rocklands Drive, Tiwi, Northern Territory, Australia
  7. 7Flinders Human Behaviour and Health Research Unit (FHBHRU), Margaret Tobin Centre, Flinders University, South Australia, Australia
  8. 8Department of Preventative Cardiology, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
  9. 9Department of Indigenous Health, SAHMRI, Adelaide, South Australia, Australia
  1. Correspondence to Dr Pupalan Iyngkaran; balaniyngkaran{at}
  • Received 1 October 2013
  • Revised 30 November 2013
  • Accepted 4 December 2013
  • Published 29 January 2014


Introduction Congestive heart failure is a significant cause of morbidity and mortality in Australia. Accurate data for the Northern Territory and Indigenous Australians are not presently available. The economic burden of this chronic cardiovascular disease is felt by all funding bodies and it still remains unclear what impact current measures have on preventing the ongoing disease burden and how much of this filters down to more remote areas. Clear differentials also exist in rural areas including a larger Indigenous community, greater disease burden, differing aetiologies for heart failure as well as service and infrastructure discrepancies. It is becoming increasingly clear that urban solutions will not affect regional outcomes. To understand regional issues relevant to heart failure management, an understanding of the key performance indicators in that setting is critical.

Methods and analysis The Northern Territory Heart Failure Initiative—Clinical Audit (NTHFI-CA) is a prospective registry of acute heart failure admissions over a 12-month period across the two main Northern Territory tertiary hospitals. The study collects information across six domains and five dimensions of healthcare. The study aims to set in place an evidenced and reproducible audit system for heart failure and inform the developing heart failure disease management programme. The findings, is believed, will assist the development of solutions to narrow the outcomes divide between remote and urban Australia and between Indigenous and Non-Indigenous Australians, in case they exist. A combination of descriptive statistics and mixed effects modelling will be used to analyse the data.

Ethics and dissemination This study has been approved by respective ethics committees of both the admitting institutions. All participants will be provided a written informed consent which will be completed prior to enrolment in the study. The study results will be disseminated through local and international health conferences and peer reviewed manuscripts.

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