Clinical Excellence Showcase

The TCHHS ENT program adopts a generalist model of integrated specialist level care. This model allows our team to address the inequitable distribution of specialist level Ear, Nose and Throat services through remote Queensland, whilst also clinically supporting understaffed and under resourced primary health care centres. TCHHS ENT 2022:

Referrals received: 445

Occasions of Service provided: 1300+

Communities served: 32

Surgical Procedures performed Locally: 54

94% of care kept locally and provided on country (i.e % of patient care prevented from being referred onwards to tertiary referral centres)

Patient service satisfaction: (Check up Patient Reported Experience Measures Report)

89% of patients surveyed felt very safe with staff

89% of patients surveyed felt very respected by staff

89% of patients surveyed felt their emotional needs were completely looked after (eg: having family or people they knew travel with them)

89% of patients surveyed said their treatment was properly explained so they completely understood what was happening

89% of patients surveyed always felt included in decision-making about their treatment

100% of patients surveyed felt completely comfortable telling the staff about their health information

100% of patients surveyed would be likely to recommend this surgery service to family or friends

Internationally, there are over 200 Take Home Naloxone (THN) programs that provide opioid overdose prevention education and supply of naloxone, the antidote to an opioid overdose. However, prior to our project, it was fairly difficult for consumers to access these programs or where there was an intervention, no medication was supplied.

Staff in Metro North Health navigated our way to obtaining permission to supply naloxone and deliver opioid overdose prevention interventions (or THN for short) to consumers of alcohol and drug services. We trained all nurses within 3 large outpatient opioid treatment centres (some of the largest in treatment clinics in Australia) to be able to deliver the intervention. And across a pilot period during COVID-19, we were able to deliver 100 life-saving interventions to our consumers. This resulted in 4 lives saved during the pilot period.

The Women’s and Children’s service at the Sunshine Coast University Hospital is applying choosing wisely principles and best evidence-based practice to provide targeted surveillance for the high-risk population of very preterm and very low birth weight infants. We have transformed a low value, high volume blanket follow-up pathway into a streamlined prioritised model of care focused on providing early detection of adverse neurodevelopmental outcomes and excellence in service delivery for our families impacted by preterm birth. Implementation of our results enables reduction in expensive time-consuming follow-up of infants with a high chance of a typical outcome, allowing targeted follow-up based on prognostic outcomes (very low, low, moderate and high risk of developmental delay).

We have managed to embed a physiotherapy outpatient clinic within a Queensland Correctional facility. We are not aware of another at this stage. In recent years Queensland Health has become responsible for all on-site prison medical centres. The High Security Woodford Correctional Centre -- which is one of few with a Maximum-Security wing – has become part of the CKW health service. Thus far Physiotherapy services to Woodford have required individual inmates to be transported to unsecured outpatient areas in Caboolture Hospital. This at great cost, Woodford and Queensland Health resources, logistical and inherent safety issues and resultant low attendance. 38 clients accessed service over 16 weeks with 1–5 appointments each. Inmates in all facility areas including maximum-security unit the accessed service. All client respondents rated service good/very good. 100% said service met their needs. The project was a success on all measures and funding has been provided for a one day per week physio clinic to continue within our prison health centre.

Research indicates that good healthcare for adolescents and young adults (AYA) differs from paediatric, adult and geriatric care, and that the design and delivery of AYA appropriate care is in its infancy. To address the gap in understanding what good AYA healthcare looks like for West Moreton youth, a Youth Advisory Council (YAC) was established in 2021. West Moreton Health (WMH) launched its inaugural YAC with members aged 16 to 30 years. The YAC includes young people from diverse cultural backgrounds, socio-economic backgrounds, health service needs and four members residing at the BYDC.

Gaining more weight than recommended and poor nutrition in pregnancy are key risk factors for the development of metabolic disease such as gestational diabetes mellitus (GDM), hypertension and obesity in mothers and future metabolic disease in offspring. Dietary counselling and weight monitoring are effective at improving nutritional intake and reducing weight gain above recommendations. However, women classified as being above a healthy weight before pregnancy experience greater barriers to achieving nutrition and weight gain recommendations, have a lower confidence to achieve health goals and require more intensive support. A face-to-face model of care to reduce gestational weight gain (GWG) in women living with a body weight above recommended at our metropolitan tertiary hospital was poorly attended, and less than 10% of eligible women were referred. We used implementation science principles and existing evidence to address existing barriers to care to develop and implement an evidence-based nutrition service into routine antenatal care for high-risk women.

Retinopathy of Prematurity (ROP) is a retinal disease affecting premature infants and remains one of the leading causes of childhood blindness world-wide. The early detection and treatment of severe disease is crucial to prevent vision loss, however screening is difficult due to lack of manpower and subjectivity of diagnosis. Our project aims to determine whether ROP.AI, an artificial intelligence algorithm developed to detect features of severe ROP, can perform as well as five expert ophthalmologists from across Australia. We found that ROP.AI was able to detect severe ROP with high sensitivity (84%) and negative predictive value (96%) compared to expert ophthalmologists. These findings demonstrate the vast potential ROP.AI holds to alleviate current limitations in ROP screening. Further algorithm training and prospective evaluation may see it be implemented as a decision support tool in the very near future.

We developed the Allied Health Demand and Capacity Management Tool (AHDC) on the System View platform (Healthcare Logic).

The tool allows for real-time visibility of patient demand for acute allied health services and the capacity (FTE) of allied health professionals to meet that demand. Additionally, it provides an 'Executive View' dashboard that shows demand and resourcing allocation across two hospital sites and identifies allied health responses to demand (reallocation, prioritisation, trends analysis).

After 18 months of profession group trials and collecting clinical consumer feedback, The AHDC tool has been implemented into business as usual across six allied health professions (physiotherapy, occupational therapy, psychology, social work, speech pathology, and nutrition) working within the acute medical units. Staff have reported that the AHDC tool is quick and easy to access, use and navigate. The tool has benefits for patients, clinicians, and management as it ensures that patients receive the right services at the right time. By providing a coordinated approach to managing the demand for allied health services, the tool is improving patient outcomes and increasing the efficiency of allied health resource allocation.

You may be aware either personally, or professionally of the electrocardiogram or ECG, which is used to measure various electrical properties of heart. In psychiatry, many of our medication uniquely affect the intrinsic timing of the heart's electrical system and its especially important to monitor these readings when commencing or changing mediations.

However, until recently, this level of community monitoring was difficult, especially in a region such as a far north Queensland where the sheer size and remoteness of the communities we serve often act as barriers to health care access and equity.

However, there is a new, game-changing, ultra-portable Bluetooth ECG device which is both medical grade and approved by the Australian Therapeutic Goods Administration (TGA) and FDA in the USA.

This new device delivers a digital six-lead ECG in just 30 seconds, without the need for invasive procedures, sticky dots or leads, and can be completed with the patient clothed. Its ultra-portable design measures only 10cm by 5cm which makes it easy to use in a variety of clinical settings and can be easily distributed to community teams!

What makes this device more compelling is that it only cost $300. We think this is a game-changing device and has the potential to revolutionise the way we deliver healthcare to rural and remote areas where access to traditional ECG machines and routine cardiac monitoring is limited and will deliver significantly improvements in the screening and detection of cardiovascular risk for psychiatric patients.

Bookings and Referrals Centre (BARC) staff receive approximately 2,500 phone calls per week. To address all these different types of enquiries, the team previously had to access more than seven distinct systems, making the provision of patient care inefficient and slow. This led to the design of our solution, Kirra, which replaces these multiple systems previously needed to manage outpatient waitlist and bookings with a single, fully integrated web application. Efficiency gains to meet service demand: Streamlined and automated processes to release workforce capacity to enable our staff to work at top of scope and return time to care.