Clinical Excellence Stories

Going from the warm, low-stimuli environment of the uterus to the bright, loud and vibrant world is a drastic change for newborns. However, when they are pre-term, it can also prove to be sight-threatening.

Retinopathy of Prematurity—or ROP—can occur in babies who are born early or weigh less than three pounds at birth. It causes abnormal blood vessels to grow in the retina, which can cause scarring that ultimately turns sight-threatening.

While a scary prognosis, ROP is highly treatable and thanks to the work of Dr Shuan Dai and the team at Queensland Children’s Hospital, they are expediting diagnosis and treatment for our littlest Queenslanders.

There are many Retcam devices across the state which are used to diagnose ROP, however Dr Dai saw a way to enhance support to smaller regional facilities to improve access to specialist consults via telehealth.

By networking the devices, this game changing partnership with places like Townsville Hospital and Health Service drastically expedites access to treatment and reduces the need to transfer babies and their families to other facilities. Saving money and sight in the process!

The power of data within the healthcare system is limitless. It helps us inform what services are required, where care should be provided and areas that need additional investment.

Noticing a gap in the way their work was captured in the Consumer Integrated Mental Health and Addiction (CIMHA) application, Metro South Hospital and Health Service’s Way Forward team worked closely with their information system manager to better describe what they do and enrich the data.

And in the process, drastically improved the care they were providing.

The Way Forward team provide culturally secure mental health and addiction services to the First Nations community across the entire health service. Combining best practice care and acknowledging the cultural rights and values of the community, they support their consumers to access care and psychosocial supports, in addition to fostering connection within the community.

While the breadth of their work could only be recorded in CIMHA as ‘cultural support’, by enabling the system to capture more detail, they now have a clearer picture of the work they do. Helping them to better advocate for more resources and support within the system and tailoring their services to the most at-risk areas.

And that is just the beginning.

Queensland is leading the way globally in vestibular care, all from the small but mighty team at Metro South Hospital and Health Service’s Complex Vestibular Service. Based within Logan Hospital’s Integrated Ear Nose and Throat Service, it combines three different allied health led models to provide holistic care for their consumers.

Dizziness and balance disorders account for roughly four per cent of presentations to Emergency Departments (EDs) in Queensland public hospitals. Seeing a gap in the care provided to people living in rural and remote Queensland, Service Director Associate Professor Bernard Whitfield and Advanced Vestibular Physiotherapist Leia Barnes invented Dial-a-Dizzy.

This telehealth model provides support to rural and remote EDs, diagnosing the cause of the dizziness or vertigo and putting patients on the most appropriate care pathway. Not only is it expediting treatment, but it is also reducing unnecessary medevacs to tertiary centres.

The broader service also includes two innovative pieces of technology—an immersive virtual reality balance assessor and a multiaxial rotational chair—to provide end-to-end care for their consumers and alleviate their symptoms.

The only virtual reality assessor in a public hospital in the Southern Hemisphere, the assessment not only pinpoints the bodily systems causing the dizziness but improves treatment for patients. While the chair can usually cure BBPV, or Benign Paroxysmal Positional Vertigo, in just one treatment.

It is three models and two pieces of technology that lead to one pioneering service!

Persistent pain is a silent, debilitating health issue which affects more than 1 million Queenslanders. By the middle of the century, that number is expected to rise by more than 50 per cent.

Defined as pain which lasts for a period of three months or more, many factors lead to and continue the pain, making it difficult to effectively diagnose or manage.

Supported by the Statewide Persistent Pain Clinical Network, Cairns and Hinterland Hospital and Health Service piloted the Fast Track Pain Management Service to improve access and provide better care for rural communities in the surrounding areas.

Taking a multi-disciplinary approach, the Cairns based team provided outreach services across the Tablelands, Douglas Shire, Cassowary Coast and Yarrabah to educate Primary Care providers and consumers on pain and support them to implement strategies for ongoing management.

From a reduction in presentations to Emergency Departments to improving support for local General Practitioners, the service not only improved access to pain services in rural areas but also provided a drastic benefit to the broader system.

And most importantly, it empowered consumers to take their lives back.

Trigger warning: this content contains frank discussions of mental health and suicide. If you or someone you love needs support, please contact Lifeline Australia on 13 11 14 or Beyond Blue on 1300 224 636. Additional crisis supports are available on the Queensland Mental Health Commission website.

Stigma: a mark of shame or discredit associated with a particular circumstance, quality, or person.

When applied to mental health, the resulting trauma not only has a negative impact on someone’s wellbeing but also creates a potential barrier to accessing much needed care and support.

When moving into a lived-experience role within Mackay Hospital and Health Service’s (HHS) Division of Mental Health, Alcohol and Other Drug Service, Debbie Lattimore was asked to deliver a presentation about stigma to the local Emergency Department. It was in that moment, that the Shatter the Stigma campaign was born.

Over the following four years, Debbie delivered the presentation to over 2000 people, having such a great impact they started producing T-shirts and pledge cards in support of shattering stigma. As the campaign started to grow in prominence, the team at Wide Bay HHS approached Debbie about implementing something similar locally.

From that spark in Mackay, the campaign exploded across Wide Bay, with people unable to walk through a facility without seeing some form of shatter the stigma messaging. Not only does it let patients know that they are safe and welcome, but it has also created an environment where staff feel valued and protected to seek help without judgement.

What started out with T-shirts and pledges has grown to champions networks and executive support which is driving grassroots change that is transforming their entire service into a stigma free zone.

Stigma affects all of us, so join the campaign to Shatter the Stigma and be the change we need.

Links

Mackay HHS website

Wide Bay HHS Shatter the Stigma campaign page

Wide Bay HHS website

Shatter the Stigma Improvement Exchange listing.

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Rheumatic Heart Disease (RHD) is an entirely preventable disease affecting the delicate valves of the heart. While it has been eradicated in the majority of the Australian population for over six decades, it is sadly still prevalent in our First Nations’ communities. Once a person has developed Acute Rheumatic Fever (ARF) or RHD, they require a painful monthly injection until they are 21 years of age or for 10 years to avoid ARF recurrence or further damage to the heart.

While their peers are out playing at the park, drawing or visiting the far-flung worlds of their imagination, this group of children face the fear and trauma of visiting a large sterile building to receive life-saving needles. And not just any needle, a very big, very painful needle.

The consequences of not getting their regular LA Bicillin injections are dire, with the medication helping maintain heart health and prevent possible open-heart surgery or even death.

Knowing the importance of getting things right from the start Clinical Nurse Consultant Erin Ferguson saw the importance of engaging these children and involving them in their care. Instead of being restrained or having clinicians become frustrated when they were scared, children didn’t care if the person was good at giving needles, they just wanted clinicians to be nice and for their voice to be heard.

In partnership with paediatric cardiologist Dr Ben Reeves, Erin extensively partnered with consumers to design a model that now helps children choose how they want to receive the injection and how best to distract them. But make no mistake, kindness is key!

Not only has the service drastically improved attendance rates, but it is also building an empowered group of health consumers into the future. And keeping them happy and healthy children in the meantime.

This is the story of Cairns and Hinterland Hospital and Health Service's Happy Heart Clinic.

Links

Information about RHD

Queensland Health's Ending RHD strategy

Happy Heart Clinic Improvement Exchange listing.

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Coronary heart disease continues to be the leading health disease in Australia. With the innovative research from Metro North Hospital and Health Service’s Professor Louise Cullen and the Statewide Accelerated Chest pain Risk Evaluation (ACRE) project team, Deane was avoided being one of those statistics.

Deane and his wife retired to a large property on the outskirts of Rockhampton in 2014, with his days spent maintaining the yard and tending to their beloved animals. From time to time, he experienced chest pain but always put it down to a hernia.

That is until one day when the pain didn’t go away and he presented to the Emergency Department (ED).

In partnership with the Telecardiac Investigations program, the ACRE team worked with local change agents at Rockhampton Hospital to implement local care pathways to identify people presenting to the ED that are potentially having a heart attack and provide timely follow-up investigative services.

Something that helps regional patients access the same level as care as their metropolitan neighbours and most importantly, saves countless lives just like Deane’s.

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Starting at a new hospital in the area, proud Ngunnawal woman and Clinical Midwife Consultant Cassandra Nest noticed that very few women were identifying as Aboriginal and Torres Strait Islander when accessing their service.

This seemingly small observation was the catalyst for transformational change within Gold Coast Health’s Women’s and Newborn Service as they empowered Cassandra to design a new model of care to improve engagement with the local First Nations community.

The resulting model combines both Birthing on Country and First 1000 Days Australia principles, but is so much more. Truly co-designed, the model was built in consultation with families and through meaningful partnerships with the local community and organisations with one goal: to not only safely bring jarjums into the world but welcome them into the community.

Little did they know it would also improve engagement with the health system at its broadest level.

Waijungbah Jarjums is proudly supported by Clinical Excellence Queensland, with invaluable partnership with Kalwun Health Services and the Yugambeh Region Aboriginal Corporation Alliance to build a service that meets the needs of locals.

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Patient centred care is the gold standard which we’re all striving for. From providing services in ways that suit consumers, collaborating across specialties and streamlining processes, it is a rich tapestry that goes in to achieving that aim.

VOICeD, or the Virtual Outpatient Integration for Chronic Disease, is a game changing service bringing multiple clinicians together via telehealth with the patient for a single consultation. It reduces the number of times a patient interacts with a health service, but exponentially improves the quality of the care provided.

It saves people like Thea multiple lengthy drives down a winding mountain road or people like Tony with accessibility requirements the time spent worried about logistical considerations.

From the bush to beach or even just down the road, a service like VOICeD is making sure care doesn’t take away from Thea and Tony living their lives.

And better yet, this is only just the beginning.

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Bent over in pain, David anxiously sat in the car as his wife urgently drove the four, long hours to get to the closest facility for lifesaving care. Driving over the rugged outback landscape, he felt every second of his journey before arriving in the hands of Dr Francis Asomah.

A Brisbane based surgeon, Francis does a five-day trip every few weeks as part of the iconic Flying Surgical Services team.

Unlike the Royal Flying Doctors Service (RFDS) who provide invaluable retrieval services and patient transfers to larger metropolitan facilities, the RFDS fly our Queensland Health surgeons out to regional and rural facilities to provide general surgical care in the local communities.

Not just improving access to care and reducing travel for consumers, the service opens up a world of opportunity with surgeons on-call for the duration of their trip should an emergency arise and allows them to follow-up with their patients in Brisbane and on their next trip.

David’s is one of many stories of the lives saved and changed by Francis’ care.

The Flying Surgical Service is a partnership between Metro North, Central West and South West Hospital and Health Services with support from Clinical Excellence Queensland, Healthcare Purchasing and System Performance Division and the RFDS.

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