Clinical Excellence Showcase: Recent Episodes
Clinical Excellence Queensland
At Clinical Excellence Queensland, we partner with health services, clinicians and consumers to drive measurable improvement in patient care through a continual pursuit of excellence.
Our annual Showcase event brings together clinicians, consumers and managers from across Queensland Health to share their projects and programs that are creating change and delivering healthcare benefits to Queenslanders.
This podcast is your opportunity to learn how others are making change happen from clinicians and administrators at the coalface who have successfully navigated healthcare system challenges to deliver improvement and innovation in their own health service.
These are some of their stories.
As always, we’ll see out the Showcase with The Great Debate. Known to entertain more than inform, this year’s debate asks whether Australia is the best place for clinicians to live and work. Joining us this year is another stellar line up of some of Queensland’s best and brightest (and unusually, most are surgeons!) Affirmative team (yes, Australia is the best place to live and work):
Dr Emilia Dauway, Director of Surgery at QEII Jubilee Hospital
Dr Bernie Whitfield, Director of ENT at Logan Hospital
Dr Rob Franz, Medical Director General Surgery at The Prince Charles Hospital.
Negative team (no, Australia is not the best place to live and work):
Associate Professor Robyn Littlewood, CEO Health and Wellbeing Queensland
Dr Diana Tam, Consultant Breast and Endocrine Surgeon
Associate Professor Cath McDougall, Chief Medical Officer for Queensland Health.
Chaired by the Deputy Director-General herself, Dr Helen Brown, this year’s Great Debate is sure to highlight the pros and pitfalls of our beautiful country!
Climate change is one of the most important challenges the world is facing currently. Climate change negatively impacts on health worldwide. To address climate change is our professional obligation. SWAPNET has established an Environmental Accountability Working Group with the aim to engage clinicians, HHSs and facilities to promote change and to develop comprehensive resources to support improvement and to lead the way to encourage other networks to also take up the challenge.
Traditionally long-term antibiotic therapy for significant infections has been given intravenously (IV). Current evidence now supports the utilisation of highly bioavailable oral antibiotic (HBOA) therapy substituting for most of the IV course. This includes quinolones, sulphonamides, tetracyclines, macrolides, azoles, lincosamides, rifamycins and oxazolidinones classes of antibiotics. HBOA therapy allows the patient to receive treatment in their own home, potentially return to work, removes the risk of long lines, and achieve therapeutic goals. However, treatment may be for several months and side effects may arise at any time; some potentially avoidable with early recognition. We established a Complex outpatient antibiotic therapy (CoPAT) service that monitor’s patients on HBOA at home. This manages in a timely fashion any adverse outcomes to allow ongoing achievement of therapeutic goals, prevention of hospital admission and reduction of overall care costs. It also allows standardisation of the follow-up care provided.
Obesity places a significant burden on Australia’s healthcare system. Currently at The Princess Alexandra Hospital (PAH), local antimicrobial guidelines do not provide advice on dosing for obese patients. Instead, clinicians are directed to utilise standard dosing advice which has been developed and tested in non-obese patients, thus adopting a one-size-fits-all dosing mentality. The aim of this project was to determine the proportion of admitted patients at the Princess Alexandra Hospital receiving antimicrobial therapy, who are classed as obese (BMI >30kg/m2) as well as audit the current prescribing patterns of antimicrobial dosing in obese patients at the PA Hospital. As a result of the audit findings, it was clear there was a severe lack in dosing advice in this cohort of patients and that antimicrobial dosing most commonly followed standard dosing guidelines with no consideration for the patient's weight. Therefore, guidelines for the dosing of antimicrobial recommendations in obese patients were drafted and are currently awaiting publication.
Children’s Health Queensland Hospital and Health Services (CHQHHS) has empowered its workforce, young people, families and care partners to pursue innovative ways to minimise their environmental impact of our health care service. We have established an Environmental Stewardship Network, the ‘CHQ Green Team’, which has grown to over 200 active members who work together to meet the targets set out in the CHQHHS Environmental Sustainability Plan 2021-2024. CHQ Green Team initiatives have resulted in emission reductions, improved energy efficiency and waste reduction at the Queensland Children’s Hospital (QCH) in South Brisbane. This has established QCH as an international example for sustainable healthcare service delivery, both financially and environmentally. CHQ Green Team initiatives support local businesses and circular economy jobs while also shifting current practices and improving Queensland’s environmental performance. CHQ showcases sustainable leadership that has successfully diverted 491 tonnes of waste from landfill and generated and saved over $580 000 in 2021/22. Our sustainability success story can be shared and adopted across other Queensland Health Hospitals and Health care services.
Borderline Personality Disorder (BPD) is a complex and serious psychiatric condition with significant morbidity and mortality. It is often characterised by a severely and persistently impaired psychosocial functioning and a high risk for self-harm and suicide, resulting in the high consumption of healthcare resources. Access to evidence-based interventions for Borderline Personality Disorder (BPD) is still highly limited in the current Australian health service system. Specialist mental health services are dominated by a generic case management model, with a lack of specific treatment modalities and staff struggling to provide psychologically focussed interventions. Similarly, non-government organisations (NGOs) report a lack of capacity, competence and confidence when working with consumers living with BPD. Despite people with BPD commonly having multiple contacts with mental health services, an audit within Metro South Hospital and Health Service (MSHHS) found that access to evidence-based treatment for this group of patients was highly limited in the Brisbane South region. The need for all workers to be able to therapeutically respond to consumers needs, and better access to appropriate intervention intensities was required. Using a stepped workforce capability framework the project aimed to increase the overall workforce capability to intervene effectively. In addition to develop higher level skillsets across NGO and public mental health and greater treatment access across the spectrum of care needs. Outcomes were significant and have directly impacted the ability of staff to provide good care from thsoe with BPD and related disorders. Over 350 NGO and MSHHS frontline staff completed training to achieve a practice-informed level of DBT capability. The project’s activities were highly valued in terms of content and presentation. Most participants reported greater use of and capability with Dialectical Behaviour Therapy (DBT)-informed practice and improved care coordination after training attendance. The significant improvements in the self-efficacy of participants that were identified immediately following training attendance appear to have been maintained in the short term. Almost 100 people attended advanced forms of training that will enable them to run DBT-informed groups, and in some cases provide individual comprehensive therapy. These individuals will serve as DBT leaders and champions who can support the maintenance of each service’s improved capability. There are new programs accessable to those with BPD in the region.
Healthcare services continue to face significant challenges to providing access to care and delivering care. Acceptance and utilisation of virtual options during the last three years has expanded as a result of the COVID pandemic. Conversely, waiting lists for surgical care have increased as a result of the pandemic. Leveraging these two competing factors, a multi-disciplinary team reimagined the surgical patient pathway to create efficiencies and improved access to care. Key stakeholder engagements across multiple business units were undertaken to inform each aspect of the implementation plan, including modifications to systems (iEMR, scheduling, booking), development of decision-making resources and frameworks, re-imaging workflows to maximise care value and virtual care opportunities, reviewing and reducing the physical footprint (through transition to virtual care touchpoints).
Where and how we care for preterm babies in South-East Queensland requires urgent review. Increased demand for service, improved survival rates, increased complexity of premature and sick newborns and a specialist nursing shortage has seen burgeoning pressure on large tertiary units, such as ours: The Grantley Stable Neonatal Unit (GSNU) at the Royal Brisbane and Women’s Hospital (RBWH). Emerging evidence indicates that early discharge of physiologically stable, pre-term neonates is safe and cost-effective when appropriate in-home supports are in place (Brooten 1986; Cruz 1997; Collins et al, 2015). Given the comfort and psychological safety of the home environment, we anticipated enhanced parent-infant bonding. Health system level improvements, such as increased capacity within the Neonatal Unit would also result if we adopted similar models. In late 2021, the Women’s and Newborn Service, Hospital in the Home project (NeoHOME and MatHOME) was successfully granted SEED funding from the Metro North Hospital and Health Service (MNHHS) Innovation Program. With their support and guidance, two arms of the project were developed (maternity and neonatal) and NeoHOME was born. The objectives of NeoHOME are:
safe and effective care in the home for preterm neonates
improved parental satisfaction, wellbeing and self-efficacy in addition to reduced financial burden, associated with long-term hospitalisation
reduction in occupied bed days with anticipated improvements to capacity and staffing demands
Clinical implementation commenced 4-months ago, and 61 neonates have been cared for in the home.
Preoperative pathology is an important component of the assessment of patients prior to elective surgery. Ordering routine preoperative pathology is listed by bodies such as the Australian and New Zealand College of Anaesthetists (ANZCA) and Choosing Wisely Australia as one of the top five practices anaesthetists should avoid (Choosing Wisely Australia 2017). The aim of this project was to evaluate current local practice for preoperative pathology at the Pre-Anaesthetic Evaluation Unit (PAEU) at the Sunshine Coast University Hospital (SCUH). The priority for improving patient care was to ensure local practice was in line with evidence-based guidelines, was sustainable and patient focused.
Intravenous iodinated contrast is commonly and routinely used in abdominal imaging computed tomography (CT) to demonstrate patient’s anatomy and visualise and pathology. Historically, a fixed volume of contrast is used for abdominal CT. However, this fixed dose approach means small patients are typically overdosed, resulting in excessive enhancement of the abdominal organs. Conversely, larger patients are underdosed which results in scans that have less than ideal enhancement. The idea of a simple weight-based contrast regimen was proposed by our team as a solution to this problem. A review of other Queensland Health sites indicated that most medical imaging departments were using fixed volume or simplified 2- or 3-step volume protocols (e.g., small, medium, and large patients). A thorough literature review was conducted to see if there was evidence to support a more tailored approach. The literature suggested that a weight-adjusted contrast dosing protocol can objectively provide more consistent vessel and solid organ enhancement and subjectively improve image quality across a spectrum of body weights. In addition, it could reduce the amount of total contrast used, saving money and reducing waste. The issue with the current body of literature is that there is no consensus as to the ideal enhancement of the image, in other words how the image should look. It is largely dependent on the country of the study and the patient demographics of that region. As a result of this, our team decided to conduct our own study to determine if the patient specific approach could work at our site. Our team consisted of radiographers, radiation physicists and radiologists. A weight-based contrast protocol was established by our team based on 1ml of contrast per kilogram of patient weight in 10kg increments and was rolled out across the department. Quantitative and qualitative data was collected to compare the fixed dose vs weight-based methods and analysed. The main aim of this clinical audit was to determine whether a weight-based contrast regimen in abdominal CT can provide more consistently enhanced images for our clinicians across the spectrum of patient sizes. In addition, can the change in practice reduce contrast wastage and therefore costs. If so, the weight-based protocol could be implemented across more Queensland health sites to improve the quality of the abdominal CT scans we perform statewide.
The care of rheumatology patients can be complex, often requiring medications that need close monitoring and education to ensure best and safe outcomes. There is often minimal time within the busy clinical outpatient setting to holistically review the patient's needs. The rheumatology clinical nurse consultant telehealth service was introduced to achieve better patient outcomes and provide a comprehensive approach to the delivery of care to any individual anywhere. Ensuring that patients have a greater understanding of their rheumatological condition can lead to patient empowerment and better outcomes. The implementation of the clinic via telehealth was to provide an alternative way to receive specialist nursing care. This also helps to reduce petrol and parking costs as well as having positive environmental implications. It also means that patients can receive holistic care wherever they may live and is particularly useful for those living in rural and remote areas. By offering telehealth, patients have less time off work which leads to more work productivity and time spent with family. It also means that the interval between patients being reviewed by the clinician can be increased as the telehealth service allows for interim follow up. This therefore allows for more patients to be reviewed in clinic by the nurse practitioner and other clinicians.
The RAID template was initially developed as part of the QI project for our Sunshine Coast Hospital and Health Service (SCHHS) Infectious Disease (ID) team. Our aim was to develop “a user-friendly template to improve our ieMR documentation on the daily patient care record. In summary, by using the RAID template, overall documentation of invasive device, antibiotic indication and plan, assessment of DVT prophylaxis and ARP plan were universally improved from period 1 to 2. It is easy to use and reminds clinicians of this important aspect of patient care.
Consumers with Borderline Personality Disorder (BPD) make up 10% of the admissions and are at high risk of dying by suicide. People with BPD are often trapped in a revolving door situation to the Emergency Department (ED) and are not getting the treatment they needed due to stigma and lack of resources. The Living Well Team is a multidisciplinary team that adopted virtual care technology combined with evidence based psychological therapies specific to BPD, it is the first of its kind in Queensland. The Living Well Team (LWT) co-designed and delivered a flexible, peer-worker supported evidenced based therapeutic service to address the gap in service delivery that was placing increased pressure on emergency and acute mental health services. Since commencement the service has grown from 30 consumers during the period July – September 2021 (onboarding 10 each month) to achieve the aim of 60 consumers. In the 3 months prior to joining the LWT service, 10 of the 49 consumers (20.4%) had been admitted to acute inpatient care (20 admissions in total). Only four consumers (8.2%) were admitted to acute care following entry into the LWT (8 admissions in total). Consumers identified that engagement with the LWT was instrumental in keeping them out of hospital and improving their recovery journey.
We piloted/evaluated a coding framework that has simplified the coding process and enabled streamlined reporting of PREMs findings to consumers and staff (including an ability to compare trends over time). This framework has been implemented across four RBWH clinical service lines and has enabled a more structured and efficient solution to analysing qualitative PREMs data. Most importantly, it has created a solution to embed a person-centred lens in how health services interpret and analyse patient-reported feedback. It has enabled service lines to prioritise improvement projects in direct response to patient feedback not otherwise available through quantitative dashboards.
The PASS model of care is an end-to-end service for complex surgical patients, that is adaptable and transferrable model of care, led by a Care Coordination Nurse (CCN) We have:
Developed a nurse led model to support safe, structured discharges for each patient
Scaled the CCN role across another surgical ward successfully
Created an integrated care approach with our community GP’s
The CCN role has:
Reduced length of stay for several complex diagnostic related group’s (DRG)
Released more to time to care for the primary nurses at the bedside
Established a successful succession program
Allowed nurses (both hospital and community) to work to top of scope
Ensured every patient has a discharge plan
Created discharge education and provided on the floor support for nursing, medical and allied health staff
Increased in patient and staff satisfaction
We aim to:
Establish an online discharge portal
Develop a discharge network for all ‘discharge’ nurses
Strengthen partnerships with the primary care sector, to sustain improvements in the patient care continuum with more connected community pathways
Establish a community home visiting service that would cater for the complex needs of surgical patients within the community, that has surgical governance
Establish Satellite Clinics
The vast majority of patients survive their ICU admission; however, the quality of survival is commonly suboptimal with a substantial proportion experiencing cognitive, physical, mental and/or psychological dysfunction and significant disability severely affecting the quality of life of the patient and their family. Emerging evidence suggests that the current bedspace environment contributes to these preventable adverse outcomes. The “ICU of the Future” project is a Queensland led, international, patient centred, multi-disciplinary and intersectoral project. Using co-design to incorporate the patient’s needs, the project team has redesigned and rebuilt two ICU bedspaces at the TPCH. This pioneering and ambitious innovation project aims to demonstrate how optimising the ICU environment will enable best practice care and lead to improved patient outcomes and experiences.
The Community Hearing Screening Program was initiated in 2017 with the vision to provide equitable and accessible post-natal hearing screening services and timely detection of hearing loss for all Queensland children. Preliminary findings of this pilot model demonstrate sustainable and low-cost care including:
Detection rate of permanent hearing loss at 7.4/1000 children
Childhood Community Hearing Clinics found 29 of these permanent hearing losses
Department of Education clinics found 9 of these permanent hearing losses
Of these, 3 children have entered the Queensland Children’s Hospital Hearing Implant Program as hearing loss was very significant. Total ‘pass and discharge’ rate is approximately 75% with 65% discharged after first screen. As well as providing a timely and accessible service to families, there was significant reduction on public hospital audiology departments waitlists.
For many families there is a disconnect between having a baby in hospital and accessing services afterwards, including the Child Health Service. Families often experience difficulty knowing who can help and health literacy is low. AEDC data shows that up to 20-30% of children from some suburbs in the Logan area are “not school ready” and are vulnerable on 2 or more of the 5 key domains of early childhood development- well above the national average of 11%. The Journey Facilitator is in a unique position to be influenced by and have influence on both families, children and health care professionals across multiple sites. The Journey Facilitator is instrumental in developing processes that foster collaborative relationships to achieve the quadruple aim of health care (improve clinical outcomes and population health; enhance clinician and consumer experience; promote streamlining of services reducing health care costs and waste).
Strategies that successfully mitigate the potential stress for children and families in the ED through the use of developmentally appropriate approaches are an essential element of holistic high-quality care. Child life therapy aims to combine the biomedical model of care with the developmentally tailored, individualised, play-based psychosocial model of care, to minimise the negative impact of potentially painful and anxiety-provoking healthcare procedures. The Child Life Therapist (CLT) role was introduced as a pilot project at The Prince Charles Hospital (TPCH) Children's Emergency Department (CED) in July 2022 to integrate a developmentally sensitive play-based approach to the clinical care of paediatric patients from infants to 16 years of age. The aim was to facilitate inclusive opportunities for ALL children to play, learn and participate in their health care. While the project is still in its early stage, positive outcomes have been highlighted by the service users. Feedback from the multidisciplinary team highlighted the contribution of the CLT in supporting clinical efficiency and patient flow.
Most commonly, women opting for surgical management of miscarriage require an inpatient procedure under general anaesthetic in the operating theatre (known as a suction curette). This requires several hospital visits and the women encounter several different clinicians during their stay. The majority of this experience is navigated without the comfort of a support person. MVAC is a procedure also used for the management of miscarriage, retained products of conception and termination of pregnancy. It is performed with a hand operated vacuum syringe under local anaesthetic in an outpatient setting. The procedure is recommended by the World Health Organisation for uterine evacuation and is used in many countries as an alternative to suction curette under general anaesthetic (GA). At the time of this abstract submission, uptake is high, patient satisfaction is over 95%, complication rates are equivalent to management in theatre and several other hospitals around Queensland have approached our department with the view of adopting this innovative service.
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.
In-hospital suicides are often associated with occurring in the evening and during night shifts when there is reduced staff supervision. During these times of high risk, suicides occur in isolated areas of the ward such as bathrooms and single rooms. In this study, a prototype for a Remote Patient Monitoring (RPM) system was developed for early detection of suicidal behaviour in a hospital based mental health facility.
The introduction of an Undergraduate Student in Nursing (USIN) model of care for ECG performance was implemented. We have contracted 2.96FTE USiN to work 2 shifts 7days a week to implement a new waiting room model of care. The model of care is deliberately procedure/guideline driven given the limited scope of practice for the USIN group. All category 2 chest pain patients are ordered and ECG by the triage nurse and referred to the USIN for completion. We have set up a direct line of review for the ECGs with a dedicated SMO allocated to review ensuring quality review is undertaken. Using a USIN to perform the task of an ECG, similar to a technician position, has freed up nursing time to perform critical thinking and clinical prioritisation within the waiting room. From a fiscal point of view, the USiN is also cheaper to add to a work force already stretched from budget perspective. It has seen an improvement in time-to-treat, specifically for the cohort of ATS Category 2 chest pain presentations. The key achievements to date, are an overall improvement in patient safety, improvement in time-to-treat measures and an immeasurable improvement in staff morale.
Primary Contact Hand Therapy (PCHT) is an innovative role substitution model of care led by Allied Health clinicians at Gold Coast Health. It was established in December 2018 in response to the Ministerial Taskforce to expand the scope of practice for Allied Health professionals.
In May 2021, headaches were the single most common referral to the SCHHS neurology outpatient department, with most headache referrals listed as cat-2. There were long-standing issues regarding access to neurology services on the Sunshine Coast, with demand continuing to exceed supply, despite significant investment in SMO FTE and clinic availability. The cat-2 clinic wait-times were over the recommended time-frame of 90-days. Furthermore, it was believed that a significant number of these headache referrals were being insufficiently and/or inappropriately managed in the community. The MPSC headache pilot trial had significantly greater than expected initial success, with 1 in 3 patients (34%) discharged following targeted active treatment. This represents a significant number of patients who did NOT require a neurology appointment. Refinement of the pathway may push these numbers higher. Owing to the success of the pilot, the MPSC headache clinic has become a permanent feature of neurology outpatients, with recurrent funding afforded.
Embedding a quality improvement culture improves overall care, service delivery and organisational culture and has even been shown to be associated with increased survival in neonates. The Sunshine Coast Hospital and Health Service paediatric and neonatal departments have implemented and grown a culture of quality improvement (QI) through two major activities.
The Virtual Fracture Clinic (VFC) model launched in August 2022 and in the first 6 months, 386 new patient referrals have been managed under the mode. and freed up the equivalent of 6 fracture clinics per month. This has meant that there has been a reduction in the amount of fracture clinics needing to be overbooked. Financially it has been determined that the VFC model is saving our health $28,800 per year in patient travel costs as well as generating revenue of approximately $61,440 in its first year. In total the finance department has calculated that between savings and revenue the department will be $132,004 better off each year.
As always, we closed the Showcase with The Great Debate. Known to entertain more than inform, this year’s debate takes a slightly controversial twist asking the question: “City versus Country – does more money and resources for the cities mean better healthcare for everybody?” Joining us this year is another stellar line up of some of Queensland’s best and brightest!Affirmative team (yes, it does mean better healthcare):* Dr Catherine McDougall, Clinical Lead Getting it Right First Time Queensland * Dr Chris May, former Clinical Lead, Clinical Excellence Queensland * Dr Tanya Kelly, Chair Queensland Clinical Senate and Anaesthetist, Sunshine Coast Hospital and Health Service
Negative team (no, it does not mean better healthcare):* Dr Marlow Coates, Executive Director Medical Services Torres and Cape Hospital and Health Service * Dr Alexander Kochi, Emergency Medicine Staff Specialist, Cairns and Hinterland Hospital and Health Service * Dr Carl de West, Clinical Director Specialist Medical Services, Gold Coast Hospital and Health Service *
Chaired by Professor Keith McNeil, Deputy Director-General Prevention Division and Chief Clinical Information Officer Queensland Health, this year’s Great Debate is sure to ignite some fireworks!
This session explores several Hospital in the Home (HiTH) models in Queensland, taking a proverbial 'look under the hood' to find out what works and why, and the many benefits of this hospital avoidance model.About the panel Melissa (Mel) McCusker is the Assistant Director of Nursing for the Acute Care@Home, COVID@Home and CHIP services in Metro South Health. Melissa was employed in the original pilot program for HITH in Metro South in 2007 and has been instrumental in the development of the service including the pilots of Criteria Led Discharge, telehealth and Remote Patient Monitoring. The Remote Patient Monitoring trial for HITH patients in partnership with Telstra Health and the Department of Health which was the first of its kind in Australia for HITH patients.Her clinical experience spans medical, critical care, post-acute and general practice nursing and she is a member of the HITH Society of Australasia and currently involved with statewide HITH working group.About the facilitators Laureen Hines is currently a Director in Clinical Excellence Queensland’s Healthcare Improvement Unit. Laureen has more than 20 years’ experience in nursing and leadership across the care continuum and departmental level. As the Queensland executive lead for Hospital in the Home (HITH), she has extensive HITH experience and has been instrumental in leading HITH reform within the Queensland context.Dr Theodore Chamberlain is the Statewide Hospital in the Home (HITH) Clinical Lead for Clinical Excellence Queensland. Theodore Chamberlain is a founding fellow of the Australian College of Rural and Remote medicine (ACRRM) with a long history of rural practice and a career involving education, teaching, innovation and transformation. His interests are broad and in addition to a fellow of ACRRM, is a member of the International Society of Bayesian Analysis (ISBA), member of the Movement Disorder Society of Australia and New Zealand (MDSANZ), member of the Hospital in the Home Society Australasia and a FORTH innovation consultant.
This presentation centres on Queensland Health’s vision to transform the health system by embedding genomics and precision health into routine healthcare delivery. Ides will show how innovative projects intersect and align to the broader agenda and that importantly, the only way we can enable innovation in this complex ecosystem is to support innovation everywhere but making sure the areas and teams are connected.This means that ultimately, system capability is advanced and able to deliver personalised early diagnosis, intervention and treatment, resulting in optimised patient experience and outcomes and reducing low value and harmful care.
Foot disease is a common, costly and complex complication of many chronic diseases which may result in lower limb amputation. Early identification and timely referral of patients with acute foot disease has been shown to reduce hospitalisation and associated lower limb amputations rates.Of the 218 lower limb amputations performed in the Townsville Hospital and Health Service (THHS), 27 per cent were performed on patients residing in rural or remote post codes and 26 per cent identified as First Nations.The Feet First Project trained Allied Health Assistants (AHA) and Indigenous Health Workers (IHW) in foot risk stratification screening and low risk foot care in each rural THHS site, providing rural consumers with equitable access to a quality, culturally appropriate foot screening and care service that identifies and manages foot disease in a timely manner.
Paediatric feeding disorders can impact a range of children and access to care may be difficult for families. In this presentation, Madeline will share research findings into the barriers families face in accessing feeding care, including the use of telepractice as a potential model to help reduce some of these difficulties.In the study, the feeding skills of 30 bottle-feeding infants and 40 children cup drinking/eating solids were simultaneously assessed by a speech pathologist in their home and via telepractice to compare assessment findings.Results indicated high reliability for most assessment elements; indicating that assessments conducted via telepractice were comparable to assessments conducted in person. In addition, parents and clinicians reported high satisfaction with the telepractice model.
Since the recommendations from the Australian Aged Care Royal Commission to reduce prescribing of antipsychotics in Residential Aged Care Facilities (RACFs) and Pharmaceutical Benefit Scheme (PBS) strict clinical criteria, there has been limited published data on antipsychotic prescribing in people who present to hospital particularly with dementia or delirium. This study aimed to investigate antipsychotic prescribing in people with dementia or delirium on admission, during their stay and upon discharge at a large regional hospital in Queensland.
West Moreton’s Heart Failure Service has implemented a new method of service delivery. The West Moreton Health / Philips Heart Health Hub is a pilot program using remote patient monitoring and video conferencing to virtually manage heart failure patients, specifically focusing on timely medication titration in their own home.This presentation will assess the feasibility and acceptability of Heart Failure Service virtual model for medication titration for heart failure patients, which is facilitated by the heart failure nurse practitioner and cardiology specialist. It will show how the new streamlined service means staff can perform titration without disrupting the patient or requiring them to come into hospital, resulting in significant health system savings as well as reducing barriers to accessing care and engaging with clinicians – regardless of where a patient lives.
This presentation will demonstrate how the Sunshine Coast Hospital and Health Service’s Aboriginal and Torres Strait Islander Health team responded to COVID-19 and the challenges experienced in the community.With working and community relationships impacted, teams had to learn new ways of communicating and engaging with the community. To support the community, they implemented a flu vaccination clinic in a pandemic environment, conducted follow up phone calls from fever clinic presentations and helped community members to emerge from isolation as quickly as possible.
While palliative care services are a well-established model of care across Australia, the same results are difficult to achieve within the Torres and Cape because of unique community needs, geography and healthcare settings.The framework for a pop-up care model to be discussed in this presentation is inclusive of palliative care principals, supports the community to identify gaps and provides resources to assist communities to meet their needs. The principles of the pop-up model are that it functions in a coordinated approach only when it’s required (i.e., it “pops up”). The model is flexible, sustainable, owned and developed by the local community and tailored to meet community needs. Importantly, it also increases the knowledge and skills base in palliative care for communities and clinicians.Torres and Cape envisage the model of care will provide clinical, cultural, social, and emotional support to facilitate the patient in returning home for end-of-life care and to “die on country”.
This presentation will explore how Central Queensland Hospital and Health Service implemented a mobile dental imaging service to provide care closer to home for residents of residential aged care facilities (RACFs), mental health facilities and disability care. This includes the use of specially procured equipment and software, the development of an implementation toolkit, and the positive impact faster diagnostics has had on patients and service providers.
Research indicates that young people with burns are at an increased risk of manifesting negative life trajectories during adolescence. This has the potential to impact on many aspects of their life including psychological wellbeing, engagement in education and career and even social contributions. Despite extensive involvement by hospital staff through follow up care, many children with burns experience considerable ongoing physical, social and emotional challenges that impact their engagement in their everyday occupations.Striving Deadly is a therapeutic outdoor adventure initiative for survivors of burn injury, which provides an extension of psychosocial care for children beyond the boundaries of the Townsville University Hospital (TUH) walls. Therapeutic goals of the program include access to peer support, challenge by choice experiences, and to build resilience through self-reflection.Learnings from the delivery of Camp Oz, a burns camp delivered annually for 12 years by the Queensland Children’s Hospital and PCYC Bornhoffen in South East Queensland, were contextualised to accommodate the specific needs of running the program in North Queensland.In recognition of the high proportion of Indigenous participants, Striving Deadly was named by Trevor Prior, TUH’s Cultural Practice Coordinator, with the aim of facilitating cultural safety within the program. It was a chosen to acknowledge that the children were striving to be ‘deadly’ or a ‘better version’ of themselves.
In this presentation Dr Avent will share results from a quality improvement study, conducted in remote and regional paediatric inpatient facilities, testing a package of intervention tools to promote the IV to oral conversion of antibiotic therapy for children with Community Acquired Pneumonia and skin and soft tissue infections.Onsite training was provided during the implementation period and continued with telehealth support for the intervention phase from a multi-disciplinary research team from the Queensland Statewide Antimicrobial Stewardship Program and the Antimicrobial Stewardship Program based at the Queensland Children’s Hospital. Clinicians could tailor the tools to their practice setting and patient’s requirements, which is more realistic of a real-world situation.In addition, the uptake of the intervention materials was supported by onsite paediatric clinical champions at each facility.
High developmental vulnerability exists throughout Queensland with disproportionate vulnerability occurring within our most rural and remote communities (more than 50 per cent). Access to tertiary-level developmental services is typically limited in these areas.Children’s Health Queensland’s Child Development Services developed an innovative virtual telehealth service designed to bring specialist developmental services to communities. Clinical assessment and intervention are undertaken with shared expertise from the family, the local health providers and the specialist team to offer a best practice clinical service that offers health equity regardless of where the child and family live.
Medication-related adverse events are linked to 15-50 per cent of readmissions and small rural hospital and health facilities are no exception. While internationally, some collaborative, pharmacist-led programs have demonstrated a reduction in readmissions, rurally, the availability of pharmacists credentialled to provide these services is extremely limited.The Rural Multidisciplinary Medication Outreach Service (rMMOS) seeks to address the current gap in post-discharge medication management support and pharmacist availability more acutely seen in rural and remote settings. The outcomes to date have included improved transitions of care, reduction in readmissions, improved patient adherence and improved patient understanding of medicines.
Dizziness accounts for approximately four per cent of chief complaints to the emergency departments in Queensland’s public hospitals. Patients who present with dizziness usually require specialist tests to determine the cause. When the cause is unclear patients living in rural or remote regions of Queensland may need to travel long distances to a tertiary hospital for further testing, taking patients away from family and support networks and increasing costs on the public health system.To ensure patients who present with dizzy symptoms at rural or remote emergency departments are streamed to the most appropriate care pathway to treat vestibular conditions, Metro South Health piloted “The Dial-a-Dizzy project”. Dial-a-Dizzy partners the integrated ear, nose and throat (ENT) vestibular team based at Logan Hospital with rural and remote emergency departments and aims to function as a telehealth diagnostic advisory hotline to guide clinicians through the management of emergent vertigo. Vesticam infra-red video goggles have also been placed in five remote emergency departments, as well as an e-consult platform to request advice and upload video images captured with the Vesticam goggles.
Frail older persons are considered a vulnerable population and this vulnerability only increases in the COVID-19 environment. The focus and aim of this project was to provide a Hospital in the Home service to frail older persons requiring acute, rehabilitation or geriatric-type care within their home, and therefore prevent unnecessary presentations and/or admissions.This service builds on existing Residential Aged Care Support Service (RaSS) and Geriatric Emergency Department Intervention (GEDI) models in place but specifically caters to the community dwelling frail older person in their home. It provides a 360 degree wrap around for the frail older person aiming for a comprehensive hospital avoidance model across all sectors.
In this Showcase Spotlight, Bav and Tricia will provide a high-level overview of how voluntary assisted dying will be implemented in Queensland, with a particular focus on regional, rural and remote access and delivering culturally appropriate care for First Nations peoples.They will also share results to date on healthcare workers’ perceptions, address concerns and knowledge gaps (including myth-busters), and workshop strategies with the audience that will assist with the legislation’s implementation and uptake of associated training.
Far North Queensland faces a number of unique health challenges due to the demographic, social, economic, cultural and geographical factors of the region. Patients often face barriers to accessing the right care, in the right place at the right time. This has led to inequity in health outcomes throughout the population.However, this also presents an opportunity to improve coordination of healthcare services across the care continuum in Queensland. To do this, the Care Coordination Service Centre has been established. The Care Coordination Service Centre is a comprehensive patient-assistance service that aims to provide the logistical and wraparound ‘at the elbow’ care support required by priority patient cohorts from Torres and Cape and Cairns and Hinterland regions, including First Nations peoples.
The paediatric sepsis Peer Mentoring Program (PMP) provides families with a child diagnosed with sepsis (surviving or bereaved) an opportunity for connection with others, validation, and normalisation of their experience.Feedback from families indicated parents and carers felt isolated during and after their child’s hospital admission, and this sense of isolation was amplified by a lack of understanding and information about sepsis within the community.The world first paediatric sepsis PMP was co-designed by consumers and is delivered by consumers, with input during the development stage from key stakeholders including The Australian Centre for Social Innovation. The PMP aims to provide families with the understanding, encouragement, and support which only another parent or carer who has walked a similar path can provide.
Sing to Connect is designed to leverage the potential of music, stories, and songs for the cultural wellbeing of culturally and linguistically diverse (CALD) mothers in the context of antenatal and postnatal care and education.Literature testifies to the fact that poor health outcomes during this period may cause chronic disease with long term ramifications for the individual, family and health system. In addition to the benefits of singing for communities, the pressing needs for social inclusion in multicultural populations in Australia dictates the timeliness of community engagement programs.By bringing together their CALD community of birthing mothers and families isolated by language barriers and other challenges related to refugee status, Sing to Connect foregrounds social connections and community wellbeing, as well as leading to greater engagement in healthcare and improved mental health outcomes.
In the current environment of escalating demand for ambulance services, the Queensland Ambulance Service has identified a more agile approach to providing care to the community. Conceptualised as a coordination adjunct, the clinical hub provides an adaptive model of service that ensures a timely, appropriate, and patient-centric ambulance response occurs.In short, the hub provides a secondary triage to a select cohort of patients and determines the most appropriate healthcare pathway that is proportionate to the acuity of the individual. Staffed by a multi-disciplinary team consisting of senior paramedics, mental health clinicians and medical officers, the Clinical Hub coordinates the entry of the patient into the broader healthcare system after a Triple Zero (000) call is received.The Clinical Hub has redesigned the provision of ambulance services in Queensland and raises the question: is the future of paramedicine behind the computer screen, rather than the windscreen?
The lack of a dedicated wound care service at St George Hospital meant patients were scheduled for complex wound care services in daily emergency department (ED)-hosted clinics. After a lot of probing, engagements and discussions, an idea was formed about an alternative service delivery model, made possible thanks to COVID-19 and the need to move services out of acute areas, like the ED.In this presentation Beth will explain how the South West team totally transformed the service into a multidisciplinary, nurse navigator-led service with telehealth links to statewide podiatry and community partners. In addition, there are now work, education and upskilling opportunities for clinicians – not to mention a very happy patient cohort whose outcomes are much improved.
When the COVID-19 pandemic began, Townsville Hospital and Health Service (THHS) and its partners aimed to keep the remote indigenous community of Palm Island safe while also keeping connection to country strong.The challenge was to prepare and enact an effective COVID-19 response which considered the limited access to the Island, transience of the community, varying levels of health literacy and overcrowding. THHS had to ensure a strong focus on the First Nations people’s connection to culture, country, family, and community, whilst maintaining the community’s safety during a COVID-19 surge. Find out how they did it and the power of working together to keep communities safe.
Diabetes is Australia’s fastest growing chronic disease, posing a significant impact on the health and wellbeing of Australians and to our health system.The impact of diabetes is over-represented within lower socioeconomic regions such as Logan, south of Brisbane. Diabetes is the most common cause of potentially preventable hospitalisations in Logan, a rate 60 per cent higher than the national average. Admissions due to complications of Type 2 Diabetes represent a quarter (24 per cent) of all potentially preventable hospitalisations.In this presentation Dr Littlewood will discuss a Queensland-first alliance with Health and Wellbeing Queensland, The University of Queensland (UQ), UQ Health Care, Metro South Health, Brisbane South Primary Health Network and Griffith University, to deliver diabetes care differently with an aim to reduce the burden of the disease on individuals, the community and the health system.
The first 2,000 days of life, commencing pre-conceptually with the development of the sperm and the ovum are critical to long-term health and wellbeing. Poor health outcomes at the start to life manifest in chronic disease with long term costs for individuals, families, and health systems. Yet women who most need comprehensive antenatal care, including those with low educational attainment, ethnic minority status, or psychosocial risk factors, are least likely to access it.To address this, Metro South Health undertook a true co-design of a continuity of midwifery care model with consumers, now known as the Community Maternity Hubs (Hubs). This included a birthing in our community model for First Nations people and implementation of community led collective impact frameworks and redesign of the service.
Navigating Happiness is a four-week practical skill group to help participants to live a more meaningful life, with promising results.The program is improving therapeutic service availability and accessibility for regional and rural consumers as well as training for clinicians, with some 250 health professionals across Australia completing the associated training.Data analysis showed statistically significant improvement of participant overall satisfaction in life, with the improvement maintaining three to six months later.
The Patient Wellness initiative is a new, innovative model of care, focused on supporting patients with a complex interplay of risk factors to reduce their health risks as they await orthopaedic elective surgery.The Patient Wellness Initiative transforms an everyday health system interaction into an opportunity for behaviour change, capitalising on the elective surgery waiting period to unveil a broader discussion about overall health and wellbeing and opportunities for reducing health risks and changing behaviour. Patients will gain greater knowledge of their health risks and will be supported to seamlessly navigate the public health system to access ongoing coaching and support to improve their modifiable lifestyle risk factors.
In this workshop, Health and Wellbeing Queensland will share overarching principles of healthy workplaces and resources, followed by a rapid design thinking exercise using case study examples.
Like other rural and regional areas in Australia, West Moreton has struggled to attract and retain medical officers. And when border closures associated with the COVID-19 pandemic further exacerbated this problem (with close to 30 per cent of the medical officer workforce lost in addition to other staff shortages as a result of sick leave and isolation requirements), the health service decided to take a different approach.To address this emergent crisis, medical officers adopted a ward-based roster instead of the traditional team-based structure. Medical officers were assigned to attend to particular wards with a team of resident medical officers (RMOs) assigned to each ward.This model was inspired by similar models of care demonstrated nationally and internationally and allowed for a smaller number of staff to cover the hospital, while simultaneously improving patient safety and minimising cross-contamination between COVID-19 and non-COVID-19 wards. It has also reduced the need for fatigue breaks and overtime.
Indigenous Cardiac Outreach Program (ICOP) is an intensive culturally sensitive initiative to bridge the gap with the capacity to address chronic diseases. Several evaluations were undertaken to define the progress of the Indigenous Cardiac Outreach Program in addressing the gap of care. In this presentation, Dr Abdul Halim will report on these results including an audit in rheumatic heart disease, investigating the lipid profiles of the ICOP cohort, and diabetes control.
In a true sign of collegiate effort, infectious disease (ID) physicians working in rural or remote areas with limited after-hours and on-call options formed a team to help manage increasing demand for ID advice.The dedicated team provided out-of-hours ID and COVID-19 advice to seven Hospital and Health Services, and by sharing the workload the risk of burnout was reduced and provided broader insight into the ID needs and issues within health services outside of their normal scope.
Australians living in rural and remote areas have poorer access to doctors compared to those living in major cities. Australian Bureau of Statistics figures confirm there are 274 doctors per 100,000 in remote/very remote areas compared with 433 doctors per 100,000 in major cities.Whilst much work has been done to address workforce shortages, long-term retention remains key. The Medical Outreach Education and Training Program (known as MOET) is a new and replicable rural registrar training model from the Darling Downs that provides medical support for smaller communities while providing a unique training opportunity for General Practice (GP) Registrars.Based primarily on training rather than service principles, the model brings together multi-systems elements that were not previously integrated. And by having supervisors with a significant understanding of the rural setting, some of the barriers to workforce retention are being addressed.
Clinicians working within rural and remote community mental health teams are often required to have an extraordinary breadth of knowledge and skillset across the lifespan. However, conversely are less likely to be able to access training and the most up to date gold standard evidence based therapeutic intervention resources or training.The Therapeutic Interventions Resource Hub is an innovative website available online to clinicians based in the Townsville Hospital and Health Service. Clinicians can access a range of resources in real time, with confidence they are utilising gold standard intervention psychoeducation and resources.The Hub is supporting rural and remote clinicians to have access to specialist support to build capacity, stepping away from traditional biomedical models of care to a more holistic mental health recovery journey, ensuring consumers can access high quality mental health care regardless of where they live.
To increase the awareness, knowledge and skills of nurses working in rural and remote Queensland in antimicrobial stewardship (AMS), weekly AMS sessions were introduced, structured around case presentation of patients admitted to the facility and prescribed antimicrobials.A Teams platform was adopted for further roll out of the program that allowed for recording of sessions for nurses that couldn't attend. What seems like a simple solution has led to increased engagement of facilities particularly across the Southwestern parts of Queensland, quantified by increased calls to the Queensland Statewide Antimicrobial Stewardship Program (QSAMSP) Infectious Disease Hotline and attendance at weekly clinical rounds.To find out more about the Infectious Disease Hotline, check out this session from Bonnie Smith.
Many people will be familiar with the PRO-moting Value Based Care in Emergency Departments or PROV-ED Project, with the team having led many successful ‘pitchfest’ initiatives for the past few years.The PROV-ED Project is about empowering frontline clinicians to make meaningful contributions to improving the care provided to patients in Queensland Health emergency settings. The unique model identifies innovative, grassroots, patient-centric initiatives from individual facilities that are suitable for further development and wider rollout.In this presentation, Sarah and Tanya will discuss how recent rural and remote-focussed initiatives have made a difference, by helping to ensure rural and remote clinicians have the resources, skills and support they need to deliver equitable patient care regardless of location. This includes promoting working to scope of practice and developing confidence in high acuity, less frequent clinical situations.
For an emergency department (ED) it is essential that any improvement in efficiency is made. ED capacity to see new incoming patients is often markedly reduced by admitted patients awaiting beds, however the majority of patients each day are discharged from the ED. Speeding up documentation will allow clinicians to discharge these patients more quickly. This may only be 5-10 minutes (often more) but when applied to more than 100 patients per day, the increased efficiency is enormous, in addition to improved patient satisfaction and reduced patient complaints.To achieve faster documentation times, a Voice to Text Application called Dragon Medical One (DMO) was introduced as a pilot across the Emergency Department and four other clinical specialties at the Mackay Base Hospital for 3 months in 2021. This presentation will discuss the findings of the pilot and feasibility of using voice to text in an ED.
To enable women who identify (or whose baby identifies) as Aboriginal and Torres Strait Islander to remain at home as much as possible whilst continuing to receive continuity of midwifery care throughout the pandemic (and ongoing), Darling Downs introduced a First Nations Midwifery Group Practice (MGP). The model involves a dedicated primary midwife who cares for a woman and her baby for the duration of antenatal, intrapartum and postnatal care, including both home visit and telehealth appointments.The success of the approach has seen increased care on community; increased engagement of women who historically have not engaged with the service whilst pregnant; individualised care for women and their families; flexibility to reschedule appointments outside of traditional clinic hours; and increased engagement with Aboriginal Health Workers.
Biosecurity restrictions implemented during the COVID-19 pandemic presented significant obstacles to clients accessing care. For the residents of Yarrabah requiring dialysis, this threatened to displace them from the community to continue to access life-sustaining haemodialysis.Not only did this model support the continuation of life sustaining care, the move On Country reduced travel time for consumers and costs for the service, which can be reinvested in delivering more care.Many months later and beyond the biosecurity restrictions, the residents of Yarrabah on dialysis are all able to dialyse within their community, on a single shift. This has measurably improved their lifestyle on dialysis, saving about six (6) hours of travel time a week for each resident.
This group presentation will provide a snapshot of how Metro North Hospital and Health Service is supporting the health and wellbeing of Aboriginal and Torres Strait Islander people in their care, as well as supporting staff to provide more culturally appropriate care.This includes:* The Better Together Medication Access service which provides prescribed discharge medication to self-identifying Aboriginal and/or Torres Strait Islander people discharging from Metro North Health facilities at no cost to the patient, aiming to improve discharge medication access and therefore adherence, resulting in improved health outcomes. * The Transforming Emergency Departments to Cultural Safety (TECS) project which is working to improve engagement with emergency and trauma care by creating a more culturally safe and welcoming environment for Indigenous people, particularly those who present with suicidal ideation or an acute mental health crisis. * Incorporating a First Nations Senior Health Worker into the multidisciplinary team at the Royal Brisbane and Women’s Hospital emergency department (ED), providing direct and immediate, culturally sensitive, clinical support to First Nations ED patients, and to role model culturally sensitive behaviours for ED clinicians.
The Cunningham Centre (Darling Downs Hospital and Health Service) partnered with the First Nations COVID-19 Response Team Aboriginal and Torres Strait Islander Division (Queensland Health) to develop an education program that facilitated and enabled Aboriginal and Torres Strait Islander Health Practitioners and Indigenous Health Workers working in clinical positions across Queensland to support the COVID-19 vaccination roll out.This project aimed to improve outcomes for Queensland’s First Nations people by bringing care on or closer to country. A series of mandatory online modules were provided with a final requirement for participants to attend a hands-on practical workshop for those directly involved in vaccine delivery. In addition, the training was made available to both hospital and health staff and staff from Aboriginal and Torres Strait Islander Community Controlled Health Organisations to increase viability and capacity.
Metro North’s Surgical, Treatment and Rehabilitation Service (known as STARS) is committed to providing cultural safety throughout a patient’s healthcare journey. From involving Elders in hospital design and planning, dedicated training for staff, proactive waitlist management and a six-point comprehensive Aboriginal and Torres Strait Islander Cultural Support Patient Program, STARS is ensuring Aboriginal and Torres Strait Islander patients are receiving the gold-standard when it comes to personalised, culturally safe care.
This panel discussion explored what it’s like to be an Indigenous clinician in Queensland. Our panel members share their deeply personally stories about growing up, how they got to where they are, what needs to change, why they got into healthcare, and how their colleagues can be more culturally sensitive (and why they need to be).This episode is not to be missed!
Now in its sixth year, the event brings together like-minded individuals to share their success and connect with others to affect change; all with the shared goal, to improve outcomes for their local community.Over two jam-packed days, we will shone the spotlight on the ways our clinicians are partnering with and listening to their communities to make sure they are receiving the right services. Featured projects will be able to demonstrate clear improvements and benefits for Queenslanders living in rural and remote regions or First Nations communities.Season 4 of the Clinical Excellence Showcase Podcast - Solving the puzzle: meeting the needs of our diverse communities - commences Tuesday 31 May 2022.
Now in its sixth year, the event brings together like-minded individuals to share their success and connect with others to affect change; all with the shared goal, to improve outcomes for their local community.The theme for Showcase 2022 is Solving the puzzle: meeting the needs of our diverse communities. Over two jam-packed days, we will shine a spotlight on the ways our clinicians are partnering with and listening to their communities to make sure they are receiving the right services. Featured projects will be able to demonstrate clear improvements and benefits for Queenslanders living in rural and remote regions or First Nations communities.All the things you love about Showcase will be making a return, but as always, the stars of the show are our frontline healthcare workers, researchers and administrators who will present on the following topics:* Care by mob, for mob * Lifestyle: working together to create healthier communities * Partnerships: working with our partners to improve the patient experience of care * Workforce: creating and sustaining a passionate and skilled rural and remote workforce
Our annual Great Debate saw six fearless clinicians and system leaders taking the stage to definitively answer one question—did COVID-19 provide the ‘re-set’ our health system has been crying out for?The Affirmative Team of Dr Helen Brown, Ms Liz Crowe and Prof Lisa Nissen valiantly argued the merits of disruption innovation and how the chaos of the pandemic forced us to think and do things differently.But ultimately it was the Negative Team that came out victorious with Prof Keith McNeil, Ms Melissa Fox and Dr Tanya Kelly, with Professor McNeil likening his definitive closing arguments to shooting shooting Lassie.
You could almost hear Billy Moore screaming “Queenslander” as a team of University of Queensland researchers set off in pursuit of a COVID-19 vaccine. While version 1.0 of the vaccine was abandoned in December 2020 because of cross-reactivity issues with HIV screening tests, the team is back in the spotlight as they take a new COVID vaccine forward. Learn more about their journey as Professor Trent Munro leads colleagues Professor Paul Young and Associate Professors Keith Chappell and Daniel Watterson in a fireside chat.
Deputy Clinical Director Prof Liz Reymond led this workshop to explore what is known about advance care planning (ACP) in Queensland and to offer suggestions about strategies to increase ACP activity during the COVID-19 pandemic.
Do you want to hear a story about how the pandemic prevented a specialist outreach service from travelling to vulnerable Indigenous communities, but it still managed to deliver essential care?It was through innovations in telehealth!Rapidly building on existing experience in the delivery of telehealth capabilities in store-and-forward technology and a hybrid model including face-to-face and telehealth care enabled the continuity of care to children with significant ear disease, hearing loss and associated impacts. Additional benefits included high attendance rates and tangible improvements in skills and confidence for staff.
With potentially the most geographically dispersed cystic fibrosis population in the world, the Adult Cystic Fibrosis Centre (ACFC) at The Princes Charles Hospital cares for adult cystic fibrosis patients residing as far afield as the Northern Territory and Northern New South Wales. The ACFC had a limited telehealth program in place as the pandemic hit, and with the looming influenza season, the need to maintain clinical trials activity, the challenges of trans-state jurisdictions and keeping the CF population well-informed on rapidly changing clinical practices, the ACFC had to rapidly adapt.In this presentation, the team will report on their rapid and comprehensive transition to an almost completely 'Virtual CF Centre' within a short period of time, including multi-disciplinary innovations around outpatient care, management of pulmonary exacerbations, online home exercise programs, medication provision, influenza vaccination, and more.
With one 46-bed hospital providing tertiary support to 12 other remote communities, the Mount Isa Hospital routinely faces bed pressures. But thanks to the Hospital in the Home model, the North West is relieving bed block by taking stable patients and conditions and managing these in the community. By establishing a medical hostel for Indigenous patients who do not reside in Mount Isa, patients are out of hospital but still receiving care. Consumers now have more options for their care, particularly the discharged against medical advice or DAMA patients, who may deteriorate in the community and need to return to hospital.
The SCHHS identified a need for an experienced medical and nursing retrieval team to road transfer critically ill patients within the district during the covid-19 pandemic climate. The SCHHS contains five health facilities spanned across 100km, a distance normally requiring rotary service. The SCHHS response was initiated to ease burden on RSQ during the pandemic, improve response capability to ensure quality patient care and improve district expertise.
A paediatric obesity clinic successfully conquered the restrictions enforced by COVID-19, empowering children and families to tackle the complexities of obesity from their own home. A multidisciplinary team including a Multicultural Health Worker, Dietitian, Clinical Nurse Consultant, Physiotherapist and Psychologist, delivered culturally tailored and family-centred care via telehealth to address nutrition, physical activity, sleep, screen time and family connectedness. Patient engagement with the service was maximised with the provision of an obstacle course kit promoting physical activity and cooking demonstrations to improve nutritional intake.
With the outbreak of COVID-19 around the world, Australia watched the effects of the pandemic on other nations and the devastation that was wrought on First Nations communities. Modelling of disease spread in our own First Nations communities suggested that any outbreak would be likely to be difficult, if not impossible to control within the community and would put vulnerable peoples at risk of infection and death.Looking to the experience of the Navajo communities in the U.S.A, the Tropical Public Health Servces Aboriginal and Torres Strait Island First Nations COVID-19 Outreach and Rapid Response Team developed strategic and operational responses to reduce potential impacts of COVID-19 on the community.The service received National Partnership Agreement Funding through the Aboriginal and Torres Strait Islander Health Division.
The statewide Assertive Mobile Youth Outreach Service from Children’s Health Queensland will describe the framework they used to manage the wellbeing of adolescents and families with complex mental health problems, including social, emotional and intergenerational complexities – all despite the pandemic.The framework (known as AMBIT) is based in neuroscience and psychology and uses a systems-based approach. As it’s not specific to youth psychiatry, you can find out how it can be used in any service with great impact. As described by the team, it’s like a new type of rocket science – but easier!
The prescribing of some high risk antibiotics, such as aminoglycosides, is complicated. If not dosed correctly (i.e. calculated specifically for each patient), the patient can experience serious adverse effects.In a joint initiative, the Sunshine Coast Hospital and Health Service’s Antimicrobial Stewardship team and ICT Software Development team, developed a desktop app to help mitigate the risks of dosing of high risk antimicrobials. The app is user friendly and accessible to all clinicians in the health service, ensuring safe and accurate dosing recommendations tailored to each patient. Used more than 2,000 times, the app is ensuring appropriate use of aminoglycosides; providing reassurance for clinicians that they are dosing appropriately and ultimately avoiding unintended harms.
The threat of food insecurity has been a long-held concern in the Maranoa Region, further emphasised during COVID-19. The community has responded to this threat with initiatives including the mapping of food relief handouts, public food pantries and basic life skills classes.
In this presentation, find out how Townsville University Hospital, in partnership with UQ and the COVID-19 Analytics Division, created a novel eHealth MaskHelper Tool. An evolution of the first quantitative fit testing (QnFIT) for N95 masks in Queensland, the tool uses a mathematical model and facial recognition software to standardise fit testing; is scalable to whole of Queensland thereby bringing uniformity and greatly reducing mask wastage.
RADS is early discharge and hospital avoidance service for patients who have chronic lung disease, particularly Chronic Obstructive Pulmonary Disease (COPD).Early positive results and evaluation of the RADS service challenge the misconception that “patients who have chronic respiratory disease feel safer in hospital”.
TeleHandover delivers team-to-team clinical handover for patients transferring between hospitals or to another healthcare service or facility via videoconferencing.Proudly supported by Clinical Excellence Queensland, this new handover model takes on the case conference format and includes the patient, family and carers, and in interdisciplinary teams from both facilities. This enables timely, shared clinical decisions to be made with consumer involvement and facilitates the safe transfer of care of patients to the setting most appropriate to their needs, often closer to home and their support base.
This virtual model between Rockhampton and Emerald hospitals was developed to ensure rural sites have access to specialist services within the operating theatre environment.This interventional telehealth model which operates 24/7 already boasts two saved lives among its very promising early results.
Denture hygiene is paramount to the overall health of RACF residents and can contribute to the reduction of hospitalisations from Pneumonia related illness.By implementing new care protocols, dentures are cleaned to remove pathogen laden plaque and biofilm, with additional benefits including improved resident self-esteem and staff compliance.
This project aimed to improve access to tertiary physical health services for people with schizophrenia, leading to improved metabolic health.By embedding the endocrinologist in an environment familiar and acceptable to people with schizophrenia, the community mental health clinic, failure to attend rates were reduced and metabolic health markers were improved.
During the pandemic, Health Consumers Queensland's kitchen table discussions, Consumer Conversations, and bespoke consultations have enabled a diverse range of consumers across the state to directly influence on policy, planning, service delivery and improvement in health.Queensland Health's openness to consumer involvement and transparent communication was credited by consumers for contributing to its overall success in responding to COVID-19 when compared with other states and federally. Ensuring that consumer voices continued to be heard; ensured system gaps were identified early and addressed; gave some surety to staff/system that they were making the right decisions.
The Happy Heart Clinic is designed children who require monthly painful injections for at least 10 years from diagnosis to prevent Rheumatic Heart Disease, an entirely preventable disease that primarily effects children who identify as Aboriginal and Torres Strait Islander.Through engaging with the paediatric patients and involving them in their care processes, the clinic is drastically improving medication delivery. By treating the kids with kindness and giving them agency, they're more involved in their health and are supported to become active consumers.
This collaborative initiative between Gold Coast Health, Queensland Ambulance Service and schools to provide an individualised ambulance management plan for young people with functional neurological disorders, including pseudoseizures.This means that when a young person has an episode at school or in the community that they can be taken home to recover rather than being brought to the emergency department, significantly reducing their time spent in an acute hospital setting.
The West Moreton Care at End of Life Collaborative was established in 2018 to improve outcomes and experiences for all people approaching the end of life in the West Moreton community.Built in true partnership with the community, the service was built from the ground up based around their needs with the goal to better prepare them to support and care for people approaching end of life.The resulting service was a multi-modal approach to providing the community with information about care at end of life services and needs, including live theatre, online resources, and difficult conversations workshop.
This multidisciplinary rehabilitation program aims to prepare patients for major surgery, ensuring they're as healthy as possible to receive their care; mentally and physically. With a strong focus on high value patient-centred surgical care, it delivers better patient outcomes and can result in cost savings following major abdominal and cardiothoracic surgery.Each care plan is designed in partnership with the consumer, with the project guided by feedback from patients that have previously accessed the service.
In 2018, HCQ conducted consultation with prisoners in seven correctional centres to inform the Offender Health Services Review Report. Three years later, the Office for Prisoner Health and Wellbeing (OPHW) engaged Health Consumers Queensland to revisit the same seven correctional centres to learn from prisoners what has changed and what needs to be improved.A total of 112 prisoners were consulted in 19 group sessions during March to May 2021. Each consultation was up to an hour, during which Prisoner Advisory Committee (PAC) members were given an opportunity to express their views about their experiences with prisoner health services, with a focus on access and delivery, and to provide suggestions about what could be done to improve services.
Matthew Page from our Statewide Telehealth Support Unit joined Dr John North from the Princess Alexandra Hospital to explore the key to success when setting up a telehealth service and how we can partner to scale and spread the models that are already having an impact.
A drive-through delivering better outcomes for vulnerable consumers with chronic conditions emerged at Redcliffe Hospital during the COVID-19 pandemic.While burgers and fries were off the menu, medication education was delivered via telehealth and waiting times on hospital grounds dropped from an hour to around two minutes.
Virtual Outpatient Integration for Chronic Disease (VOICeD) allows people to see multiple healthcare providers in a single online appointment.VOICeD complements to face-to-face services and can reduce appointment numbers by almost two thirds. It also enables improved access in situations where mobility is constrained.
This service reduces the barriers faced by patients in correctional facilities when accessing healthcare by: taking X-rays onsite, providing appropriate treatment, and reducing avoidable transfers to hospital.In addition to the significant benefits to patients, onsite X-ray operators have also reported improved job satisfaction through being able to work to their full scope of practice.
This alternative model of care allows individuals with burn injuries to receive specialist care either at home or their nearest healthcare facility.Its benefits include improved patient outcomes and upskilling opportunities for regional clinicians, in addition to half-a-million kilometres in saved travel (April 2019 to December 2020).
This primary (first contact) and secondary (referred after medical review) model of care helps meet the needs of Queensland children with bladder, bowel and/or pelvic floor dysfunction (BBPFD).This service utilises multiple digital technologies to provide family-centred care directly to a patient’s home, including the ability for families to enter their own patient reported outcome measures (PROMs).
While the pandemic fundamentally changed the way we live, this disruption has led to innovative new ways of doing things. From ordering from the table at the restaurants to improving the technological literacy of older Queenslanders, Queensland Department of Health Manager Dr Ides Wong explores how the pandemic has pushed us forward, particularly when it comes to research.Ides also discusses the COVID barometer which was built in partnership with multiple Government Departments and the CSIRO to help track and support outbreaks using a range of data sources.
Metro North Hospital and Health Service’s Women’s Business Shared Pathway is improving access to gynaecological care for First Nations women.This new culturally safe pathway has seen a drastic reduction in missed appointments and includes a range of support services to provide care in a way that suits consumers.Designed in partnership with the Institute for Urban Indigenous Health, the pathway was designed in consultation with their consumers to ensure it truly meets the needs of the local community.
In this presentation, find out how Gold Coast Health created a software platform that can model the spread of any communicable disease in any city or region. The platform was used to accurately model the 2020 COVID-19 outbreaks in Sydney, Melbourne and the Gold Coast and is also being used to inform the potential impact on hospital and ICU admissions, resource utilisation, and to explore potential vaccination strategies and their interaction with social restrictions.
In response to the restrictions enforced during the COVID-19 pandemic, the senior music therapist at Gold Coast Health introduced a new way of working with patients to reduce isolation, improve wellbeing and enhance self-expression.Clients were invited to participate in ukulele lessons in the form of individual and group lessons, with patients encouraged to continue learning in their own time. Client behaviour was observed during the lessons with positive changes seen in attention, memory and self-expression. Clients also showed high rates of motivation.
The Digital Sepsis Algorithm Project is designed to test the sensitivity and specificity of a sepsis algorithm developed by the Westmead Hospital in New South Wales using data in the ieMR to predict the onset of sepsis. The algorithm uses both rigid data sources such as pathology data and vital signs, as well as free text contained within the record. As a time-sensitive medical emergency, faster identification and management of sepsis leads to better patient outcomes.
Sit, Talk and Yarn—or STaY—is an innovative suicide prevention initiative in Cherbourg, implemented under the Darling Downs Indigenous Health Unit. Dovetailing best practice suicide intervention with a whole of community approach, the service is drastically improving support provided to consumers identified as lower risk in the clinical setting.Through embedding non-clinical interventions, connecting support networks and embedding social and emotional wellbeing principles in the standard model of care, the project is destigmatising suicide and improving outcomes for the community.
The team developed a culturally and clinically appropriate preoperative health and wellness check by phone to ensure Aboriginal and Torres Strait Islander patients are appropriately prepared to undertake surgery.Utilising clinical and administrative data, the team developed a script to give Nurse Navigators all the information they need to ensure the consumers are informed and comfortable to continue with their care.
Biosecurity restrictions implemented during the COVID-19 pandemic presented significant obstacles to clients in affected communities accessing care. For the residents of Yarrabah requiring dialysis, this threatened to displace them from the community to continue to access life-sustaining haemodialysis.Not only did this model support the continuation of life sustaining care, the move on Country reduced travel time for consumers and costs for the service, which can be reinvested in delivering more care.
Waijungbah Jarjums means place of mother and child and is a one-stop community service that provides continuity of care for First Nations People. Our service offers continuity of care by a known Aboriginal and Torres Strait Islander midwife and child health nurse from conception to the first 1000 days (2 years).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.
Based out of Princess Alexandra Hospital, this model of care improves access to kidney transplantation services to First Nations communities across the state.Indigenous-led and proudly supported by the National Indigenous Kidney Taskforce and Clinical Excellence Queensland, the team have liaised extensively with local Elders and traditional custodians to ensure that the outreach truly meets the needs of the community.From appropriate education to face-to-face yarning, this on Country outreach is drastically improving transplantation rates.
The Ambassador program is focused on the proactive engagement of patients and visitors to improve the patient experience to prevent and/or reduce aggressive and disruptive behaviours.In collaboration with the Surgical and Perioperative Nursing leads, Royal Brisbane and Women’s Hospital’s Protective Services team, and QOVSU, it was established that the trial would be undertaken in the three most high-risk wards who regularly house complex surgical patients.
Darling Downs Health know that selfcare and wellbeing looks different for everyone and that their people experience a wide range of thoughts, feelings and reactions, especially when presented with the challenges posed by a global pandemic.To keep their team mentally and emotionally strong during the disruption caused by COVID-19, they developed a multi-modal staff wellbeing support system, including support from the clinical psychology team to resources for self-guided mental health strategies.
The project aimed to ensure that staff involved in Mater Home Visit services were as safe undertaking their roles as those working at a facility. A series of protocols were developed to ensure that staff were not at more risk and could be assured that they were potentially exposing their families and patients in the changing environment post-COVID.Through a series of process testing simulations risks were identified and procedures were amended to address any gaps, to improve the safety of patients and staff.
This body of research explored the impact of working in healthcare during the pandemic, within the context of low infection rates. The study aims to evaluate the psychosocial impacts on all staff in the cancer care service, from clinicians to administrative and operational staff.The research will be used to inform inclusive policies for all frontline staff and better prepare health services to maintain positive culture and staff mental health in a time of crisis.
Warning: this episode features discussions about suicide and mental health.Dane Bird-Smith An Olympic 20km Racewalker representing Australia for the last 12 years, 4 x World Championship teams, 4 x World Cup teams, a gold medal and Games record at the 2018 Gold Coast Commonwealth Games and on debut a Bronze medal at the 2016 Rio De Janeiro Olympic Games.Bird-Smith has been around the world and taken on every competitor and challenge, but his greatest challenge was from within himself.After years of punishing training, singularly focused on competing at the highest level he found himself achieving his dreams but shadowed by a dark cloud. Reaching out for professional help was a decision that shook his Olympic values of strength, resilience and chasing perfection, but it was a move that he believes saved his life.With renewed support and changes in perspective he not only continued to compete against the best in the world but put a spiral of depression behind him. Now he wants to share his journey and be a catalyst for conversations in mental health and men’s health.If you or anyone you know needs help:* Lifeline on 13 11 14 * Kids Helpline on 1800 551 800 * MensLine Australia on 1300 789 978 * Suicide Call Back Service on 1300 659 467 * Beyond Blue on 1300 224 636 * Headspace on 1800 650 890 * ReachOut at au.reachout.com * Care Leavers Australasia Network (CLAN) on 1800 008 774
Chair of the Queensland Clinical Senate (QCS) Dr Alex Markwell walked us through how clinicians have remained connected during COVID-19 through clinical bodies, advocacy and a range of virtual communication methods.Dr Markwell also gave us an overview of how the QCS works and recent and upcoming priorities. Future priorities include continued COVID briefings, clinician engagement and procurement, voluntary assisted dying, virtual care, system reform, and the health impacts of climate change.
Showcase favourite Professor Keith McNeil opened this year’s event, recapping the last 20 plus months since COVID-19 arrived in Queensland.From cases to treatments and the vaccines, Professor McNeil shared his wisdom while offering a bit of hope as we transition to the new ‘business as usual’ in healthcare.
Since the onset of the COVID-19 pandemic, global health systems have been challenged like never before. As time and resources were directed towards responding to the virus, it was the dedication of healthcare workers that kept services running.Amongst the uncertainty, our hard-working Queensland clinicians have continued their pursuit of excellence – innovating and adapting the way they work, to ensure consumers always receive the best care possible.To them, the pandemic was an opportunity to learn and grow, and to ensure healthcare delivery continues to evolve to the ever-changing landscape.Because if we’ve learnt anything from the last two years, it is that things will always change. And our clinicians will always rise to the occasion.Social mediaTo continue the conversation, follow us on social media:* Facebook @ClinicalExcellenceQueensland * Instagram @ClinExcelQld * Twitter @ClinExcelQld
Following the same tried and tested format of previous events, the best was saved to last at Showcase 2020 with The Great Debate closing out Day Two. Looking at the impact of technology and the huge costs associated with bricks-and-mortar hospitals, the 2020 debate examined whether hospitals as we know them would cease to exist in 50 years’ time.The teams featured some old and new debaters including Carl de Wet, Chris May and Champika Pattulo (affirmative team), and Nikia Goldsmith, Rob Franz and Robyn Littlewood comprising the negative team.With several humorous and personal digs between opponents, each team came up with interesting and thought-provoking ideas of what the future would hold. Including: personalised, technology-driven medicine embedded in our brain with a little chip, futuristic hospitals, and overall improvements to our wellbeing that would reduce hospital burden. But in the end, the winner (as determined by the audience poll and chair Prof Keith McNeil) was ... well, you'll just have to listen to find out!Connect with Clinical Excellence Queensland* To learn more about us, visit the Clinical Excellence Showcase website. * Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Central Queensland residents are benefiting from a global shift towards technology-enabled care to provide cost-effective specialist rheumatology services. This novel telehealth outreach model is providing better access to care thanks to a collaboration between Central Queensland and Metro North.
Learn more* To watch Ashleigh and Eugene’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Older Persons Enablement and Rehabilitation for Complex Health Conditions (OPEN ARCH) is an Australian-first model of care for the community dwelling older person with complex needs. OPEN ARCH provides comprehensive care through connection and collaboration at the primary-secondary interface.
Learn more* To watch Jennifer’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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The Prince Charles Hospital provides general surgeons on a rotating basis to 16 hospitals throughout the South West and Central West. patients benefit by being close to home, local hospitals benefit by providing a broader scope of care and issues around recruitment are solved.
Learn more* To watch Robert’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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A pilot implementation of the Allied Health Brief Therapies (AHBT) Clinic Model of Service within the Darling Downs, Metro South and West Moreton Health Services supported allied health mental health staff in delivering brief psychotherapeutic interventions to consumers at risk of suicide.
Learn more* To watch Sarah and Tom’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Babycam is a ground-breaking innovation connecting families to their pre-term and critically unwell babies via a smart device application and revolutionising neonatal intensive care in North Queensland. The program received the Minister's Award for Outstanding Achievement at the 2019 Queensland Health and Department of Health Awards for Excellence.
Learn more* To watch Yogavijayan’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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The assessment and care of people experiencing a mental health crisis prove a challenge for paramedics on scene, in people's homes and into the emergency department. As a result, the QAS has implemented a number of initiatives to support the development of more appropriate responses to people experiencing a mental health crisis.
Learn more* To watch Sandra’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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This project trialled persistent pain medical specialist's initial assessment/review consultation via telehealth instead of face-to-face, with specific allied health and general practitioners involved in the telehealth conference based on the patient's condition and needs.
Learn more* To watch Jane and Richard’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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STARTT involves collaboration with the patient's family to identify salient memories and create a recorded memory narrated by a familiar voice. The team identifies appropriate and significant sensory stimulation and prescribes a personalised program.
Learn more* To watch Christoel’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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RPTTP aims to improve surgical outcomes for patients in crisis situations in rural facilities through the use of teamwork, communication and system design.
Learn more* To watch Christopher’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Influenza outbreaks place a significant annual burden on the Australian healthcare system. There is well documented evidence that increasing rates of influenza vaccination, especially amongst high risk patients will decrease the number of confirmed cases of influenza, reduce hospital admissions, associated costs and death. Despite this, under usage of immunisation programs continues to be a significant public health concern with inadequate time to attend a venue for vaccination being identified as a significant contributor to less than ideal vaccination rates. The Royal Brisbane and Women's Hospital pharmacy service has input into ambulatory outpatient services, making it ideal for providing opportunistic vaccinations to patients in a hospital outpatient setting. The aim was to investigate the impact of such a service on increasing access for high-risk patients to receive their annual influenza vaccination.Learn more* To watch Kim’s interview, visit the Clinical Excellence Showcase website. * For information about the project, visit their page on our Improvement Exchange. * Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Expediting access to Hepatitis C treatments for prisoners in South East QLD prisons, through utilisation of a Nurse Practitioner/Nurse Navigator led model of care. The role includes direct patient consultations, with referrals coming from nursing staff, medical officers, mental health clinicians and tertiary specialists.
Learn more* To watch Chris’ interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
The Gold Coast has implemented a student resourced service for vulnerable patients at risk of hospital acquired complications including the co-design of individualised care strategies focussing on risk minimisation and supporting staff to meet the unmet needs of this population.
Learn more* To watch Jenny and Justine’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Rural maternity services are currently experiencing a high degree of political focus and consumer driven advocacy forcing system review and change. Across the Darling Downs, maternity services have battled significant workforce shortages and heightened media scrutiny. In order to meet consumer expectations and ensure continuity of services, change processes have been implemented to improve service delivery.
Learn more* To watch Jennifer and Peta’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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The Julia Creek Multipurpose Health Centre's Integrated Model of Care project aims to deliver care that meets the current and future needs of the McKinlay Shire community.
Learn more* To watch Margaret’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Implementation and uptake of evidence-based interventions to reduce obesity was driven by a high-functioning community partnership and tribal leader network. The collective impact of the tribal approach of continuous leadership of and investment in tribes resulted in behavioural changes in active living, healthy eating and weight loss.
Learn more* To watch David’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Following the introduction of a benchmarked model of care and identified service priorities, gaps in youth health outcomes (such as STI rates, teenage pregnancy, risky alcohol consumption etc) were targeted in order to build stronger and healthier communities. This project was a finalist in the 2019 Queensland Health and Department of Health Awards for Excellence.
Learn more* To watch Friederike’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Funded by the New Technology Funding and Evaluation Program, the Royal Brisbane and Women's Hospital has been working to locally manufacture CAR-T cells. Patients' T-cells are modified to include a chimeric antigen receptor (CAR), which can directly target and kill cancer: a new era in cancer immunotherapy.
Learn more* To watch Glen’s interview, visit the Clinical Excellence Showcase website.
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Vesticam goggles are assisting doctors and physiotherapists in correctly identifying nystagmus in dizzy patients, improving the confidence and accuracy of diagnosis of dizzy patients. The ability to remove fixation and replay assessment of ocular movements has greatly improved the confidence and accuracy in determining peripheral versus central causes of vertigo.
Learn more* To watch Andrew’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Recognising the role of simulation in testing workplace transition (Adler et al 2009) and the recommendation for the use of simulation to improve electronic medical record use (Mohan et al 2017), simulated scenarios were used to prepare for the change to integrated electronic medical records (ieMR) at the Sunshine Coast University Hospital. Fifteen inter-professional and inter-departmental ieMR simulation exercises were conducted as part of the health service's preparation for digital transition.
Learn more* To watch Clare’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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To overcome the limitations inherent to the recording of suicidal presentations to emergency departments, Gold Coast's mental health services developed a machine learning algorithm that searches EDIS for Records of Suicidal Presentations (SERoSP).
Learn more* To watch Chris’ interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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The Jelly versus Foam project aimed to improve image quality and intraoperative imaging doses through the use of optimised positioning aids.
Learn more* To watch Hannah and Sasha’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Gold Coast Health piloted a shared governance business model in the orthopaedics department, granting clinical departmental leads with direct accountability for achieving agreed outcomes, supported by increased financial and HR delegations. This enabled them to more directly and efficiently manage the day-to-day operations of the department and improve its overall clinical and financial performance.
Learn more* To watch Kate and Kimberley’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Getting Rid of Stupid Stuff - Removing the non-value adding activities in everyday work! Need we say more?
Learn more* To watch Michelle’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Mater Health Services has developed a program to optimise recovery after elective caesareans and enable earlier discharge for healthy, well women and their babies in accordance to best evidence based practice.
Learn more* To watch Kym’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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In 2016, funding was granted to expand the vestibular service at Logan Hospital to include onsite First Point of Contact (FPOC) Vestibular Physiotherapy and Vestibular Diagnostic Audiology. Within three short years, the staffing FTE has multiplied significantly and the team won the 2018 Metro South Board Chair's Award for "Delivering Our Values: Unleash Potential".
Learn more* To watch Leia’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Patient flow difficulties with delayed discharges on the Public Postnatal Unit at the Mater Hospital was causing bed block and impacting the birth suite, antenatal unit and OT. Find out how the Mater reduced length of stay from 2.1 to 1.9 days and other reductions and improvements.
Learn more* To watch Katie and Kerrie’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
The Maternity and Antenatal Telehealth Service of Central Queensland is unique in their adoption of digital pathways that connect antenatal high-risk women in rural and remote areas to the hub site in Rockhampton. The three phases of this project included the development and implementation of antenatal telehealth services, high risk antenatal telehealth clinics and CTG co-signing by telehealth.
Learn more* To watch Christina and Vickey’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Electronic clinical audit tools and reports were redesigned or developed using existing Microsoft 365 applications, enabling staff to access dashboards displaying information by service area, national standard and facility level.
Learn more* To watch Alison’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Central line associated bloodstream infections (CLABSI) in neonatal intensive care is associated with mortality, morbidity, increased length of stay and increased healthcare costs. Implementing a bundle of evidence-based interventions, continual audit and improvement and education and promotion has led to a significant reduction in CLABSI rates and 157 consecutive CLABSI-free days at the Mater Hospital Brisbane.
Learn more* To watch Pita’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Increased junior doctor and nursing support for the Princess Alexandra Hospital's Hospital in the Home (HITH) service led to an dramatic increase in admitted HITH patients: up from 6 per month to 60 or more.
Learn more* To watch Tauqeer’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
As a result of the proposed rollout of ieMR, additional bed space for the decanting of acute areas of Toowoomba Hospital was required. A decision was made to relocate a clinical ward offsite, the logical answer being to relocate tee sub-acute rehabilitation unit.
Learn more* To watch Karen’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
An after hours, multidisciplinary team based approach for Patients of Concern. The introduction of new nursing and medical leadership positions has led to proactive clinical reviews for Patients of Concern, mentorship and support for junior after hours staff, and new educational initiatives to improve staff recognition and response to clinical deterioration.
Learn more* To watch Julian’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
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Queensland’s Women’s Week is about recognising and celebrating our diverse community of strong women and the unique contributions they make in our communities. So, to acknowledge this week-long celebration (which started on March 6 – day two of the showcase), we held a dedicated plenary session with some of the best female-led projects in Queensland!The second Women in Healthcare presenter was Adjunct Associate Professor Leanne Stone, who is the Director of Nursing for the Division of Cancer in Metro South Hospital and Health Service. Leanne is leading the research and build of an electronic Actionable Patient Perspective or eAPP that will inform Patient Reported Experience Measures or PREMs.PREMs ideally capture hospital performance in six domains advocated by the Institute of Medicine (IOM), ranging from respect for patient needs and preferences, care coordination, physical and emotional support, and the involvement of significant others.The Patient-reported Experience-Cancer (PRE-C) instrument was developed to capture these variables in the cancer service and inform responsive health service delivery. Leanne’s team tested the instrument across all streams of cancer care by embedding it into the Integrated Electronic Medical Record or ieMR. Leanne provided attendees with an insight into how the platform works, how it can be customised, current benefits and limitations.At the end of her presentation, session facilitator Professor Keith McNeil, then-Acting Deputy Director-General Clinical Excellence Queensland said it was a fantastic example of harnessing data and turning into useful information accessible in real-time.Learn more* To watch Leanne’s interview, visit the Clinical Excellence Showcase website. * For information about the project, visit their page on our Improvement Exchange. * Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Queensland’s Women’s Week is about recognising and celebrating our diverse community of strong women and the unique contributions they make in our communities. So, to acknowledge this week-long celebration (which started on March 6 – day two of the showcase), we held a dedicated plenary session with some of the best female-led projects in Queensland!Nakia Beaton, Senior Radiation Therapist at the Princess Alexandra Hospital, kicked off the session discussing the implementation of Deep Inspiration Breath Hold or DIBH for breast cancer treatment. Breast cancer is the most common malignancy in Australia affecting 1 in 8 Australian women. Adjuvant therapies have resulted in significant survival benefits with five-year overall survival increasing from 73 per cent in 1987 to 91 per cent in 2017.Cardiovascular (CVD) disease is the greatest non-cancer cause of death for breast cancer survivors with women with breast cancer having a higher risk of CVD than other women. This is thought to be associated with the radiation exposure the heart receives during breast cancer treatment.DIBH is a motion management technique used for left-sided breast/chest wall patients and right sided breast patients with internal mammary nodes. Using the technique, the heart moves inferiorly, becomes more elongated, and moves away from the deep border of the radiation field thereby reducing its exposure to the radiation.At Showcase 2020, Nikia shared the outcomes of their pilot study, which assessed whether DIBH decreases the incidence of subclinical myocardial dysfunction as determined by a 2-dimensional strain imaging echocardiography.Learn more* To watch Nakia’s interview, visit the Clinical Excellence Showcase website. * For information about the project, visit their page on our Improvement Exchange. * Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
The Accelerated Chest Pain Risk Evaluation (ACRE) project is a statewide project supported by the Healthcare Improvement Unit. The ACRE project aims to facilitate implementation of the best evidence for the safe and efficient evaluation of patients presenting to emergency department (EDs) with possible cardiac chest pain. The project utilises clinical redesign methodology to support adoption of accelerated diagnostic protocols (ADPs) that are evidence-based, safe, and patient focused.
Learn more* To watch Sarah and Tanya’s interview, visit the Clinical Excellence Showcase website.
* For information about the project, visit their page on our Improvement Exchange.
* Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Stephen Stathis last joined us in 2018 when he shared the evolution of Children's Health Queensland's gender clinic, which at that time had only been in operation for about 12 months. At Showcase 2020, Stephen was joined by colleague Olivia Donaghy to bring us up to speed on how the clinic has changed and to provide updates on other advancements in youth mental health.Olivia explains that given there was no multidisciplinary gender service before the establishment of the clinic in 2017, the first few years of the service saw an exponential growth in referrals. “The main challenge has been managing that growth, but at the same time it has been wonderful to provide the service to more than 600 families.”Stephen said before the service there was extremely long waiting lists and no dedicated place or service for these families to go. “It’s a place for them, a place to be heard, and a place for them to attain the necessary assessment and treatment they need,” he said.With families attending the clinic coming from right across Queensland, Stephen highlighted that the value of the Clinical Excellence Showcase was its statewide focus. “Showcases like this are very important to showcase what we do, not just to the broader community but to clinicians right across the state because it allows them to understand what we do here. It’s a statewide service and a large proportion [of families] come from regional and rural Queensland.”Learn more* For more information on Children’s Health Queensland’s Gender Clinic and Statewide Service, visit their website. * To watch Olivia and Stephen’s interview, visit the Clinical Excellence Showcase website. * For information about the project, visit their page on our Improvement Exchange. * Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
Robyn Neilson, keynote speaker for Day One of Showcase 2020, is a trained nurse having worked as a clinical nurse, nurse educator, director of nursing and general manager of clinical services for St Luke’s Nursing Service (Anglicare) Queensland. As Founder and Director of the Rescue1st charity, proudly sponsored by the Rural Doctors Association of Queensland Foundation, Robyn is the pioneer and innovator of the patented revolutionary system that creates Emergency Position Indicating Radio Beacons (EPIRB) from mobile phones (Patent Pending).Raised on grain, sheep and cattle properties and later owning family cattle stations in New South Wales and Central Queensland, Robyn developed an early passion for farm safety, encouraged by her mother as a nurse and father from the military.A passion that would eventually enable her to save the life of her neighbour Gayle Shann, following an horrific farming accident. Their story and Robyn’s efforts as First Responder was recorded by the ABC’s Australian Story. “With This Ring” is reportedly the most requested episode in the history of the program.Robyn shared the harrowing tale of saving her neighbour's life with us at Showcase 2020, and the social and psychological impact of that day. Her story and the advice she gave based on that experience left the room so moved and quiet, you could have heard a pin drop. Unsurprisingly, she was met with a standing ovation and importantly; began many important conversations about the need for healthcare professionals to take care of their mental health too.Learn more* To watch Robyn’s interview before her presentation, visit the Clinical Excellence Showcase website. * You can watch Robyn’s episode of Australian Story on ABC iView. * Please subscribe to ‘Clinical Excellence Showcase’ wherever you digest your podcasts, rate and review on iTunes and follow us on social media: Facebook, Twitter and Instagram.
In the rapidly changing world, healthcare needs are constantly evolving and clinicians need to find new ways to deliver care. And often the best way to do that, is by looking back.Without Marie Curie, there would be no pioneering improvements to medical imaging today. If Edward Jenner didn’t inoculate a 13 year-old with cowpox, there wouldn’t have been a space for Professor Ian Frazer‘s cervical cancer vaccine.Our clinicians are standing on the shoulders of those that came before them – learning, growing and advancing – to improve care delivery.Hindsight isn’t 2020, It is our future.Social mediaTo continue the conversation, follow us on social media:* Facebook @ClinicalExcellenceQueensland * Instagram @ClinExcelQld * Twitter @ClinExcelQld
As first responders to incidents in the community, our hardworking police officers are frequently required to attend to people with mental health problems who are in crisis.Through collaboration with the Queensland Police Service and support from Queensland Ambulance Service, West Moreton Health commenced the Mental Health Co-Responder Project (MH-CORE) in March 2017, to better meet the needs of people with mental health problems who are in crisis.Links* Hear Janet and Sgt. Leon Margetts talk more about the model at the 2018 showcase.
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In 2013, Mater Private Hospital Brisbane, was the first hospital in Australia to implement room service. This private hospital study reported an increase in nutritional intake, improved patient satisfaction and reduced plate waste and patient meal costs compared to traditional models.From its proven success, Mater implemented the model across the remainder of its public and private facilities in 2016. And after presenting at the Clinical Excellence Showcase 2018, was introduced to the Queensland public health system.Links* Hear Sally talk more about the model at the 2018 showcase.
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Ordinarily, manual patient observations including blood pressure, temperature, heart rate, respiration rate and blood saturations are taken by nursing staff every four hours during an admission. Supported by Clinical Excellence Queensland, Metro North Hospital and Health Service is conducting an Australian first wireless vital sign monitoring pilot at Kilcoy Hospital.In this innovative trial, patients will be connected to a monitoring system which sends live, up-to-date observations to a tablet at the end of their bed and directly to the nurses’ station dashboard or another monitoring facility. The observations are cross-checked against Q-ADDS scores, allowing for deterioration to be picked up and treated earlier.Social mediaTo continue the conversation, follow us on social media:* Facebook @ClinicalExcellenceQueensland * Instagram @ClinExcelQld * Twitter @ClinExcelQld
Integrating care across the spectrum, putting the patient at the centre of their needs, is the way of the future for the system. But why then, is it so difficult to effectively design? And most importantly, sustain.Caroline Nicholson, Director of the Centre for Integrated Care and Innovation with Mater Health knows that finding the answer is complex, but once we have, the future of healthcare is limitless.And focused on the needs of the individual.Links* Hear from Caroline as she headed for an interview backstage.
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Talented multi-hyphenate Dr Tim Duncan started out his career in the family business of medicine, before realising he wanted more. And that that more came in the form of filmmaking.Switching the catheter for the camera, Tim enrolled at the Victorian Collage of the Arts and three short years later, graduated a penniless artist.Before embarking on his creative career , he returned to medicine for what he thought would be the last time.It was then that his life changed.After a car accident in remote Australia, lying near-death on the side of the road, Tim found his calling.Links* To learn more about Tim’s creative endeavors, visit Doctored Films. * You can watch his episode of Australian Story on ABC iView. * His short film Aboriginal Heart is available on his website.
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At its core, healthcare is about people. While the patients are always at the centre of care, that care is delivered by hardworking, passionate people that want to make the world a better place by helping others.The Clinical Excellence Showcase 2019 delved deeper into the people behind the care because it is their dedication, innovative spirit and a desire to give back that keeps our system running.These are the real people delivering remarkable healthcare.Social mediaTo continue the conversation, follow us on social media:* Facebook @ClinicalExcellenceQueensland * Instagram @ClinExcelQld * Twitter @ClinExcelQld