Shared learnings from three distinct clinical quality improvement activities across a tertiary paediatric facility

Abstract

Introduction: Children’s Health Queensland Hospital and Health Service (CHQ) is a state-wide public paediatric health service for children and young people in Queensland Australia. CHQ prides itself on undertaking clinical quality improvement activities to deliver better care to children and families. Over the past 24 months, significant projects were undertaken in three clinical areas to better understand consumer needs and opportunity to optimise lifelong outcomes. These clinical groups were: Children with congenital heart conditions Children who are deaf Young adults who have cancer Each project team engaged with a range of consumers including children, young people and their families, health providers, and support groups or organisations such as non-government organisations. All conducted a literature review. It became apparent as each of the projects began presenting their findings that, despite the clinical differences between the cohorts of children, there were consistent themes and learnings-in-common across the three inter-professional-led projects. Theory / Methods: A focus group will be conducted with the three project leads: an occupational therapist from the cardiac project, a speech pathologist from the deafness project, and a physiotherapist from the youth cancer project. The focus group will be semi-structured and will be recorded and transcribed. The data will be themed. A literature review will be conducted to determine whether a comparison across multiple clinical quality improvement activities has been conducted to find similar findings. The focus group is scheduled for September 2018. The literature review will aim to be conducted in January-March 2018. Results: Expected results from this project will be determined through the focus group and a subsequent transcription and theming process, supported by the literature review. Some initial insights based on the individual project reports indicate common findings include neurodevelopmental concerns, mental health concerns, lack of longitudinal care-planning, lack of integration with primary care and long-term health care planning. Discussions: We know that children and young people with chronic and complex conditions are in need of integrated care. Each project identified a lack of continuity of care, pointing to a lack of integration with the child and families’ primary care providers and their own social supports, and schools etc. It is envisioned that the insights gained from this work will inform not only future quality improvement projects, but also support and deliver upon CHQ’s commitment to an integrated care agenda and interprofessional working. Conclusions: The shared learnings will likely fall under three major domains: clinical practice (how we provide health care to children and young people) process (how we build and apply inclusive protocols and pathways for care) systems (how we connect within and across services and sectors) Limitations: The projects have varying levels of rigour and ethics, meaning the technical findings are varied. Suggestions for future research: Systematic review on how shared learnings can inform translation of research and findings to practical clinical practice improvement along the continuum of care.

Keywords

• children
• young people
• improving health care
• connecting care