A presentation given by Bethany Hooke at the October 2012 CHA Conference, The Journey, in the 'Beyond hospital Walls: Community Care' stream.

2. The Journey
towards excellence in Children’s
Health Care 23-24 October 2012
Reinventing Child Development:
Steering the ship through uncharted waters
Child Development Working Group
Statewide Child and Youth Clinical Network

3. Queensland’s Context
 How far away is it?
 Coolangatta to Bamaga
 2246 km
 Brisbane to Cairns
 1392 km
 Unique challenges
 Third largest capital city
 45% of state’s population
 Five regional centres with
population >100k people
 Greatest number of people
living in outer regional, rural
and remote locations
 Young population
 Developmentally vulnerable

4. What do we mean by
“Child Development”?
 Skills children acquire in infancy childhood and adolescence
 Functional application of those skills across contexts
 Approx 15% of paediatric population has a developmental
impairment
 Long and short term health implications:
 impacts on social, educational, & vocational outcomes,
 economic participation,
 physical and mental health outcomes,
 health literacy and engagement across the lifecourse,
 interface with justice and welfare systems.
 Vulnerable populations

5. SCYCN: CDWG
Statewide Child and Youth Child Development Working
Clinical Network Group
 Established 2009  Established 2009
 Initially 4 priority areas  Membership
 Child Development  Multidisciplinary (medical
 Now supporting activity and allied health)
more broadly  Multiregional
 Chair: Dr Julie McEniery  Advice, support and
advocacy
 Robust clinical and
corporate interface

6. Our starting point
 CDS in QH have evolved:
 Ad-hoc
 Historical context, local needs,
preferences, skills
 Absence of:
 Clear policy direction
 Commonly understood roles
and responsibilities
 2010: Common Vision
 2011: Common Name
 2012: QSCDSIP

7. QSCDSIP
 12months funding filled at 0.6fte
 March 2012 to June 2013
 Objectives:
 Profile each team and their current and historical
contexts
 Develop an integrated resource document to support a
common understanding and common language
 Develop Clinical Service Standards to support a model
of care more similar than different
 Work with teams to develop individualised change
management plans

8. What has been done differently?
Strategic approach to identifying teams within scope
Network of clinicians who identify and are identified
Clinicians identify local champions
Actual vs aspirational
 Profile that is increasingly attractive to clinicians and better understood
Its our job to understand you, your team, your business, your region
Reciprocity – two way active relationship building
Face-to-face contact with all teams statewide including site visits
Culture is as (?more) important as form and function
Appreciate variation
Outcomes = clinician led, project supported
Evolving end point
Change management plan (Objective 4) will vary from team to team
Each team is responsible for innovative problem solving at local level
Clinical relevance and applicability

9. 4Cs
 Continuum of Care
 Support understanding of child development as a high incidence, low acuity
clinical service area that impacts on all levels of service provision across the
care continuum
 Core Business
 Children with complex developmental difficulties require sophisticated
assessment, diagnostic, and support services to optimise their family’s
understanding and capacity to manage this over time
 Complexity
 Not all developmental impairment is complex; complexity exists within and
across developmental domains; complexity requires an interdisciplinary
approach to practice
 Capabilities
 Specialist service provision requires specialist clinical capabilities, knowledge
and skills

10. Standards for Clinical Practice
 Why?
 Framework for consistency in service planning and provision
 Guide quality improvement and professional development
 Three components:
 Conceptualised
 Structured
 Delivered
Each team still needs to consider: So each CDS can be:
Local issues Inherently adaptable
Strategic directions Locally responsive
Legislative requirements Innovative acc to context

11. Current QH Context
 Much change, including:
 Health and Hospital Services
 Hospital boards
 Children’s Health Queensland
 Queensland Children’s Hospital
 New funding models
 Metropolitan clinical services integration
 Anxiety: low acuity (high incidence) clinical services

12. Risks and Opportunities
 Being drowned out by louder voices and more acute
clinical areas
 Collectively we can grow a simple but clear and consistent message
 Perpetuating ad-hoc service development
 Collectively we can effectively and strategically plan a model of care
that is more similar than different and that better meets the needs of
Queensland Children and their families
 Continuously re-inventing the wheel
 Collectively we can use our shared experiences to support service
development and problem solving
 Inequity in service access
 Collectively we can improve access and reduce inequities for
vulnerable children and families

13. What we’ve learned so far…
Trust Make complex simple
Transparency Common End parallel conversations
Relationships Use language others
Add Value
Language understand
Be Available
Big
End point influenced by Flexibility
stakeholders (ongoing) Picture Start BIG then drill
down
Engage beyond the ‘scope’
History is pervasive

14. Comments & Questions