This combined CHA Paediatric Emergency Care and Paediatric Units face to face meeting was held on the 23 and 24 October 2017. This meeting was co-hosted by the Sunshine Coast University Hospital, and tours of the facility were conducted of this new service that opened in March this year.
Presentations included a stimulating discussion started by Sarah Jamison and Anna-Marie Grace from Starship Children’s in Auckland on how it is that we evaluate the quality of our emergency care for children & families. Barb Vernon & Jason Acworth then facilitated discussion about the metrics that could be used to support all EDs caring for children to assess the quality of their care.
The incredible depth and capability of our leaders in Paediatric ED care was clearly evidenced on day 1 when Zaahid Pandie from The Prince Charles Hospital presented a moving presentation on how he has attracted, retained, and grown his paediatric ED team. He says “if you recruit great people and then comprehensively support them to achieve strong outcomes, then your team will be far more than what you started with”. Mike Anscombe presented on the challenges of providing a paediatric ED service in a very busy mixed ED.
Michelle Davidson and Becky Halsall from the Sunshine Coast presented on the concepts surrounding their new front of house model of care. They have implemented several processes that have made it easier to ensure you have the right equipment, for the right child, in the right place, at the right time. Although they did note that a fully automated pharmacy system does provide some obstacles to speedy access to emergency medicines. A problem that they have solved by having emergency medicine packs tagged and ready to go.
Day 2 commenced with a presentation from Deborah Browne on the opportunities to collaborate on improving outcomes for children with sepsis. Collaboratives are a proven method of translating evidence into practice and in achieving reliability in the delivery of evidence based care to children.
Andy Lovett from Bendigo presented on the outcomes achieved from paediatric in-reach to the ED. A key message was that successful strategies need to be funded on an ongoing basis. It is a continuing discussion to gain and maintain support (both in-principle and financial) for initiatives that are proven to be very successful. Later Kylie Stark from the Sydney Children’s Hospital led a discussion around paediatric ED nurse development. The key elements to having well-equipped Paediatric ED staff are: identify what you want to achieve, identify the key areas where you will need to build skills to achieve that aim, and to be very structured in your ED staff development strategies.
There were active discussion around the management of the behaviourally disturbed child in the ED. Consideration was given to how, and who, should best manage kids with developmental delay or acute behavioural disturbance, and who the prescriber/manager should be for kids requiring ongoing psychiatric medicines.
Day 2 ended with bidding farewell to the emergency care delegates, with a call for everyone from both wards and EDs to “extend some forgiveness to the other tribe”, in the interests of improving care for children. There was much goodwill in the room about fostering more understanding & mutual respect between EDs and wards and about the value of having been together for the day.
Please Click Here to view the program.
The first day focussed on the key themes already identified by the SIG as priority topics for networking. Please see below for presentations:
- Introductions and goals for the meeting - Jason Acworth
- Preliminary insights from CHAs paediatric ED Data collection - Barb Vernon
- Quality measures in ED - clinical audits (antibiotics, sedation, sepsis) at Starship - Anna-Marie Grace & Sarah Jamison
- QLD state-wide project, assessing the quality & improving ED Care for children under 5 years of age - Fiona Thomson
- Providing paediatric ED services in a busy mixed ED - Michael Anscombe
- Front of house model of care for paediatric patients in a mixed ED - Michelle Davison & Becky Halsall
The second day was a combined meeting with the participants in the CHA Paediatric Units SIG, which included Directors of Paediatrics and Nurse Managers. This day provided opportunities to share best practice approaches to meeting the needs of families & of ED and ward staff. Please see below for presentations:
- Sunshine Coast Hospital and Health Service - Cathy Styles
- Improving flow thorugh a Short Stay Service - Michelle Hutch
- Building the capacity of your ED workforce in paediatric care - Christa Bell
- Establishing a Paediatric Nursing workforce fit for purpose that supports streaming efficiency flow and safety - Kylie Stark
- Case study of a young person with acute behavioural disturbance - Matt O'Meara & Kylie Stark