Well if the preparation wasn’t enough of a whirlwind, two days with the ‘best of the best’ Queensland currently has to offer has definitely left us swept off our feet!
First up was Dr John Wakefield, Director-General Queensland Health who joined us virtually from his office when Minister for Health and Ambulance Service The Honourable Yvette D’ath was unable to attend.
Dr Wakefield admitted whilst he spent his day off this week going on a motorbike ride with his wife, he has struggled to find balance between work and his wellbeing during the past 18 months as DG. So he tries to focus more on appreciating the small things he enjoys such as gardening and listening to music.
So, what does he want to focus on for the next six months? While he said he’d like to not have to talk about COVID, in his interactions with staff and consumers across the state, he has realised many people think Queensland has “sorted COVID”, but that “couldn’t be further from the truth - it is very possible we will be in a situation like New South Wales or Victoria which will place great strain on our system and each other.” Dr Wakefield said sustainability will be key. “To achieve this, it’s about reform and radical change - particularly in how we think about primary care and chronic disease management, aged care and mental health. Thinking about what we need to do in hospital and getting the rest out into the community space.”
“That will be challenging, but I’m confident we can do that by working together and with the presentations you will see today. I don’t have all the answers but I know we have to change, and that change starts with us.”
The DG was then followed by Olympic medallist Dane Bird-Smith who shared his struggles with mental health while at the height of his career. Dane has been competing for Australia at the highest level for 12 years. After narrowly missing out on a spot for the London Olympics by just three seconds, Dane set his sights on not just making the next Olympic team, but being the fastest ever Australian at an Olympic Games.
However, his ongoing pursuit of perfection meant sacrifices to his relationships and missing simple things like parties and having a beer with mates. By 2017, while he was Australian Athlete of the Year and winning every race and breaking his personal best time regularly, but his sacrifices started to build up and he felt many other things in his life were going wrong. But once he spoke to his GP he felt a huge weight was lifted. His doctor encouraged him to consider mental illness like a physical illness – something that needed rehabilitating.
He said winning gold at the Commonwealth Games in 2018 was the proudest moment of his career – not because he won, not because he broke a Commonwealth record or because he was again wearing the green and gold – but because he had done it for himself and had overcome something very challenging.
Dane is now a Lifeline Ambassador, talking to people about being aware of their mental health and knowing the dangers. His parting message: “every situation and feeling is valid.”
Following Dane, we were meant to hear from infectious diseases expert and newly-appointed Chief Health Officer Dr Krispin Hajkowicz but he was unable to join us. In his place, Chair of the Queensland Clinical Senate Dr Alex Markwell walked us through how clinicians have remained connected during COVID-19 through clinical bodies, advocacy (through the QCS and clinical networks) and a range of virtual communication methods. Alex 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.
After a chance to snack on some delicious quiche and grab a quick coffee, delegates then had a choice to head into (or dial into) Technology overcoming the tyranny of distance or Care through the eyes of consumers; the latter facilitated by CEO of Health Consumers Queensland – Melissa Fox.
Her session included Anne Curtis from Health Consumers Queensland who discussed her work with Office for Prisoner Health and Wellbeing, CEQ. She was tasked by Corrective Services to consult with prisoners about their health and wellbeing. Over a few months, a total of 112 prisoners were consulted across 19 group sessions. With only a pen and paper allowed, each session required a lot of fast writing! The investigation found prisoners were affected by six key health themes – dental hygiene, medication management (including access to the basics such as Panadol and Nurofen), health system and response, communication and cultural understanding, mental health, and vaccinations.
Dr Penny Larcombe from Gold Coast Health discussed their work with the Queensland Ambulance Service in taking care of young people with functional neurological disorders. Using a multidisciplinary team approach they have developed individualised plans to help young people get back into their normal environment which has also reduced stresses on the family unit. Paramedics may still get called to assist with these patients, but with the plan in place, ED utilisation is reduced and patients can return home. In total, 85 emergency presentations have been avoided to date – a cost saving of more than $100,000.
In the Powerhouse Auditorium, the Technology session included Metro North’s teleburns service. On average, patients live more than 300 kilometres from the Royal Brisbane and Women’s Hospital. With almost all health services referring into the hospital and patients requiring multiple appointments, there is significant demand for the service as well significant travel involved. Using implementation science methods they implemented and evaluated a new model of care for acute burns management which involved a specialist providing advice to a receiving clinician via Telehealth who managed the burns treatment locally. Their analysis found 96 per cent of patients agreed or strongly agreed the telehealth sessions met their needs. For clinicians supporting patients rurally, 97 per cent reported they were confident to assist in future telehealth appointments and were satisfied with the organisation of the appointments. The economic evaluation found 500,000 kilometres in travel were saved which equates to some $147,000 in travel expenses (plus additional costs for travel-related expenses).
Also in this session, Edwin Cheung and Michael Spargo shared Metro North’s ‘drive-through prescription service’ which was set up during COVID to keep people away from the hospital. They found patients were quite willing to try something new. The model involved a pharmacy assistant delivering prescriptions to the patient’s car whilst also providing clinical advice about the drug/s and checking relevant identification. Workflows were adjusted to accommodate the drive-through collection which was quite beneficial to the team in terms of workload planning. In terms of results, on average they had 10 patients per day and patient waiting times decreased from more than an hour pre-COVID, to just two minutes. Physical distancing was also maintained.
The session concluded with CEQ’s Telehealth Support Unit facilitating a ‘how to set up a Telehealth service’ workshop which was well received.
After lunch (rather delicious and healthy poke bowls!), our final concurrent sessions for the day were Alternative models of care which improved patient outcomes and the second issue of Maintaining safe and high-quality care, systems and services during COVID-19.
The Alternative session included a presentation from Diana Simon from Children’s Health Queensland about their Healthy Kids Club and how they tackled the complexities of obesity despite the pandemic. Using Telehealth, they addressed sleep time, eating habits and physical activity via virtual cooking demonstrations and exercise circuits. To date, families have opted to continue using Telehealth or in-home visits rather than attending in-hospital clinics, demonstrating a continued desire to move away from traditional models.
Also in that session, Rebekah Pace and Judi Cavanagh from Mackay shared their telehandover model used when a patient is transferred across facilities. Questioning why we continue to use “discharge summaries” often written by a junior doctor not involved in the patient’s care, Mackay has introduced multi-disciplinary case conferencing that involves a patient and their family/carer where appropriate. Describe as a communication channel, they are helping to ensure everyone is on the same page – including the patient. The team initially felt rehab patients were the most appropriate cohort for the telehandover model, it has been expanded to include other patients too, GPs, aged care facilities and NDIS services. The handover itself follows the SBAR format and is recorded so information can be uploaded to relevant systems. In total, 1,286 bed days have been saved, improving patient flow as well as the patient’s experience.
In the second instalment of of Maintaining safe and high-quality care, systems and services during COVID-19, Hayley Jones, Dr Michelle Davison and Dr Ian Humble explained how the Sunshine Coast developed their own road retrieval service to ease strain on Retrieval Services Queensland during COVID. Staff were up-skilled in retrieval medicine and provided with a range of checklists to facilitate the retrieval process from start to finish and were able to monitor performance indicators thanks to the development of a data dashboard. The team also performed monthly clinical case reviews to ensure best practice was maintained and to identify any recurring issues.
Also in that session, Ade George from the North West discussed their Hospital in the Home model which is improving access to quality health services and reducing rates of “Discharged Against Medical Advice” particularly amongst their First Nations communities. By providing care for their patients in the right setting and providing more options for how they can access care, the health service is reducing bed block at Mt Isa Hospital. The model was so well received the team received their first referral within 25 minutes of going live! To provide more culturally appropriate care, the team also developed partnerships with hostels (termed “medical hostels”) where patients could stay instead of the hospital.
Following a literal “muffin break”, once again the two-day event ended with The Great Debate and our award winners. This year’s debate explored whether the COVID-19 pandemic provided the ‘re-set’ our health system has been crying out for, and was chaired by Michael Zanco. On the affirmative team: Lisa Nissen, Liz Crowe and Helen Brown. On the negative team: Keith McNeil, Tanya Kelly and Melissa Fox.
Once again the debate proved to be the jewel in the Showcase crown, with lots of laughter and witticisms. Of note:
- The pandemic brought all of the health system puzzle pieces together with “all hands on deck” and “when has a tween known the name of the CHO?!” - Prof Lisa Nissen
- Upside to the pandemic? “Teams was no longer just for people who could play sport. I could be on a Team for the first and last time in my life!” (Microsoft Teams) – Dr Helen Brown
- “When has anyone cared about health professionals? About our wellbeing? You can get free car insurance now!” – Liz Crowe
- “It’s definitely a great idea for your first day on the job to come and meet everyone here today and then come up here and fight with everyone.” – Dr Tanya Kelly (incoming Chair Queensland Clinical Senate)
- Searching for a debate win longed for since high school! – Melissa Fox
- “I feel like I am about to shoot Lassie.” – Keith McNeil
But there can only be one winner, which according to Michael Zanco as the moderator and the crowd, was the Negative team – the fifth consecutive year for Keith! A big thank you to our debaters for taking the time to provide such excellent entertainment (and costumes)!
To see out the event we congratulated our three award winners:
- People’s Choice Award – this most popular presentation award went to two winners this year! The ehealth MaskHelper Tool and the Sepsis Algorithm!
- Consumer Choice Award – as determined and presented by Health Consumers Queensland representative Helen Mees, who after attending several showcases was really keen to see an increase in consumer engagement and encouraged all delegates to engage with patients they wish to benefit with a new project at the beginning. Two honourable mentions this year: Sepsis algorithm and the Happy Heart model. This year’s award went to VOICeD!
- Excellence Award – went to the Sit, Talk and Yarn (STaY) suicide prevention initiative from Cherbourg.
And that was Clinical Excellence Showcase 2021.
We’d like to thank all our keynote speakers and presenters for their time and flexibility as we adapted to a hybrid event mid-planning. Your time and dedication to healthcare improvement is inspiring.
We also thank everyone who joined us – whether that was in person or online – for your enthusiasm for innovation and delivering better healthcare.
Thank you all for another great Showcase!
If you were unable to attend or dial in, don’t worry – all of this year’s presentations will be released as episodes in our next instalment of the Clinical Excellence Showcase podcast series. To keep up to date with all the action follow us on Facebook @ClinicalExcellenceQueensland. For more information and to relive all the glory of our past Showcases, please visit www.clinicalexcellence.qld.gov.au/showcase.