Clinical Excellence Stories returns to highlight the heart of Far North Queensland

Thursday, September 15, 2022

Despite being entirely preventable, Rheumatic Heart Disease or RHD is sadly still prevalent in our First Nations’ communities.

Once a person has developed Acute Rheumatic Fever (ARF) or RHD - which affects the delicate valves of the heart - they require a painful LA Bicillin injection every month until they turn 21 (or for 10 years) to avoid ARF recurrence or further damage to the heart.

When Cairns and Hinterland Hospital and Health Service’s (HHS) paediatric cardiologist Dr Ben Reeves noticed the high number of patients failing to attend for their LA Bicillin injection, he approached Clinical Nurse Consultant Erin Ferguson to explore not just the ‘why’ behind the figure but to set upon a journey to get all their young patients back on track with their injections.

And so, following a co-design process, the Happy Heart Clinic was born. While co-design is not a new concept in healthcare, it is not widely done directly with a paediatric cohort, and it was the input of these children that Erin attributes all of their success.

“The children accessing our service are faced with a daunting needle every month for all of their childhood and the fear is often too much for them to be able to rationalise the fact it is keeping them healthy,” Erin said.

“Many of our patients have had traumatic experiences when getting their injections which led to them disengaging from the service. This is what made Ben and I to take that step back and ask our kids what would help when coming in for an injection, and while you would think it was someone being good at giving needles, all the kids really cared about was whether a clinician was nice to them.”

That realisation led to a transformation of the clinic, focusing on building relationships and trying to keep things fun as a way to keep fear at bay. In addition, they developed a range of resources for their patients to document how they like receiving their needle including positioning, distraction aids and any pain relief.

“We service a large patient cohort across Far North Queensland, so by rebuilding that trust and helping to overcome the trauma from negative experiences, we have been able to get kids back on track with injections and transfer them back to a local facility rather than travelling into Cairns each time,” Erin said.

While filming a documentary can be a daunting task, Ben and Erin said the team at CEQ made them feel at ease and look forward to helping inspire others to make similar changes within their services.

“Filming with CEQ was a great experience and we look forward to having some extra exposure on the work we do locally in the pursuit of ending rheumatic heart disease,” she said.

The Happy Heart Clinic is the second team from Cairns and Hinterland to be featured in Clinical Excellence Stories, after the highly successful Virtual Outpatient Integration for Chronic Disease model of care.

The CEQ team are always on the hunt for more innovative stories to tell, so join the conversation on Facebook or email your suggestions to For more information or to watch past episodes, visit the Clinical Excellence Showcase website.

Last updated: 15 September 2022