Queensland Paediatric Critical Care Pathway Project (PCCP)

Overview

Initiative type

Model of Care

Status

Plan

Published

19 March 2019

Summary

The Queensland Paediatric Critical Care Pathway (PCCP) project is a multi-year project, with the first year focused on diagnostics and solutions design. The project’s key outcome for phase 1 is to develop a defined and prioritised set of solutions for the provision of statewide paediatric critical care and transport over the next five to ten years with a focus on equity and consistency in access, capacity, capability and quality. Subsequent years will focus on implementation.

Key dates

Apr 2018 - Jun 2022

Partnerships

Interdependent projects include: Statewide Emergency Care of Children (SWECC), Statewide Paediatric Sepsis Pathway (SPSP), Paediatric Patient Safety Review

Aim


The purpose of the PCCP is for critically unwell children and their families in our state, and its catchment, to receive the best possible experience and outcome.

Benefits


The benefits of the PCCP project can be categorised as follows;

  • Quality and safety – clinical governance for statewide paediatric critical care and transport.
  • Child and family experience – certainty for best care as close to home as possible.
  • Staff engagement – collaborative network for delivery of visions, strategies and operational plans.
  • Service improvement – equitable, reliable and effective clinical practice and pathways.
  • Financial – efficiency through care at the right time and place.
  • Service integration – consistency and continuity of paediatric critical care across health service boundaries.

Background


  • There is increased demand on care for the critically unwell child driven by population growth with changing key demographics and socio-economic indicators, consumer expectations, and improved technology.
  • There is an over-representation in the reported SAC1 Clinical Incidents in children from rural and remote Queensland as well as Aboriginal and Torres Strait Islander children.
  • Recent coronial inquests have identified gaps in the provision of quality care for critically unwell children.
  • There is excess infant and early childhood mortality in Queensland that could possibly be favourably influenced by reduced variability and inequity in the provision of care for critically unwell children.
  • There is no mandated reporting against core clinical indicators for the provision of paediatric critical care, and therefore there is no overarching surveillance to detect variation in care.
  • Concerns raised regarding shortfalls in standardised clinical coordination for transport of critically unwell children across the state.
  • Variability in paediatric expertise and skills at some facilities therefore there can be variable access to senior paediatric medical input in a timely manner for critically unwell children.
  • Concerns have been raised around the Clinical Service Capability Framework (CSCF) ‘Intensive Care – Child’ module; it has not been reviewed in recent years.
  • There is significant risk associated with an overreliance on strictly centralised paediatric critical care resulting in transport capacity issues, bed block at the highest-level facility, disconnection of families from home and communities, and resources inefficiencies.

Solutions implemented


The PCCP solutions design workshop was held on 30th April, 2019 and the endorsed solutions design report followed thereafter. 

Solutions / “quick wins” implemented to date:

  • commenced development of a family information pack with essential information for families when their critically ill child is retrieved
  • pre-transport checklist – to be re-issued and made more widely available
  • developing a process for discharge summaries from PICU CHQ to be placed on iEMR / EDS viewers with the link to be emailed to referring site
  • ‘Statewide Paediatric Critical Care Case Discussion’ monthly forum for interested HHSs, hospitals and groups in Queensland. Contact: CHQ_PCC_GrandRounds@health.qld.gov.au
  • drug libraries for Alaris and Braun smart pumps will be available from CHQ - contact Michelle Cree: Michele.Cree@health.qld.gov.au
  • agreement for a single contact point for Paediatric Critical Care Units for clinicians at referring sites to follow up critically ill children.

Key contact

Lynette Adams

Principal Project Manager - Queensland Paediatric Critical Care Pathway Project

Children's Health Queensland

Email:  pccp@health.qld.gov.au

Last updated: March 2019

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