Child Development Working GroupStatewide Child and Youth Clinical Network

Reinventing Child Development:Reinventing Child Development:Steering the ship through uncharted watersSteering the ship through uncharted waters

The Journey

towards excellence in Children’s Health Care 23-24 October 2012

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

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

SCYCN: CDWG

Statewide Child and Youth Clinical Network

Established 2009 Initially 4 priority areas

Child Development Now supporting activity

more broadly Chair: Dr Julie McEniery

Child Development Working Group

Established 2009 Membership

Multidisciplinary (medical and allied health)

Multiregional Advice, support and

advocacy Robust clinical and

corporate interface

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

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

What has been done differently?

Strategic approach to identifying teams within scopeNetwork of clinicians who identify and are identified Clinicians identify local championsActual vs aspirational Profile that is increasingly attractive to clinicians and better understood

Its our job to understand you, your team, your business, your regionReciprocity – two way active relationship buildingFace-to-face contact with all teams statewide including site visitsCulture is as (?more) important as form and functionAppreciate variation

Outcomes = clinician led, project supportedEvolving end pointChange management plan (Objective 4) will vary from team to teamEach team is responsible for innovative problem solving at local levelClinical relevance and applicability

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

Standards for Clinical Practice

Why?Why? Framework for consistency in service planning and Framework for consistency in service planning and

provisionprovision Guide quality improvement and professional Guide quality improvement and professional

developmentdevelopment

Three components:Three components: ConceptualisedConceptualised StructuredStructured DeliveredDelivered

Each team still needs to consider:Each team still needs to consider: So each CDS can be:

Local issuesLocal issues

Strategic directionsStrategic directions

Legislative requirementsLegislative requirements

Inherently adaptableInherently adaptable

Locally responsiveLocally responsive

Innovative acc to contextInnovative acc to context

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

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

What we’ve learned so far…

Common Language

Flexibility

Relationships

Big Picture

Trust

Transparency

Add Value

Be Available

Trust

Transparency

Add Value

Be Available

Make complex simple

End parallel conversations

Use language others understand

Start BIG then drill down

End point influenced by stakeholders (ongoing)

Engage beyond the ‘scope’

History is pervasive

Comments & Questions