Abstract
Introduction/Background: Children's Health Queensland Hospital and Health Service (CHQ) partnered with a general practice organisation to establish and pilot the first known paediatric minor injury and illness clinic (P-MIIC) in Australia. The P-MIIC was built and operated within the Queensland Children’s Hospital (QCH), proximate to the emergency department (ED). The aim of the new model of care was to pilot a response to the state’s growing demand pressures in hospital EDs, by improving waiting times and enhancing the experience for children aged 0-18 and their families seeking high-quality and timely care.
Who is it for? The pilot model of care was designed to provide an alternative pathway for families presenting at the ED to be seen by an experienced General Practitioner-led (GP) team. The clinic was physically situated close by the ED, medical imaging, and pathology collection services within the QCH. Children who presented at the ED and were triaged as category 3, 4 or 5 against the Australian Triage Scale were given the option to bypass the ED to be seen by the GP-led team working in the P-MIIC.
Who did you involve and engage with?
The model of care was overseen by an inter-agency strategic governance committee, consisting of:
- Hospital and Health Service and Primary Health Network executives,
- Paediatric and General Practice clinical and practice management leads,
- Hospital Facilities Management and Arts in Health advisors,
- Project and research/evaluation leads.
In parallel, the QCH Emergency Consumer Group was consulted throughout the pilot development for input and feedback on all aspects of the model of care, communication materials and to raise community awareness of the pilot.
What did you do? The clinic was constructed in a former retail space directly above the QCH’s ED, consisting of four consultation rooms, dual treatment space, dirty clean-up room, reception and waiting area, and telehealth consult/meeting room. The clinic pilot operated from June-November 2022.
What results did you get? The clinic treated approximately 1000 patients during the pilot period. Interim evaluation findings included that families reported higher levels of positive experience than those whose children were treated exclusively within the ED across 7/12 measures. This was particularly relevant in the domains of waiting time for treatment, confidence and trust in treating clinicians, and post-discharge care arrangements.
What is the learning for the international audience? This pilot demonstrated the potential benefits of incorporating a primary care model like P-MIIC in a hospital setting could significantly enhance patient experiences and improve efficiency in the QCH ED.
What are the next steps? This pilot will inform the concurrent state-wide co-commissioning of other minor injury and illness or urgent care centres across Queensland and nationally which have been funded by the Federal Government. This pilot serves as an exemplar for audiences considering more intentional collaborations with general practices to pilot dynamic models of care. Formal research outputs in development will detail the pilot’s demonstrated improvements in demand pressures in the QCH ED, wait times and consumer experience for families seeking high-quality and timely care.