Integrated Care Innovation Fund Projects

Metro North Hospital and Health Service-Queensland Civil and Administrative Tribunal (QCAT) Guardianship Process Initiative

This Integrated Care Innovation Fund initiative focuses on frail, vulnerable and elderly inpatients who lack capacity to make decisions about their care and require the appointment of a substitute decision maker by QCAT. These people are often stranded in hospital-bed limbo, waiting for tribunal hearings to appoint a substitute decision-maker before they can be discharged.

The goal of the initiative is to reduce waiting times from application to hearing date through staffing enhancements, process improvement and funding of additional hospital-based hearing days.

The initiative puts patients at the centre of decision-making by increasing access to guardianship tribunal services and promotes strong and respectful relationships through streamlined inter-agency communications and pathways.

During 2016/17, data from 255 patients indicates a high probability that the intervention reduced waiting times by around 48 days per patient and length of stay by around 25 days per patient, saving an average of 4,767 bed days at a median cost of $101 per bed-day. The project demonstrates that reframing interagency partnerships to focus on mutual gains can yield tremendous results.

Children’s Health Queensland Hospital and Health Service – Attention Deficit Hyperactivity Disorder (ADHD) Project ECHO™ Model

Attention Deficit Hyperactivity Disorder (ADHD) is a growing burden on hospital outpatient care. Despite many children being medically stable and suitable for management by their General Practitioner (GP), specialist paediatricians often provide ADHD management in Australia.

GP-led services are more accessible to patients and deliver holistic care to the entire family. Funded by the Integrated Care Innovation Fund, Children’s Health Queensland (CHQ) will use ECHO™ telementoring to train, support and collaborate with GPs in the community. The Project ECHO™ Model facilitates training GPs to provide care that would otherwise require specialist hospital outpatient care.

Torres and Cape Hospital and Health Service – Integrated Oral Health in Remote Primary Care Locations

In Queensland’s isolated regional areas, provision of routine health services such as dental clinics is challenging. With the support of the Integrated Care Innovation Fund, the introduction of tele-dentistry in prevention and early identification of dental disease is a novel and inclusive way of providing care. Sustainable dental care to remote populations is vital to reduce the oral health disease burden in these communities.

This project uses community healthcare workers, an existing important element in primary care, to deliver this innovative care approach. Training in both oral assessment and intraoral camera use and technology use are critical to the project’s success, which will establish a sustainable training, education, governance and implementation strategy.

The project is a pilot program examining how care can be integrated across similar communities in Queensland and nationwide. A wide variety of cultural, geographic, and financial considerations make this pilot an important insight into how care can be adapted to specific regions to ensure the greatest success. It has the potential to represent the new model of care for geographically isolated and culturally diverse populations around the world.

Darling Downs Hospital and Health Service – Floresco Centre Mental Health Integrated Care and Innovation

With funding from the Integrated Care Innovation Fund, Toowoomba’s Floresco Centre is providing an innovative service for adults experiencing mental health illness who require integrated care in the community.

The project’s goals are to improve quality of life and health outcomes, reduce unnecessary admissions and inpatient stays in the public mental health system, enhance integrated care, and improve social participation. The innovative service delivery model is recovery-oriented, and uses an evidence-based approach with consistent outcome measures for initial assessment, ongoing measurement and evaluation.

Participants can access a range of community mental health support services in the one space: clinical mental health services, private practitioner services, and co-located services such as employment and housing services, and drug and alcohol services. The Centre provides a creative solution to service gaps and need for integration into the Queensland mental health system.

The Toowoomba Floresco Centre is a multi-agency service for people (between the ages of 18–64 with mental health issues), as well as their carers and family members. The Centre operates in partnership between Darling Downs Hospital and Health Service, Darling Downs and West Moreton Primary Health Network and Aftercare.

Sunshine Coast Hospital and Health Service – Regional Hepatology Partnership

Hepatitis C contributes to a significant burden of disease in Queensland, affecting almost 50,000 people across the state. Recent advances in treatment mean that many patients living with the disease now have a cure. Identification of liver conditions is usually conducted through primary care, but for segments of the population with access inequities, the health system needs to be proactive and dynamic in its care delivery to prevent disease progression and higher costs down the line.

With the support of the ICIF and the national government, the Regional Hepatology Partnership (RHP) project has made this treatment more accessible. The partnership seeks out undiagnosed liver disease in regional Sunshine Coast populations, where patients may not otherwise be able to access the care they need.

For isolated or economically disadvantaged populations, the burden of coordinating healthcare providers across vast geographic regions often falls to patients. For the RHP, the Hospital and Health Service and Primary Health Network have partnered to create positive working relationships that are critical to patient care. The RHP is designed to streamline clinical services, creating a clear patient journey from identification to diagnosis to treatment.

Hepatitis C is an extremely topical disease given recent advances in treatment and equity questions surrounding the populations most as risk. The RHP initiative showcases a novel, feasible, and engaging way of addressing liver disease, and could represent a blueprint for delivering care to rural and disadvantaged patients with chronic disease in the future.