The vital element of great care is finding and fostering exceptional people. Thanks to a $3.26 million donation through the Good Friday Appeal, RCH staff are advancing their clinical skills through ongoing education and development.
These funds directly benefit Allied Health Professionals (AHPs) and nurses, who make up over half of The Royal Children’s Hospital staff and collectively care for children, adolescents and their families across all areas of the hospital.
This investment in The Royal Children’s Hospital team ensures the hospital attracts and retains the best and brightest minds, and remains a centre of excellence in paediatric healthcare.
“This opportunity for RCH Allied Health and Nursing staff is unique and enables us to support our staff to ensure the best, evidence based care for RCH patients. Through this generous funding, we can support our staff to learn, develop and deliver excellent care.”
– Bernadette O’Connor, Director of Royal Children’s Hospital Allied Health
Advancing Allied Health Through Good Friday Appeal support, 180 AHPs have pursued professional development through local and national training courses, seminars and conferences. A number of these AHPs have presented papers on great care and innovation in their work on behalf of the hospital. The learning acquired at these events is also benefitting other staff members. Attendees are sharing their insights through their departmental continuing education programs and staff education committees.
Nurturing nursing education It’s paramount for nurses to grow their knowledge and skills to improve clinical practice outcomes for RCH children. Thanks to Victorian support for the Good Friday Appeal, 63 nurses have received the funding necessary to complete their post graduate qualification in the past year. Many of these nurses have gone on to make significant contributions that have advanced the quality and safety of care provided at the hospital. This has occurred through investigating and leading practice change, bringing increased expertise to teams and taking on leadership positions.
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Complex Care Service
These children require multiple specialists and services involved in their treatment, which can be extremely challenging for families to coordinate and manage. With the new Royal Children’s Hospital (RCH) Complex Care Service, this is changing.
The RCH Complex Care Service is a new way of working, created, piloted and evaluated in 2014/15, to better support complex patients and their families.
The complex care team believes that the most successful care comes from partnership, which is why there is now a specific team dedicated to working with complex patients and their families.
By offering additional support, the needs of the patient and their family can be better managed and the impact of the child’s illness on the family is lessened.
The dedicated team, consisting of a Clinical Nurse Consultant (CNC), a doctor, an administration assistant and a social worker, work closely with the family to understand their needs and develop care and emergency plans to meet them.
“The CNC, acts as a single point of contact for the family, providing 24/7 access to advice and support liaising with all the child’s health care providers, both inside and outside of the hospital. This not only takes pressure off the family to coordinate the child’s treatment, but results in improved coordination of care as all of the patient’s health professionals are kept informed, enabling a holistic approach to the child’s care,” says Nicki Mountford, RCH Clinical Nurse Consultant.
The team help the family to better navigate the hospital system in any way they can. Whether this is by coordinating their appointments, helping to connect the family with community supports, or by providing advice or answers to any questions they have, The Royal Children’s Hospital Complex Care team is keen to support the family in any way possible.
“This increased level of support and coordination for the families means that they are attending The Royal Children’s Hospital less frequently and spending more time enjoying life outside of the hospital.”
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Wadja Health Service
The team runs regular clinics with both paediatricians and Aboriginal Case Managers to deliver holistic care that incorporates Aboriginal and Torres Strait Islander patient’s medical, social, cultural and emotional needs.
Wadja Manager Selena White said Wadja Health Clinic has played a significant role in delivering the best health outcomes for children and families at the RCH.
“When Wadja commenced in 2009, our paediatricians saw three patients in its first month of service, and this has now significantly grown to between 28 – 38 patients a month,” Selena said.
“[In 2016], our Wadja Case Managers supported more than 300 patients and families with attendance, cultural support and safety throughout clinic consultations.
“Wadja was a new model of care for paediatric health, so it’s great we’ve had such positive feedback from families – knowing our Koori community value our service is very rewarding.”
Selena White, Manager of the Wadja Aboriginal Family Place, and Annette Gaulton, Case Manager.
In 2017, the clinic implemented an enhanced model of care for Aboriginal patients who fail to attend outpatient appointments, to identify and address barriers to accessing health services.
“I’m very proud of how the team has worked together to develop our service to improve the overall health of Aboriginal and Torres Strait Islander children,”
Selena White
“Together we have built trusting relationships with families, formed partnerships with Aboriginal Community Controlled Organisations, and collaborated with many other RCH teams – including Social Work – Vulnerable Children, Mental Health and the Education Institute – who are all very much involved in service delivery and care co-ordination of Aboriginal patients’ who attend our clinic.”
“Our role is to support the delivery of holistic wellbeing for our patients. Their health is just one part – we also look after the spiritual, physical, emotional and mental wellbeing of patients and their families.”
Selena White, Manager of the Wadja Aboriginal Family Place
During the COVID- 19 response in 2020, Wadja Health Clinic clinicians adapted the outpatient service model to Telehealth to ensure Aboriginal patients and families have ongoing access to the service.
“Many of our families have welcomed consultations via the Telehealth platform and we plan to maintain this option where clinically appropriate post COVID-19,” Selena said.
Despite the COVID-19 limitations, the Wadja team saw an increase in presentations over the previous twelve months, providing care to 3,612 Aboriginal and Torres Strait Islander children and their families during the 2019-20 financial year.
Since its establishment, Wadja has significantly enhanced the experience of Aboriginal and Torres Strait Islander patients at the RCH.
Kirra Grimes experienced the care of Wadja when her child, Malu, was admitted at age 3.
“As soon as Malu was admitted to the RCH, we were introduced to the Wadja Aboriginal Family Place and given a dedicated Case Manager. Having somebody who was also Indigenous that we could talk to when we were in a really emotional state and open up to and connect with was a godsend.
Baby Malu at RCH.
“It was helpful to have someone there walking us through all of the administrative side of things, from parking to financial matters. They would also check in on us, and make sure we felt comfortable, despite everything that was going on.”
“If we didn’t have support from Wadja, we wouldn’t have felt as comfortable as we did through that time.”
Kirra Grimes, Parent
“Wadja is a leading model of care for indigenous child health, and what the team has achieved over the past 10 years has been fantastic,” Selena said.
Wadja also offers a general paediatric health clinic, specifically for Aboriginal and Torres Strait Islander patients. Delivered by a multi-disciplinary team consisting of case managers, paediatricians, mental health clinicians and allied health clinicians, the clinic aims to address the complex medical and social needs of this patient cohort.
“We’re with families every step of the way, and often our case managers wear many hats. Not only are they a support person, they also ensure parents or guardians understand things like consent forms and what their child’s surgery involves.”
“Of course, this is something we want to keep building on, so we’re looking for opportunities to improve the effectiveness of our service and ensure we have a comprehensive approach to meeting the needs of our patients and families.”
“We’re also looking to enhance our physical environment, to reflect the traditional owners of the land, and we’re working on strengthening relationships between the RCH and the Aboriginal community by increasing engagement with Aboriginal organisations, Aboriginal elders and community members.”
To date, the Wadja team has held over 8,000 sessions of delivery, helping improve outcomes and the overall patient experience for Aboriginal children and their families.
The incredible impact of Wadja extends further than just its patients. Since 2009, the Wadja team has developed a reputation within the community, working closely with local Victorian Aboriginal organisations, including the Victorian Aboriginal Health Service (VAHS) and the Victorian Aboriginal Child Care Agency (VACCA), to provide service delivery and referral pathways for the Aboriginal and Torres Strait Islander community.
They have also played an integral role within the hospital, building understanding, empathy, cultural knowledge and culturally safe care among RCH staff.
Impact Milestones
April 2022 – March 2023
The Wadja team has provided 4,169 occasions of service delivery from April 2022 to March 2023 to Aboriginal outpatients.
The Wadja Health Clinic has remained consistent at 87 per cent attendance rate during the period from April 2022 to March 2023, with a total of 500 outpatient appointments booked and 433 attendances.
During this period, the Wadja team continued to engage and consult with community partners, including the Victorian Aboriginal Health Service (VAHS), the Victorian Aboriginal Childcare Agency (VACCA), and various Victorian Aboriginal Community Controlled Health Organisations (VACCHO’s), for the provision of service delivery and referral pathways for Aboriginal communities.
April 2023 – May 2024
The Wadja team collectively provided over 4,000 occasions of service delivery to Aboriginal outpatients and their families.
The Wadja multidisciplinary team held a workshop to review, develop and uplift the current scheduling of patient appointments, triaging processes and referral screening of new patients. This has helped minimise the waitlist at Wadja.
The Wadja team are currently working on educational materials such as podcasts and eLearning modules with Campus-wide partners, including the University of Melbourne and the Melbourne’s Mental Health Strategy to ensure that Aboriginal patients and community are supported better.
The Wadja team are continuing to engage and consult with community partners for the provision of service delivery and referral pathways for Aboriginal communities.
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Enhancing quality and safety in health through simulation based education
Thanks to support from the Good Friday Appeal, The Royal Children’s Hospital (RCH) will continue to provide staff education through training by simulation.
Using state of the art medical technology, the RCH Simulation Team creates rare, high risk and critical patient events, as well as common clinical situations, to practise teamwork, communication, and technical skills. The Simulation Program gives staff the opportunity to receive feedback on their communication skills through simulated scenarios using trained actors.
The program aims to enhance clinical skills, decision making, communication and teamwork among staff, ultimately leading to better patient care in all situations staff may be faced with, including critical and everyday situations.
It doesn’t just benefit RCH staff and patients – healthcare professionals from across Victoria, Australia and even internationally are able to access training through the program. Over 18,000 participants have participated in training through the program since 2015.
By exposing teams to acute, but rare patient events in a safe environment, the program is improving clinical decision making, enhancing communication skills, and furthering great patient and family care in the most critical situations.
With staff from multiple departments working closely to deliver great care, it’s important that everyone is clear on how teams work together to deliver the best patient outcomes. Replicating critical patient care scenarios gives staff the opportunity to gauge how they react in difficult situations and understand the strengths and weaknesses of each team.
“The strength of our Simulation Program is our ability to recreate rare events, to bring them to life and let people fully experience them,” says Associate Professor Meredith Allen, Director of Medical Education. “Staff become immersed in the process, and are able to enhance their skills and reinforce their clinical response.”
To ensure the simulation experience is realistic, the Good Friday Appeal has supported the purchase of high-tech mannequins that imitate human responses.
Able to breathe, cry, talk, seize and bleed, these mannequins also mimic heart and lung sounds. Each mannequin is controlled by a Simulation Technologist, who ensures that they react appropriately to each simulation, reinforcing critical skills and making each simulation as authentic as possible.
“It’s difficult to comprehend just how isolated you might feel in critical situations until you experience them firsthand,” says Jenni Sokol, Clinical Lead for Simulation. “Education helps, by training teams to work together efficiently and mitigating human error.”
RCH Medical staff train on childlike simulators that mimic emergency situations on the wards like a cardiac arrest. Nursing staff Matthew Stockton and Ella Scott ‘resuscitate’ a patient.
The simulation program also offers staff the opportunity to get feedback on their communication skills through the use of highly trained actors. Scenarios challenging our staff to deliver the most difficult news have been created from real events and are offered back as training opportunities. The actors are highly trained to provide feedback that helps participants navigate through some of the most challenging parts of being a health professional.
Though challenging, the realism of simulations is what makes them an effective way to train staff. Participants experience the same emotions and responses they would in a genuine high-pressure situation, and this makes a lasting impression. There is evidence that staff retain more knowledge and behavioural skills through simulation-based education than through book learning and lectures.
“To work together efficiently as teams and deliver the best patient care, we need to break down the silos we’ve traditionally trained in and focus on enhancing our skills collaboratively,” says Jenni. “The aim for the program has always been to turn groups of experts into expert teams and we’re making great progress in achieving that.”
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Nuclear Medicine SPECT/CT Machine
This combined machine includes a SPECT gamma camera, integrated with a CT scanner, meaning for the first time at The Royal Children’s Hospital, these two different types of images can be taken together during one visit. It’s already having a big impact, supporting patients from across the hospital.
What is SPECT?
SPECT stands for single photon emission computed tomography. With this type of scan, images are taken once a patient has been administered with a radioactive tracer. This tracer is then detected by a SPECT camera, which rotates around a patient’s body to produce a three dimensional image.
What is CT?
CT or computed tomography scans are obtained when an X-ray machine rotates around a patient to provide a three dimensional image of their anatomy.
Duncan Veysey, Deputy Chief Medical Imaging Technologist and Senior Nuclear Medicine/PET Technologist at The Royal Children’s Hospital explained how the combined SPECT/CT Machine is able to take both of these scans at the same time, improving patient care at the hospital.
“The combined machine enables us to overlay these two types of scans. We can use the image taken from the CT scan to identify exactly where the radioactivity displayed in the SPECT image is in a patient’s anatomy,” said Mr Veysey.
For clinicians, these more detailed images mean they can diagnose conditions and recommend a treatment plan with greater certainty and accuracy. Being able to do this is particularly important for patients with complex medical conditions, who require specialised and ongoing care.
“We are fortunate to have this top of the range, flexible model at The Royal Children’s Hospital, and are very thankful to our community of supporters for funding such a vital piece of equipment.”
– Duncan Veysey, Deputy Chief Medical Imaging Technologist and Senior Nuclear Medicine/PET Technologist
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MR PET
The nine tonne, $6 million Magnetic Resonance Positron Emission Tomography machine, or MR PET, was funded by community donations through the Good Friday Appeal.
RCH Neurologist Dr Simon Harvey said the MR PET combined the most effective medical scanning procedures, Medical Resonance Imaging (MRI) and Positron Emission Tomography (PET), into one piece of equipment for the first time.
“For our young patients, some of whom require sedation and even general anaesthetic to undergo these important but intimidating procedures, the MR PET will means fewer scans, and therefore a more positive experience,” Dr Harvey said.
“It also means more accurate diagnoses, because in addition to giving us high quality MRI and PET scans in one session, the MR and PET will be accurately overlaid into one image.
What is a PET scan?
PET is a form of metabolic imaging – an imaging technique that uses radioisotopes and provides critical information about the metabolic state of body tissues. Doctors use PET scans to identify and monitor tumours, areas of inflammation and sites of seizure activity.
What is an MRI scan?
MRI is form of structural imaging – an imaging technique that provides doctors with critical information about the structure and function of body tissues.
“This will show us, very precisely, the location of tumours, malformations and sites of inflammation in the body, many of which might not be visible with the single images.
“The MR PET will be used to assess and diagnose a wide range of patients, but it has particular advantages for children with certain forms of cancer, uncontrolled epilepsy and inflammatory disorders.”
– RCH Neurologist Dr Simon Harvey
The MR PET was transported to The Royal Children’s Hospital on a semi-trailer and manoeuvred into its new, purpose-built, copper-lined lab in the Medical Imaging Department via a 20 tonne forklift and a team of eight people. The copper shielding is to ensure the operation of the MR PET magnet does not affect other areas of the hospital.
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Improved imaging services
Located within what was the Front Entry Building of the old hospital, 48 Flemington Road features many medical centres run by hospital clinicians.
It’s a “home away from home” for these clinicians, making them more available to patients and helping to provide them with better care. However, great care includes not only high quality medical consultations, but also accessible medical imaging services.
Thanks to community support through the Good Friday Appeal, 48 Flemington Road will soon feature its own imaging services.
Specifically, your generosity will fund a fixed x-ray machine with its own waiting room, as well as two ultrasound machines within the same facility.
“The new imaging facilities will provide convenient access for patients seeing their doctor at 48 Flemington Road to the latest digital x-ray and ultrasound machines. Integrated with the main RCH imaging archive system, clinicians will have a complete patient imaging record. The new facility will create a flow on effect for patients at The Royal Children’s Hospital, allowing better access to imaging and reduced waiting times.”
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Hydrotherapy Pool
Since its opening in 2013 the pool has become a vital part of Royal Children’s Hospital (RCH) physiotherapy. By helping children achieve what they can’t do on land, the program is a fun and effective way to provide great care to infants, children and adolescents.
The RCH pool is specifically heated to a warmer-than-usual 34 degrees Celsius, which aids recovery through relaxation of muscles, reduction of muscle spasm, increased circulation and pain relief.
It can also facilitate the treatment of children with a limited ability to regulate their own body temperature.
Aquatic Physiotherapy uses the buoyancy of water to assist treatment. Water acts by assisting and resisting movement which helps increase muscle strength and joint movement.
This form of therapy is great for children with everything from sports injuries to chronic conditions like cerebral palsy, as it allows them to complete exercises and participate in activities which they aren’t able to do on land.
When designing a pool for clinical use, the health and safety of patients is of the utmost importance.
“Unlike many adult hydrotherapy pools, our purpose built facility includes shallow water, a ramp and specific equipment to enable training of running, walking or crawling in young children and infants.”
– Emily Ramage, Senior Physiotherapist
Hydrotherapy physiotherapist Daniella Feuerlicht plays with cardiac patient Davina
“Seeing a child’s face light up as they master a new skill or regain the ability to walk, hop or run in the pool is a special moment. But even more rewarding is seeing these therapy gains translate to the child’s everyday abilities at home, in the playground and beyond.”
– Emily Ramage, Senior Physiotherapist
Photo: David Caird, Herald Sun
Posted: December 2016
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Melbourne Genomics Health Alliance
Genomic medicine and exploring how it can help young patients is a new research initiative pivotal to contemporary research at The Royal Children’s Hospital.
Genomic medicine is the sequencing and analysis of a person’s genes. By looking at an individual child’s genes, diagnosis and treatment can be tailored to each child.
The Royal Children’s Hospital is a founding member of the Melbourne Genomics Health Alliance, which brings leading local healthcare, research and academic organisations together to conduct further research.
Their vision is for Victoria to be a world leader in the use of genomics in healthcare.
The Good Friday Appeal is pleased to fund the hospital’s membership to the Alliance, providing an expanded world-wide networks to the hospital’s researchers and clinicians.
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Murdoch Children’s Research Institute
The Good Friday Appeal supports the research capability and output of the Murdoch Children’s Research Institute (MCRI) and The Royal Children’s Hospital (RCH).
MCRI is Australia’s leading child health research organisation and ranks among the top three children’s medical research institutes globally. MCRI aims to improve the prediction, prevention, diagnosis, and treatment of rare, complex diseases and common conditions affecting children and young people.
MCRI’s mission is for all children to live healthy and fulfilling lives. Their vital research is making a life-changing difference to children not just in Australia, but around the world. From developing new treatments for inherited and chronic kidney disease to bioengineering prosthetic heart valves, the MCRI is transforming the health and lives of a generation of children and their families.
More than 1,900 MCRI researchers are working to find answers to rare and common childhood conditions. This research allows cures, new treatments and medications to be developed for the biggest health problems facing children.
“The support we receive through the Good Friday Appeal helps us achieve great things at MCRI. With your help, we can continue to find cures and prevent illnesses and disease in babies, children and adolescents so they can live long, healthy and fulfilling lives”
– MCRI Director, Professor Kathryn North AM
Thanks to the Good Friday Appeal, MCRI can undertake significant research projects and access cutting-edge technology.
For example, the MCRI runs life-changing clinical trials to improve childhood cancer survival rates and reduce the risk of scabies in countries like Fiji and more.
Additionally, the MCRI is developing new treatments for inherited and chronic kidney disease using stem cells and bioengineering prosthetic heart valves.
The MCRI’s commitment to improving the lives of children by shaping government policy, developing clinical guidelines for diagnosing and treating children, and informing best practice is helping children live healthier and more fulfilling lives.
Sharing a campus with The Royal Children’s Hospital means patients have ready access to clinical trials and research, helping to quickly translate research into great care. Many MCRI researchers are also clinicians, which allows them to use their research to solve problems they see in their daily work with children and families.
