Dr Bushra Nasir is a Research Fellow at the Rural Clinical School, Faculty of Medicine, The University of Queensland. She is committed to implementing the successful initiation and completion of a range of exciting epidemiological and clinical research projects designed to improve the health of rural Australians, by conducting clinical and scientific research in collaboration with academic and clinical staff associated with the Rural Clinical School.
Background: While Australia has one of the highest life expectancies in the world, the 3.5% of the population that identify as Indigenous face a life expectancy that is not comparable to first world standards. Almost 95% of Indigenous Australians are affected by suicide with rates that are twice those of the broader community. Importantly, suicide is the leading cause of death among 5- to 17-year-old Indigenous children. Despite these alarming statistics, at present, there are no gold-standard suicide intervention-training models that are specifically designed for Indigenous people.
Methods: Frontline education and intervention training is one of the most effective suicide prevention strategies available. Using a co-designed wrap-around framework, we developed the Indigenous Network Suicide Intervention Skills Training (INSIST) program to enable Indigenous communities to keep each other safe, by increasing the knowledge, awareness and sense of connectedness between at risk groups and health services or support groups. This was developed over three years in close collaboration with community members, service providers, education experts and mentors, as well as drawing on existing models and previous research.
Results: The co-design approach of the training led to successful uptake, and provided strong evidence on value and sustainability. The resulting program focuses on cultural importance and empowerment for Indigenous communities. The intervention includes a mobile app to provide training refreshers, support resources, and intervention guides, provides further utility of the training package and its long-term sustainability. The training provides participants with the necessary skills and knowledge to apply a suicide intervention model. The framework behind the intervention model provides caregivers the awareness to recognise when someone may be at risk of suicide, skills to connect with them and to understand and clarify that risk, steps to keep that person safe for a specific period, and then provide them with the resources or links required for further help. The training is delivered across a two-and-a-half-day workshop, during which knowledge and practice of the model is interactively developed. An increase in confidence, awareness and intervention skills are achieved at the end of the training.
Conclusion: Existing and ongoing research indicate a lack of sustainable evidence-based intervention training programs for which high uptake has been achieved, or which has led to outcomes that have been evaluated to show societal improvements. The co-designed innovative framework and social enterprise model of this training, ensures its appropriateness and long-term sustainability.
With a background in nursing, Ann Nicholas has spent over 20 years involved in the health industry. After her mother was diagnosed with dementia, Ann took two years out of the workforce to provide care for her. Ann’s personal experience has created an awareness of the difficulties and rewards the role of a full-time carer present, that only first-hand experience can provide. She also has experience in dealing with persons with serious mental health issues. Her passion for caring for others has led to her working on education campaigns with Commonwealth Serum Laboratories and the NSW Cancer Council. Ann’s career also includes medical risk management, specialising in national and international sporting, concert and entertainment events, such as the Survivor television series.
Funded by the Department of Social Services, Carer Gateway is a free helpline and website designed to assist over 2.8 million carers in Australia who provide an estimated $60.3 billion in unpaid assistance each year.
Following the roll out of Carer Gateway in 2015, two years of consultation with carers and the carer sector has led to the development of the new Integrated Carer Support Services Program.
From late 2019, this program will see the establishment of a new network of regional delivery partners across Australia to help rural carers identify local services relevant to them and provide support where it is needed most.
These new regional delivery partners will provide assistance with navigating relevant local services available to carers through federal, state and local government and non-government providers, including the National Disability Insurance Scheme, My Aged Care and palliative care. They will provide needs assessment and planning for carers along with in-person and phone-based coaching, counselling and peer support . The program will also see access to emergency crisis support and targeted financial support packages with a focus on supporting employment, education, respite access and transport.
In addition, digital counselling services, online peer support, self-guided coaching and educational resources will be available to the public through the Carer Gateway website, a further support for rural carers.
The introduction of the Integrated Carer Support Service displays the continued effort to adapt to the needs of carers and help them obtain support services and information throughout their care-journey, temporary or permanent. The ongoing development of this vital service is evidenced by the Federal Government’s continuing commitment to meet the needs of carers in regional and remote areas of Australia.
This presentation will outline how the new Integrated Carer Support Service can assist rural and regional carers and identify how to access these services.
Jessica Nicholson is a registered nurse with 14 years' experience providing care to patients with haematology and oncology conditions throughout Queensland. She has worked within the tertiary centre as Clinical Practice Facilitator and acting Nurse Unit Manager and regionally as Regional Case Manager for paediatric oncology and palliative care patients within the Metro South Hospital and Health Service. Jessica has a graduate certificate in Health Professional Education and currently works as the State-wide Educator for the Queensland Paediatric Palliative Care, Haematology and Oncology Network (QPPHON). In this role Jessica provides educational leadership, develops curriculum, facilitates training programs and supports education activity for staff employed in the Children’s Health Queensland, Hospital and Health Services (CHQHHS) and across the State in the Regional Paediatric Shared Care Units.
Aim: It is well recognised that childhood cancer treatments require specialised tertiary care centres that offer dedicated paediatric services and a multidisciplinary approach to care. In Queensland, approximately 60% of new paediatric oncology patients (150–180 annually) live over 50kms from the tertiary centre.
In 2007, in recognition of the need for cancer service enhancement in regional centres, the Queensland Paediatric Haematology and Oncology Network (QPHON) was established to assist in the delivery of coordinated high quality clinical service across the state.
Method: Shared Care Units were established in 10 regional hospitals throughout Queensland. Formalised education and support to regional clinical teams including dedicated Paediatricians, and advanced practice nurses, provided the foundations for the delivery of a shared model of care in regional hospitals.
Results: The service delivery within the Share Care Units has continued to develop over the last 10 years. The introduction of standardised pathways and strong clinical leadership has improved timeliness, appropriateness and efficiency of care, whilst enhancing safety and quality. This has allowed for the expansion of service capabilities such as more intensive supportive care and increased complexity of chemotherapy administration. In 2016 QPHON became QPPHON to formally acknowledge the increasing palliative care component to the RCM’s role for both oncology and non-oncology patients.
Conclusions: The successful development of QPPHON has ensured the Children’s Health Queensland’s commitment to provide safe, expert, accessible child and family-centred care for children and young people has been upheld, by providing advanced care in regional centres that facilitate and underpin ongoing clinical safety for the paediatric oncology/haematology and palliative care patient as close to home as possible.
Ilsa Nielsen is A/Director Allied Health in the Allied Health Professions’ Office of Queensland. This role supports workforce policy, planning and development for rural and remote allied health services in Queensland Health. Ilsa is a physiotherapist and has postgraduate qualifications in public health, education, and health economics and policy. Her former appointments include academic and clinical physiotherapy roles.
Introduction: Temporary, supernumerary rural generalist training positions for early career allied health professionals were trialled in Queensland Health between 2014 and 2018. The trial sought to develop a model of rural generalist employment and training for nine allied health professions: nutrition and dietetics, occupational therapy, medical imaging (radiography), pharmacy, physiotherapy, podiatry, psychology, social work and speech pathology.
Methods/strategy: Rural and remote teams hosted fully-funded, temporary rural generalist training positions in a specified profession. Twenty-two positions were implemented in successive three and two-year funding rounds commencing in January 2014. Sites changed between rounds. Individual position holders were employed for a one or two-year term.
Evaluation of the trial included collation of host site training and service outputs, trainee employment tracking using HR data systems, and a qualitative evaluation completed by Southern Cross University in 2014.
- Mandatory position specifications and support requirements were defined as:
- Greater than 0.1FTE allocated development time
- A formal and funded development plan
- Profession-specific supervisor, which for graduates is co-located for 50% or more of work hours
- Participation in a local service development activity that implements rural generalist service delivery strategies such as telehealth or delegation to support workers, in order to improve access, quality and efficiency of services.
- Retention in the training role was 94% for the 35 position holders to July 2018.
- Employment destinations twelve months after separation from the training roles for 2014-16 cohorts showed 64% remained in regional, rural or remote Queensland Health facilities.
Service development outcomes from host sites included:
- new telehealth clinics for dietetics, physiotherapy, pharmacy and speech pathology moved care closer to rural and remote clients
- improved utilisation of allied health assistants in rural hospital and primary healthcare clinics.
- Training plans were developed locally for the 2014-16 cohorts and were guided by profession-specific supervisors. Stakeholder feedback indicated that this was not optimal and award-based training was sought.
- The 2017-18 cohort undertook a formal program of study developed and delivered by James Cook University through a partnership with Queensland Health.
Conclusion: The training requirements, supporting systems and employment model for the early career stage of an allied health rural generalist pathway has been successfully developed and evaluated in the five-year trial. Health services can now implement the model in their organisation to support allied health workforce and service outcomes.