Complex health needs of Indigenous children are being fast-tracked by a unique project designed to reduce red tape and deliver timely paediatric services.
With a remarkable 90 per cent attendance rate by the 200 families taking part in the Perth-based Initiative, critical diagnoses and interventions are being made earlier in the children’s lives.
Funded by BHP in partnership with Derbarl Yerrigan – Perth’s biggest Aboriginal community-controlled health service – and The Kids Research Institute Australia, the project supports a Paediatric Coordinator to support and engage families through their paediatric clinical journey and help them navigate the complicated referral requirements of Perth’s health and social service system. The model also has GPs who work alongside the paediatricians as well as speech therapists and occupational therapists. The model is centred around case coordination putting families at the centre.
Derbarl Yerigan paediatrician, Dr Andrew Haak, said most of the children engaged with the service have multiple, complex challenges in their daily lives.
“The typical presentations are concerns around children’s attention, social functioning, school functioning, or emotional dysregulation – that might be anxiety or depression or difficulties regulating their emotions in their daily life,” Dr Hark said.
Many of our clients have already cycled through multiple systems in attempts to get things sorted out. And all along that line there have been lines of communication that have been broken.
Average wait times to see a specialist paediatrician in the Perth region can be up to two years, just for a first consultation.
For many children – that’s simply too long to wait.
As Paediatric Co-ordinator, it is Jacquie Rushford’s responsibility to keep the children, and their families, engaged with the service and attending clinics.
A large part of how she does that is by reducing the significant burden faced by families when accessing services.
“To me, case coordination is so important because what it means is that when the families come to their appointment, we can actually do something for them and they feel like there’s been an end point of that appointment,” Ms Rushford said.
Before each child’s first appointment, Ms Rushford gathers together a detailed picture of their medical, developmental and social background.
This includes things like school records, reports from teachers and doctors, and a detailed explanation of the child’s challenges and family dynamics.
For many of the families engaged with the service, gathering the paperwork needed for their child’s treatment can be overwhelming.
“We’ve cut through that process at Derbarl by getting all that information on the table prior to the family even coming through the door for the first time so it’s really making that service so much more efficient for families.” Ms Rushford said.
She ensures each child is triaged into an appropriate care plan and then closely tracked through the system and pro-actively engaged for follow-up treatments and consultation.
Often, this takes the form of a phone call or text message from Ms Rushford to the child’s family.
“I’ll regularly yarn with the family or carer to see how the child is going, whether there are any concerns with medication or changes in their health or wellbeing that we should know about,” she said.
“They know they can contact me directly to talk about any concerns they have, and that makes a real difference in terms of engagement. The family is dealing with the same person every time and I have their child’s full history in front of me.”
The Kids Research Institute Australia Journey Together Program Manager Kristen White said the initiative combined research, action and advocacy in partnership with communities, families and services to create change at family and systems levels.
“We are working directly with Aboriginal community-controlled organisations to trial new approaches to responding to community identified priorities. At the same time, we are collecting important data that builds our understanding of family and service system needs,” Ms White said. “The unique model of this project allows us to deliver immediate support for children and families in parallel with research and evaluation.”
The Derbal Yerrigan project is one of three that form the Journey Together initiative. The other two projects include a new model of perinatal and early childhood care for Aboriginal families in Newman and the Western Desert communities and a wraparound service for families with complex needs in Port Hedland.
Dr Haak said the way the Derbal Yerrigan clinic wrapped around each patient and their family had completely revolutionised the way he treated his patients.
“I know I can turn up in the morning and Jacquie will bring me up to speed on everything that’s happened with each child on the list since I last saw them and any concerns the family has raised with her,” he said. “And then at the end of the day, I can give Jacquie an outline of actions that we need to take for each child, and I know that she will close the loop on those.”
Derbarl Yerrigan general practitioner Dr Kim Isaacs said another key factor in the success of the Paediatric Clinic was the trust the Aboriginal community had in the service overall.
“Cultural safety is so important in providing any health services for disadvantaged families that face barriers,” Dr Isaacs said.
“So to provide a culturally safe environment, like we do at Derbarl Yerrigan, encourages Aboriginal families to engage with our services, especially when they’re seeing familiar faces to develop trust and rapport.”
Dr Hark said the positive impacts of the service spread beyond the individual child and their family, to the wider community.”
“We have children who had a zero per cent attendance rate at school who are now re-engaged - they’re back at school,” he said. “They’re socialising with friends again, they’re playing sports in the community.
For Jacquie Rushford, it’s hard to pinpoint just one success story.
“It’s so rewarding to see the genuine difference it’s making to the kids we see and knowing that they’re engaging with people and building trusting and therapeutic relationships that will hopefully follow them through life,” she said.
“I just get so many little positive snippets of news every day that it just keeps me going.”