Overview
Initiative type
Service Improvement
Status
Deliver
Published
June 2026
Summary
Statewide telehealth simulation strengthening paediatric retrieval communication, teamwork and system reliability in regional Queensland.
Implementation sites: Queensland Children's Hospital
Project dates: January 2024 - Ongoing
Partnerships: Children's Health Queensland Retrieval Team; Retrieval Service Queensland; Rural, Remote and Regional Hospitals; Retrieval Call Centre Teams; Simulation Outreach Educators
Aim
To improve safety, communication and system performance during paediatric retrieval through interdisciplinary telehealth simulation.
Outcomes
- Demonstrated the feasibility of embedding retrieval call centres into live in situ simulation.
- High participant engagement and reported increased readiness for real retrievals.
- Identified latent safety threats, including:
- Bandwidth instability
- Delayed role clarification
- Suboptimal camera positioning
- Prompted local workflow and technology adjustments at participating sites.Strengthened collaboration between regional hospitals and retrieval services.
Background
Queensland spans 1.7 million km² and includes 106 hospitals, creating significant challenges in delivering equitable paediatric care (1). Critically unwell children frequently present to regional facilities without onsite tertiary paediatric capability. Telehealth connects local clinicians with tertiary specialists and retrieval services, forming a critical link in the patient journey.
Despite reliance on telehealth for high-stakes retrieval decisions, interdisciplinary communication across sites is rarely practised in realistic, system-level environments. Breakdowns in role clarity, leadership alignment, workflow coordination and technology performance may only become visible during real emergencies.
Building on an established paediatric simulation outreach program, this initiative integrated retrieval call centre teams into telehealth-enabled in situ simulations conducted in regional resuscitation bays.
The project addressed the question:
How can we proactively test and strengthen communication, workflows and technology within Queensland's paediatric retrieval network before real patient events?
Guided by translational simulation principles, the focus shifted from individual technical skills to system learning, examining how teams, processes and digital infrastructure interact under pressure (2,3). This aligns with Clinical Excellence Queensland priorities of safety, equity, workforce capability and system integration.
Methods
This descriptive quality initiative leveraged an existing statewide simulation outreach service.
Design
- In situ paediatric emergency scenarios delivered in regional hospitals.
- Retrieval call centre clinicians are embedded remotely via authentic telehealth systems.
- Real communication platforms are used to replicate live retrieval workflows.
Implementation
- Scenarios mirrored common retrieval triggers.
- Retrieval coordinators participated in real-time assessment and decision-making.
- Telehealth feeds were broadcast into resuscitation areas.
- Debriefs co-facilitated by local educators and retrieval-based co-debriefers.
Evaluation and System Learning
- Structured debriefs explored leadership, communication, psychological safety and workflow efficiency.
- Latent safety threats and system barriers were documented.
- Written improvement summaries were provided to sites after the course.
- Local teams implemented immediate changes (e.g., camera repositioning and role-clarification protocols).
The methodology aligns with translational simulation, treating simulation as a system-improvement tool rather than solely as an educational intervention (2,3).
Discussion
Enablers of Success
- Established a statewide simulation outreach program
- Existing telehealth infrastructure
- Executive and retrieval service engagement
- Interdisciplinary psychological safety during debrief
- Leveraging existing programs ensured sustainability and minimised additional resource burden.
Lessons Learned
- Technology reliability significantly influences clinical coordination.
- Early explicit role allocation improves efficiency and reduces cognitive load.
- Inter-site relational familiarity enhances psychological safety.
- Simulation can safely reveal system vulnerabilities before patient harm occurs.
Limitations
- Descriptive design without quantitative patient outcome measures.
- Short-term evaluation focused on engagement and identified system issues.
- Resource dependent on simulation outreach scheduling.
Scalability Across Queensland Health
This model is transferable to:
- Adult retrieval services
- Trauma and emergency telehealth networks
- Neonatal and maternity retrieval systems
- Rural critical care telehealth programs
It supports CEQ priorities by strengthening system integration, workforce capability and rural equity of access.
Next Steps
- Formal evaluation of impact on retrieval efficiency metrics.
- Development of structured telehealth communication frameworks.
- Integration into statewide retrieval training standards.
- Expansion to additional emergency care networks.
- This initiative demonstrates a sustainable, system-focused model for improving safety and equity in paediatric retrieval across Queensland.
References
1. St-Onge-St-Hilaire A, et al. Paediatric resuscitation in regional Queensland. Emergency Medicine Australasia. 2025;37(2).
2. Victoria Brazil, Reedy G. Translational simulation revisited. Advances in Simulation. 2024;9(1).
3. Victoria Brazil, Purdy E, et al. Improving relational aspects of trauma care. Advances in Simulation. 2019;4(1).
4. Dietl JE, et al. Interdisciplinary communication and psychological safety. Frontiers in Psychology. 2023;14.
Key contact
Myfanwy Williams
Nurse Educator
Queensland Children's Hospital