Overview
Initiative type
Service Improvement
Status
Deliver
Published
June 2025
CEQ Showcase 2025 -Let's bounce - Virtual Behavioural Paediatric Clinic
Summary
Care closer to home through equitable access to Paediatric Behavioural assessment services virtually within Central Highlands.
Dates: 10 October 2024 - 30 April 2025
Implementation sites
Rockhampton Hospital
Partnerships
TeleCare external vendor providing virtual Behavioural Paediatricians
Aim
Provide care provision that is most sympathetic to families through virtual delivery of paediatric behavioural assessment and management services.
Outcomes
- Positive patient outcomes reported
- Behavioural Paediatricians part of this service completely virtual
- Literature outlines the importance of consumer involvement and requirements through service delivery development.
- Staff still required at patient end including nursing, admin, local medical oversight to ensure external service is living up to Central Queensland (CQ) expectations and patient requirements
- We will continue to encourage both locally based and external provider service provision throughout CQHHS for paediatric services.
- Virtual care does not change children’s behaviour – these children will behave as they always would.
- At the end of the day these patient's need to be seen and we are willing to move heaven and earth for this to occur.
Background
Emerald has introduced a new telehealth service. The paediatric behavioural telehealth clinic connects families with a specialist paediatrician by video call, reducing wait times and the need to travel to Rockhampton for face-to-face appointments. This is an essential service as behavioural and developmental challenges impact every part of a child’s day-to-day life, as well as those who care for them.
The service commenced in October 2024 with approximately 5 months of service provided. Current service level agreement with Rockhampton Paediatrics provides behavioural assessment clinics to Central Highlands, however Rockhampton are currently unable to provide this service due to staffing issues.
There are limited support services available locally in Central Highlands for allied health, GP support and specialised paediatricians. Families traveling from Emerald to Rockhampton requires 241 kilometres and Emerald to Brisbane requires 830 kilometres of travel.
Methods
- Families engaged about upcoming service provision to be virtual. - Local schools informed of service recommencing within Central Highlands.
- External vendor engaged and contracted as CQHHS service.
- Feedback from staff involved was positive and staff felt pt’s were heard and seen appropriately. - Pt’s/families did not mind that the service was virtual – they were just happy to be seen.
- One child was not able to attend school for 2 years due to behaviours – and was seen by virtual service. - KPI to - reduce waitlist - consult with ‘new’ cat 1 & 2 pt’s in Emerald rather than Rockhampton – enable review patients to then be seen virtually – provide a clinician (specialist nurse) at patient end to assist with questions and direction for family post appointment.
- July 2024 had 124 total waiting pt’s for service compared to Nov 2024 had 73 on waitlist for
total paediatrics patients (mainly reduced due to behavioural pt’s being seen virtually – April 2025 has 54 on waitlist (some of which are behavioural paediatrics). - All consult info provided to pt’s GP and available to CQ paediatric services.
- Is a financially viable service provision model even after paying for external vendor, therefore financially sustainable utilising QH funding models.
- Assessments and paediatric pt tools sent to family/carer ahead of time for completion prior to the consult with family & pt.
- Some patients are now in-home appointments for new & review patients which provides even greater access for vulnerable community members – however there is a gap is this type of service provision with nurse not present at consult and families left to contact Emerald services themselves for clarification or further information.
- Prior to virtual service implementation there were long wait times, access issues, delay of early diagnosis and intervention meaning children are missing early milestones which is affecting their ongoing ability to be present in society as a contributing member of community.
- Privacy of pt info ensured using only encrypted platform to share pt information.
Discussion
Behavioural Paediatricians are scarce throughout Australia and have become versatile in delivering care through multiple modalities with the paediatrician part of this service completely virtual. Latest evidence around the delivery of paediatric care is highlighting the effectiveness and opportunities for delivering care through innovative modalities.
In Central Queensland Hospital and Health Service, we are adopting innovative delivery methods for many new service types. Virtual paediatric behavioural clinics are no different, with current work offering a promising and innovative approach to
meeting the challenges of equitable access to paediatric behavioural care for rural residents. The total number of patients consulted, and appointments provided are 324 within five-month period.
The top 10 presentation types for this virtual service includes Autism Spectrum Disorder, ADHD, Speech and Language Delay, Global Developmental Delay, Challenging Behaviours, Sleep Disorders, Iron Deficiency and family/caregiver Stress for crisis-level coping difficulties, needing NDIS and respite support. Currently all new patients consulted are from long wait list, with review pt’s next on list to be seen and commencing being seen within next clinics.
The face-to-face service when available in Central Highlands over 6 months from September to February 2024 showed - 60 total new consults within clinic and 69 total review with nine FTA’s equally a 6.9% FTA rate for face-to-face service provision. 98% of patients and families who attended appointments have been happy with virtual service – FTA rate for service provided so far is 18 patients equalling 5.6% for virtual care.
A total of 24 patients were removed and not seen by service, due to uncontactable or moved out of catchment area. Feedback - Staff feedback included that an experienced nurse required at patient end to ensure pre & post appointment support provided to family/child/adolescent – excellent service – staffing difficult at rural facility.
Feedback provided directly to Emerald staff from local schools stated this has had a very positive impact in classroom behaviours and activities. Parents are able to have their children diagnosed within 1-2 visits, with more referrals coming through to service now as the community are aware there is a service locally.
References
Virtual delivery of group-based cognitive behavioral therapy for autistic children and youth during the COVID-19 pandemic was acceptable, feasible, and effective | Scientific Reports. Assessment of Competency-Based Behavioral Health Anticipatory Guidance Skills Among Pediatric Residents: the Role of Virtual Reality | Journal of Technology in Behavioral Science. Children | Special Issue : Developmental and Behavioral Paediatrics.
Private service providing virtual Paediatric - Telecare. Impacts of health care service changes implemented due to COVID‐19 on children and young people with long‐term disability: A mapping review - Merrick - 2023 - Developmental Medicine & Child Neurology - Wiley Online Library.
Innovative virtual care delivery in a Canadian paediatric tertiary-care centre | Paediatrics & Child Health | Oxford Academic. Virtual health care for children: Parental willingness to adopt virtual health‐care technologies - Lawrence - 2022 - Journal of Paediatrics and Child Health - Wiley Online Library. Mapping the Gaps: A Scoping Review of Virtual Care Solutions for Caregivers of Children with Chronic
Illnesses.
Key contact
Christina McInally and Marsha Abbott
Telehealth Coordinator; Clinical Nurse Consultant
Central Queensland Hospital and Health Service
Email: christina.mcinally@health.qld.gov.au