Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
Embedding a nurse-led service within general paediatrics outpatient services with nurse led clinics, shared care and clinical preparation and integrated work with allied health and paediatricians to optimise care.
Dates: June 2024 - June 2026
Implementation sites: Queensland Children's Hospital
This project was presented as a Poster at CEQ Showcase 2026 (PDF 245KB).
Aim
Reduce or eliminate the long wait list for children on category 2/3, referred to the general paediatric wait list, by integrating nurses in the service working top of scope. Ultimately reducing wait times for better patient outcomes and reduce fail to attends/duplication of services.
Outcomes
The project delivered 1 637 occasions of care across service components, with nurse-led clinics recording 577 occasions of service and a 98 % timely attendance rate (5 % no-show rate).
- Of the 577 patients seen in nurse-led clinics, 75 % were discharged back to their general practitioners without requiring paediatrician consultation
- 25 % required further medical review.
- Long wait-list numbers reduced markedly from >350 in June 2024 to 9 by January 2026.
- Improved clinical readiness for intake pathways
- Reduced appointment cancellations
- Enhanced linkage with community care services.
The model enabled a significant progression of nursing practice to top of scope.
Background
The General Paediatric Department at Queensland Children's Hospital traditionally operated as a medically focused service. It faced challenges including rising demand, extended wait times, and limited multidisciplinary collaboration. In particular, Category 2 referrals frequently exceeded the recommended 90-day timeframe, and children with dysregulated behaviours in Category 3 experienced waits exceeding 365 days. A formal Model of Care review identified these challenges and recommended trialling nurse-led services as part of a redesigned pathway.
Methods
Using the clinical service redesign methodology a project for the nurse led service was commenced. The project launch to implementation phase took three months to establish but the planning was instrumental in success and now sustainability. Nurse led clinics were established and a model for clinical supervision with consultant paediatricians was embedded to ensure safety of care and nursing remaining in scope of practice. Targets for occasions of service were identified and reporting structure in place to ensure accountability.
Discussion
The nurse-led clinic model demonstrates a viable and effective strategy to improve access, reduce wait times, and enhance integrated care pathways for paediatric outpatients within a tertiary hospital setting. This innovative model supports efficient, patient-centred care and collaborative practice across multidisciplinary teams. Its success suggests wider applicability for paediatric services seeking to optimise referral-to-recovery pathways and expand nursing roles in ambulatory care.
Implications for Practice:
This changed model of care highlights the potential for nurse-led services to mitigate systemic service pressures, deliver timely care, and strengthen community-based partnerships. Adoption of similar models may support broader health system goals in improving paediatric outpatient access and outcome.
References
- Children's Health Queensland Modal of Care:
- Queensland Children Hospital - General Paediatric Service
- General Paediatric Nurse Led Clinic Consumer Survey 2024-2025
- Nurse Led Clinics in General Paediatrics Service QCH- Guideline
Key contact
Maria Ronan
Clinical Nurse Consultant, General Paediatrics
Children's Health Queensland