Overview
Initiative type
Service Improvement
Status
Deliver
Published
13 May 2024
Summary
This joint project supports First Nations residents from Cunnamulla and surrounding communities to attend appointments at Toowoomba Base Hospital, using a wraparound, person-centred approach. It encourages and assists patients to travel and keep their appointments, promoting better engagement, improved condition management, enhanced wellbeing, and stronger overall outcomes.
Key dates
Feb 2023
Implementation sites
Darlings Downs and South West HHSs
Partnerships
Cunnamulla Aboriginal Corporation for Health
Aim
Reduction in FTA rates of First Nations People travelling 650km each way to attend appointments at Toowoomba Hospital - improving patient experience and contributing towards overall improvements in health outcomes.
Background
Reasons behind 'Fail to attend' (FTA) are complex, including miscommunication, difficulties in travelling, distrust of services “particularly those provided away from home“ and other factors.
Not attending appointments, especially for people living in the community with chronic conditions, can have a significant impact on quality of life and may also delay waiting times for other people in need of treatment.
Across the remote South West, there are significantly high rates of complex, chronic conditions “including cancer, heart disease and diabetes“ and these issues are intensified in First Nations people. This is a joint project between South West HHS and Darling Downs Health, with an initial focus on First Nations residents. Originally initiated at the request by the Cunnamulla Aboriginal Corporation for Health.
Outcomes
Compared to FY2022-23, First Nations FTA rates in local communities have halved in the financial year to date - demonstrating positive impact and great potential for wider implementation.
This joint project, initiated March 2023, supports First Nations residents in Cunnamulla and surrounding communities attend their appointments at the Toowoomba Base Hospital, approximately 650Km from home. Effective July 2023, the initiative was also expanded to Charleville and surrounds.
Methods
Proactive engagement and discussion with patients to confirm travel arrangements (or, when care transitions to telehealth, appointments from South West facilities) in the community to discuss any questions or concerns they might have about what to expect and who will be taking care of them. These are ideally done face to face rather than letters or phone calls to build trust.
Weekly collaborative case management meetings between Toowoomba and South West HHS colleagues, ensure client needs and preferences are fully understood and supporting clinicians are kept informed.
Discussion and results
This end-to-end approach also includes follow ups to discuss patient experiences, confirm next steps in their care and help with travel claims. Feedback is shared between teams to improve local services and, where appropriate, follow up appointments are converted to Telehealth, enabling the South West team to support people closer to home.
To evaluate the project FTA data maintained by Darling Downs Health, against an internal benchmark of <9% was used.
In the Financial Year to Date, at 22 February 2024:
- Total South West Resident First Nations FTA rates at Toowoomba Hospital have fallen from 7.3% to 4.7% in Cunnamulla and from 8.5% to 5.8% in Charleville
- Specialist appointment FTA has reduced from 10.4% to 5.5% (Cunnamulla) and 11.3% to 8.6% (Charleville)
- These results are even more impressive given, for both locations, prior financial year FTA rates had been static - demonstrating the significant difference this more personal approach is making.
Key contact
Nina Jordan
CNC Health Equity Service Redesign
South West Hospital and Health Service