Providing Enhanced Access to Child Health Services across NSW (PEACH NSW)

Overview

PEACH NSW is a quality improvement and research initiative designed to reduce inequities in healthcare access and outcomes for children and young people aged 0–17 years.

Building on interventions developed and tested at the Sydney Children’s Hospitals Network (SCHN), PEACH NSW is expanding across three partner Local Health Districts: Murrumbidgee, Sydney and Northern Sydney.

The initiative focuses on improving access, care experiences and health outcomes for children and young people from priority populations, including those who are Aboriginal and/or Torres Strait Islander, require an Interpreter, from refugee or asylum seeker backgrounds, living in out-of-home care, or living with disability.

Our approach

PEACH NSW combines digital health solutions, service improvements, workforce development and locally led quality improvement initiatives. Its interventions have been co-designed with children, families, health professionals and service partners and are being adapted to suit metropolitan, regional and rural healthcare settings.

The PEACH Checklist and Toolkit support improvement across four key areas:

• Improving identification: strengthening the identification of children and young people from priority populations through referral pathways and electronic medical record alerts.
• Providing earlier and enhanced access: prioritising children and young people on waiting lists and connecting families with appropriate support, including Aboriginal health workers, refugee nurses, social workers and out-of-home-care or NDIS coordinators.
• Supporting equity-focused care: using equity dashboards to help services identify priority patients, monitor access and outcomes, and guide clinical and organisational decision-making.
• Creating lasting cultural change: establishing PEACH Clinical Champion Networks and supporting teams to undertake PEACH Improvement Projects that address locally identified inequities.

Key goals

• Improve the identification of children and young people from priority populations across participating health services.
• Provide earlier and more coordinated access to appropriate healthcare and support.

• Embed successful PEACH digital solutions within electronic medical record systems (including SDPR).

• Build an equity-focused culture through clinical leadership, workforce engagement and consumer partnership.
• Support locally led quality improvement projects across participating services.
• Evaluate PEACH’s effectiveness, implementation, sustainability and cost-effectiveness to inform potential statewide implementation.

Consumer partnership

Children, young people and families from priority populations have played a central role in developing the PEACH interventions. Their experiences and perspectives have informed strategies to address barriers to care and improve identification, access and service delivery.

PEACH NSW will continue working with consumer groups across participating sites to adapt the initiative for local communities and ensure improvements are relevant, practical and sustainable.

Evaluation and impact

A mixed-methods evaluation is examining the impact, implementation and economic outcomes of PEACH NSW.

The evaluation assesses:

• changes in healthcare access and outcomes including

  • Emergency Department (ED) measure (triage category, direct admissions to Intensive Care (measures of severity), admissions to wards and left ED without being seen;

  • Admission measures (length of stay, discharge against medical advice (DAMA) and readmissions within 28 days)

• the acceptability, appropriateness and feasibility of the PEACH interventions

• barriers and enablers to implementation 

• changes in organisational culture and the uptake of equity-focused practices
• patient-reported experiences and outcomes
• implementation costs, potential healthcare savings and the budget impact of broader implementation across NSW.

Findings will help determine how PEACH can be sustained, scaled and embedded across the NSW health system.