There has been an increasing awareness and discussion about burnout in clinicians – but what does this mean, who is affected and what can we do about it? The humanity in healthcare is at the heart of what we do in paediatrics, yet sometimes modern medical care can get in the way of this. We believe it is essential to nurture a culture of kindness throughout the healthcare system.
In 2004, the Family Court of Australia defined hormone treatment for transgender adolescents as a “special medical procedure”. This created a law which necessitated that all transgender adolescents were required to gain legal authority from the Family Court of Australia should they wish to medically transition to their affirmed gender identity. Even with the consent of the young person, their parents and approval of the medical team involved, court authority was required. This situation was unique to Australia, with no other jurisdiction in the world having such legal barriers to treatment.
Some of the policy work the Department of Health and Human Services Child Health and Wellbeing Unit has been undertaking since its creation in November 2017.
Recent cases of conflict around medical treatment for seriously ill infants and young children have raised a number of questions about the nature, consequences and ethics of disagreement in neonatal intensive care.
How often do serious disagreements about treatment occur? Are they becoming more common? Why do disagreements occur? If there is disagreement between parents and health professionals about treatment for a child, what should the health care team do?
The language we use with patients and families has a profound impact on them, and shapes their relationship with health professionals. In Victoria there is a large cohort of children with complex medical needs. Many are seen at RCH by a wide variety of professionals, over many years. In the care of these children, communicating effectively with them and their families can be as important as any medical therapy or procedure. Language can make the difference between a powerless family and an empowered one. It also enables health professionals to empathise better with their patients, improving patient outcomes and practitioner wellbeing.
Dr Doug Bryan is a paediatrician who has worked at the Royal Children’s Hospital since 1970. During those 48 years the prognosis and life prospects for children with chronic and complex medical conditions have improved dramatically. This has occurred partly from the discovery of new interventions but also in large part to the development of systems of care that specifically focus on the care and needs of these children and their families.
The most important vectors of the 21st century epidemics are not mosquitoes, ticks or lice. They are the giant supranational tobacco, alcohol and ultra-processed food and beverage corporations
On the first of February 2017 the office of the Health Complaints Commissioner came into operation under new legislation, the Health Complaints Act 2016. This Act repealed the Health Services (Conciliation and Review) Act 1987 and thus replaced the previous office of the Health Services Commissioner with the Health Complaints Commissioner.
The RCH National Child Health Poll was launched in December 2015 to build the level of public debate and discussion about child and adolescent health issues. The poll methodology combines the rigour of academic research with the timeliness and reach of online quantitative data collection to deliver new knowledge about the experience of children and young people, and the households and communities responsible for their wellbeing.
It was during his fellowship at RCH PICU in the mid-90s, that Bernhard Frey first encountered patient safety initiatives such as critical incident reporting and evidence based medicine. Back home, he tried to implement these concepts in Switzerland and complemented them in the following years by issues such as allocation of care, organizing PICU, technical measures, avoiding overtreatment and the importance of the prevailing culture. In this Grand Round, Bernhard Frey will discuss a practical approach for safe medicine, based on his experience and the current literature.
