Table 1 Core components of medical follow-up strategy
Core components of the medical follow-up strategy | How each component will be provided? | Who will be involved in providing/delivering the core component? | Outputs | Outcomes (How we will know the core component was delivered as intended) |
|---|---|---|---|---|
1. First Nations lead | • Advisory lead on all cultural components of project | • First Nations lead | • Culturally secure operations with First Nations knowledge privileged | • First Nations lead identified and appointed and employed for duration of study |
2. Stakeholder engagement | • Engagement occurs with focus groups and interviews for the purpose of identifying current state, barriers and facilitators to providing the strategy • Inner setting: patients, HCPs, executive • Outer setting: primary care HCPs and other key stakeholders such as umbrella First Nations primary care organisation) and the Telethon Kids BREATH team consumer reference group | • Qualitative experts will lead the interviews, focus groups and analysis • Interviews and focus groups will capture voice of parents, HCPs and primary care HCPs involved with children hospitalised with ALRIs | • Identified barriers and facilitators | • Written report summarizing key findings, process map and tailored implementation of strategy for each site |
3. Training of clinicians and other health staff | • Online module and podcast(s) accessible and free of charge • In-person training | • Clinical champion will promote module and podcast at each site • In-person clinical training by pediatric respiratory clinician • Cultural training by Aboriginal cultural educator | • Module and podcast hosted on National website • Clinical/cultural training accomplished | • Metrics of completions at each site (electronic capture system) • Percentage or proportion of HCPs trained out of the total number (denominator) who could be trained at each site |
4. Educational resources | 1. Health information flip chart 2. Health facts sheet for parents 3. Letter to local clinic | • Champion at each site ensures accessibility of documents | • Educational resources adapted for each site • Available on internet/intranet • Hard copies easily accessible in clinical workrooms |  |
5. Patient admission process | 1. Patient is identified as being First Nations and local clinic is updated on electronic record system 2. Parent receives lung health education and is instructed to follow-up in 1-month at local clinic | 1. Clerks 2. Doctors 3. Nurses | • Automated SMS sent to parent | • Audit of discharge summary to check First Nations identification and local clinic contact |
6. SMS follow-up reminder | • A SMS is sent to each patient at 4-weeks post discharge with reminder to take child to local clinic for follow-up if chronic wet cough | • Site Information Technology (IT) department | • Automated SMS sent to each patient at 4-weeks post discharge | • Number of SMS reminders recorded |
7. Discharge process | • Electronic discharge summary requires instructions for primary care clinicians • Instructions to be integrated into the existing electronic discharge form via template | • Doctor to complete discharge summary with all required information • IT technician at hospital site to embed template with instructions for easy integration by doctor when completing summary | • Instruction template is integrated into the electronic discharge summary system | • Audit of discharge summary compliance with required information (see Additional file 6) |
8. Local champions | • Champion helps HCPs to uptake new processes and reminds HCPs about best practice at routine staff meetings | • Identified by clinical lead at each site | • Champion is provided with training at each site | • Number of champions and interactions recorded at each site |