Med Talks: Fionnagh Dougan, CHQ Chief Executive

Acting Executive Dean Professor Robyn Ward recently sat down with Children’s Health Queensland (CHQ) Chief Executive Fionnagh Dougan, for a chat about the great work happening at CHQ. The pair discussed partnerships, medical education and research, and improving health outcomes for young people across Queensland.

Robyn (RW): To start off, can you tell us a little bit about Children's Health Queensland?

Fionnagh (FD): Sure, so Children's Health Queensland is a state-wide organisation. We have an accountability for leading the development of a strategy for children and young people and we also have a tertiary quaternary hospital with over 300 beds that we flex up and down to 350 beds.

Obviously being the most complex healthcare provider in the state, we have great opportunities for learning for the workforce and for really constructive partnerships, not just with the universities but the rest of the health sector too. We can really influence what happens in terms of improving outcomes for children and young people.

We deliver outreach services in the remote parts of Queensland, but we also partner with other HHS's to make sure that the flow in and out of our organisation are appropriate, and quality and safety are our priority.

RW: So one of the things I've heard you talk about before is how important you think it is for students to train not only in big hospitals but also in the remote areas. Could you tell us a little bit about why you think that’s important?

FD: Well I think it’s really important for a diverse state like Queensland, and I think that if you're always spending time in a tertiary quaternary hospital, you actually don't really understand issues around equity, of access to healthcare, and how things like indigeneity and poverty can actually impact outcomes.

If you actually have experience across the state, you understand the region you're working in and you understand the constraints and the partnerships required to deliver really excellent healthcare.

I am a real advocate of students having experience in the primary care context, even in a city, because of very different presentations and the opportunity to understand that as a clinician, you need to develop an ongoing relationship with, for example, a child and their family.

And we're looking at GP's leading healthcare for life, and a lot of medical students don't naturally gravitate towards that experience.

RW: What sorts of behaviours do you think medical students see exemplified in the workplace, where they're working in an environment where they've got doctors and nurses and allied health people working together, how does that work in practice in a hospital such as yours?

FD: Well in practice, I still think we've got quite a lot of work to do to make sure we're not operating in silos. We want young medical students and newly qualified staff to understand that our drive is towards interdisciplinary working where the patient is at the centre of everything we do and we're partnering with the family. That means that healthcare professionals need to work as a team, and I think that's something CHQ is on a journey towards doing well, along with our overarching integrated care agenda.

So I would like to think that students and new graduates coming into the organisation will sense that teamwork, and start to understand that, for example, a lot of our workforce development is going to be about interdisciplinary learning, and I'm very aware that UQ shares that agenda.

I believe we've been invited along to participate in some of the thinking about how that might be delivered really successfully. I'm delighted to see UQ leading in that space.

RW: One of the other things that we do together is research. We've got a shared facility with our researchers working together. What do you think are the key elements of a successful partnership in research in your mind?

FD: Well it’s been fantastic that we can actually look to you to provide us with guidance around our research strategy. As a provider organisation, we have lots of clinicians interested in research, but how do we know that we're doing the right things?

You've got a dedicated team of people whose everyday thinking is about research, is about the future, is about what's going to make a difference, not just in the world of healthcare, but more broadly. So I think from our partnership with you, we really benefit from that world-class institution being on our doorstep and guiding us about what the priorities should be, particularly if we're really aiming to take that population of children and young people.

We have the needs assessment, we understand that population. We want UQ to work with us and guide us around where the critical priorities are. It has been fantastic to have that partnership.

Now that we have established the centre, the everyday conversations between researchers, the cross-fertilisation of ideas through co-location are really adding value.

RW: One of our observations is just how enthusiastic researchers and clinicians are to really engage and solve problems, and that's come about through the co-location, as you say, and also through the shared purpose, so it’s also been great working with Children's Health Queensland in that capacity.

FD: And I think it really has expanded peoples thinking to have that opportunity again, we've got individual clinicians who might have a particular perspective on the research that they want to do. While that’s really important that we do some pure clinical research, my agenda is increasingly, "let’s do broader health services research so that we really understand what models of service delivery make a difference." And we can work with you around that as well because you're developing that thinking in your Faculty.

RW: When you look to the future, a decade from now, what do you think the health system is going to look like?

I’ve seen an unprecedented change in my lifetime around the health system. Obviously, consumer and family demand, and that personalised healthcare.

The challenge for the public sector is actually to work with that agenda while still dealing with declining public funding, and we need to be really innovative so integrated care and delivering services in the right place, at the right time.

We should have fewer hospital beds and we should be delivering many services not just through traditional healthcare providers, but through new groups that develop and we will need to look at different professions who are perhaps less traditionally well qualified, but have the skills to do some of the work that we'd consider now, say a nursing or allied health accountability that might be developing the family as a late provider or other entities where we can deliver care more cost effectively.

RW: It's been wonderful talking to you today and hearing your perspectives, not only on the health system but also the role that partnerships play with the university in both research and education. Thanks for sharing your thoughts with me.

FD: Thanks very much for your time Robyn, it was lovely to be here.