The Royal Children’s Hospital (RCH) Emergency Department (ED) is facing more challenges than ever with increased demand and complex patient needs. To help address these challenges, and thanks to support from the Good Friday Appeal and Woolworths, the RCH is extending its Child Life Therapy (CLT) program to this critical department.  

CLT is a proven solution that tackles the emotional and social aspects of a hospital stay, as well as engaging, educating and empowering young patients and parents.  

At its core, CLT is about creating an environment where children and young people feel safe and supported, which can reduce anxiety, and turn hospital visits into positive experiences. Child Life Therapists focus on the emotional wellbeing of young patients, offering tailored interventions to ease stress associated with medical procedures. 

Through techniques such as medical and therapeutic play, and procedure preparation and support, CLT creates a positive and engaging environment, fostering emotional expression and understanding. Therapists collaborate with clinical teams to advocate for the child’s perspective, contributing insights into emotional states and ensuring a holistic approach to care.  

Sinead Walker, mother of 6 year old RCH patient Charlie, has seen first-hand how CLT can improve a child’s hospital experience.

“The child life therapist came and talked Charlie through the options – about what they could do and the way that they could do it, and spoke through what would happen and why it would happen. It was quite a calming influence.  

“It was very reassuring to know that someone was leading us through that process and leading Charlie through it… It was very supportive.  

“The little donations probably feel small but actually for us, anything in the hospital that makes life easier is such a huge benefit to us and our kids.” 

Beth Dun, Manager of CLT and Music Therapy at the RCH, explains the importance of this program in helping make hospitals a more comfortable environment for children.  

“Sometimes a child’s first hospital experience will be the ED. It can be a scary place if they’ve never been before, and one of the things CLT can do is help make it a positive place and experience.”  

Beth shared an example of CLT in the ED in action when an eight-year-old boy with autism presented with a foreign body in his ear. With CLT support, the boy and his mother engaged in medical play, introducing them to the removal process. The therapist’s help allowed the clinician to practice on the boy’s mother, and the visual example helped the child cooperate.  

Remarkably, the foreign body was removed without sedation, completing the process in just 30 minutes. In contrast, this same scenario without CLT would likely involve a need for restraint and sedation, involving more staff, upsetting the child, and taking up to three hours to recover.  

“For example, if a child is distressed, the clinical staff may choose to use something like nitrous to help reduce stress. If the child has nitrous, they have to stay in the hospital until that wears off. The wait times are then so much longer. So we’re hoping that the use of sedation might come down in cases of distress,” Beth said.  

This example illustrates how CLT not only enhances patient care but also significantly improves efficiency and cost-effectiveness in the ED. Benefits like improved patient flow and decreased sedation requirements will all contribute to a more positive experience for children and families overall.  

Beth and her team are incredibly grateful for the community’s support in making this project a reality.  

“Any donation is going to make such a difference to the child’s experience. It’s heartwarming to know that that the community’s behind us and what we do,” she said. “People donating to this cause can be assured that their money is going towards creating more positive experiences for children at The Royal Children’s Hospital.”

Thanks to support from the Victorian community and the Good Friday Appeal, the RCH can expand vital services like CLT, ensuring every child receives compassionate and individualised trauma informed care. 

Impact Milestones

2024

• Implementing Child Life Therapy (CLT) in the Emergency Department (ED) service, which includes evening shifts seven days per week, launched in February 2024.  
• Three brand-new, dedicated Child Life Therapists have officially begun working across the ED.   
• Since commencement of the service, over 1,900 episodes of care have been delivered. 

Thanks to the generosity of the Good Friday Appeal and its supporters, children receiving care at The Royal Children’s Hospital (RCH) will soon be the first in Australia to have an expert team of specialist nurses providing support with the insertion of peripheral intravenous catheters (PIVCs).   

Also known as a cannula or drip, PIVCs are used to deliver life saving medications and fluids to patients across the RCH. Each year, approximately 30,000 PIVCs are inserted at the RCH, making it the hospital’s most common invasive procedure.   

For some patients, the trauma of their first PIVC insertion can leave a lasting impact, causing high levels of anxiety and fear. Routine assessments or even simple checks, such as looking at the site, can become distressing triggers for children and young people. 

This is where the Vascular Access Specialist Team (VAST) comes in.  

Committed to revolutionising paediatric care, the VAST brings together a group of expert clinicians equipped with advanced knowledge and skills in vascular access. Recognising the challenges and trauma faced by young patients, the VAST is dedicated to improving expertise, reducing complications, enhancing staff education, and championing a patient-centred approach to PIVC insertion. 

Eloise Borello, a Clinical Nurse Consultant who specialises in vascular access, explained that the project will make an enormous difference in the quality-of-care patients receive.  

“Many children who present to the RCH often require urgent medical treatment, and the fastest way to administer the medications and fluids they so vitally need is through a PIVC. 

“Whilst PIVCs are common, it can be challenging to insert these devices in children as they have smaller, more fragile veins which are often difficult to see. This becomes even more difficult in children who are critically unwell. No child likes to have a needle inserted, and young children can become very scared and distressed when they need a cannula,” Eloise explained.  

“We know that inserting a cannula is one of the scariest procedures for children in hospital. Children and families have told us that the memories of a bad experience can last many years which can impact care in and out of the hospital. We are committed to reducing pain, anxiety and trauma that can be associated with PIVC insertion. The goal of the VAST is to create the best experience possible for children and their families”. 

“By ensuring a best practice approach to PIVC insertion, including use of advanced technology like ultrasound guided insertion, by a team of highly skilled clinicians who are experts in the field, the RCH will be at the forefront of care for children and families”.

While ultrasound guidance is scientifically shown to be the best technique to insert PIVCs, its uptake has not been widespread across most Australian healthcare settings because it takes clinicians months of training and experience to develop the advanced ultrasound skills required. 

“The new ultrasound machines, also supported thanks to the Good Friday Appeal and its partners, will be instrumental in allowing us to use ultrasound guidance routinely for PIVC insertion, which is key to the successful outcomes of this treatment.  

“Growing a team of nursing experts skilled in the advanced ultrasound techniques will provide children who need this treatment with the best opportunity of having a successful insertion of the PIVC on the first attempt, drastically improving their experience,” said Eloise.  

Importantly, the impact of the VAST will reach beyond the four walls of the RCH.  

“Our goal is to create a service which includes a team of expert PIVC inserters and educators who will mentor and train junior doctors and nurses in best practice in PIVC insertion. As these clinicians rotate to different hospitals as part of their training, the skills they have developed will benefit children across Australia. 

“We will also share our learnings around service design, data and outcomes. This collaboration will expand on the existing relationships the RCH has with our national colleagues and will ensure we cultivate a community of practice where ideas and learnings can be shared, and where implementation of best practice PIVC insertion is spread to all states,” said Eloise.  

The introduction of VAST at the RCH will be a turning point for paediatric healthcare in Australia, something that Eloise knows would not be possible without the generosity of the Good Friday Appeal and its supporters.  

“We’re so grateful for the community in making this project possible. For our team, receiving this support represents how our community shares in a vision that values improving the experience of treatment in hospital for sick children across Victoria and Australia.   

“Your generosity allows us to innovate and develop a service which will be an Australian first in paediatric healthcare, and for that I would like to say thank you,”.

Eloise Borello

Impact Milestones

2024

• July: Recruited team leads 
• October: Recruited VAST nurses. There are 11 VAST nurses in total who will work from 8am – 10pm, seven days a week, across the hospital. 
• December: state-of-the-art ultrasound machines purchased

Ensuring access to mental health prevention and early intervention for this cohort has been an ongoing challenge. The Melbourne Children’s Campus Mental Health Strategy is on a mission to change this and is predicted to impact more than 600,000 children beyond the strategy’s proposed five year period.

The Melbourne Children’s Campus Mental Health Strategy is an ambitious multi-year project that aims to provide a uniform and evidence based approach to mental health prevention, care and advocacy for all children, young people and their families across the Melbourne Children’s Campus, which includes The Royal Children’s Hospital (RCH), the Murdoch Children’s Research Institute and The University of Melbourne Department of Paediatrics.

Supported by the Good Friday Appeal and their partner Decjuba Foundation, this multi-year strategy is making strides in transforming child and youth mental health care, education, and research. Over the past three years, it has increased engagement with lived experience advisors, launched a world’s first evidence-based Clinical Practice Guideline for children and young people with anxiety, developed staff training programs in mental health literacy, and skills and has six active research projects on the go.

Led by Professor Harriet Hiscock (pictured below) and Belinda Horton, the strategy is ensuring a holistic approach to mental health across the campus.

“One of the objectives of the strategy is to advocate for and equip staff to see children’s health and wellbeing as integrated physical and mental health. Our tagline – ‘mental health is everyone’s business’ – conveys this collective responsibility. We’re very grateful to the Good Friday Appeal for supporting this vital work.” 

Professor Harriet Hiscock and Belinda Horton, Program Directors of the Melbourne Children’s Campus Mental Health Strategy. 

“Our tagline – ‘mental health is everyone’s business’ – conveys this collective responsibility and our strategy activities have facilitated new conversations about this,” Harriet and Belinda shared.

Both Harriet and Belinda shed light on the pivotal role that engagement with campus stakeholders has played in guiding the strategy towards success. The collaboration with the Steering Committee, and advisory, working and focus groups, has been instrumental in shaping the strategy’s approach to mental health, fostering a collective commitment to its objectives.

“These ‘pockets of awesomeness’ across the campus are about bringing together the people who are already doing exceptional work, to integrate and build on this work and to identify gaps.

It has also been wonderful to equally privilege children, young people and families’ lived experience of mental health and recovery and the lived experience of campus clinicians, researchers, and educators,” they recalled.

With over 100 individuals actively participating in advisory and working groups and many more engaging with strategy communications and activities, Harriet and Belinda shared the significance of this broad engagement across the Melbourne Children’s Campus.

“We have been privileged to work with many people from across the campus from multi-disciplinary backgrounds and the full range of research, education, clinical and non-clinical expertise.

“We see this as a privilege because the contributions of these very busy people have been provided in kind from their commitment to improving research, education and care of the mental health of children, young people and their families,” they shared.

“In line with our initial strategy planning, the final two years will be focused on ensuring that the outputs of each part of the strategy are embedded where they need to be across the campus and embraced by staff and campus leaders,” Harriet and Belinda explained.

Through innovative approaches, collaborative partnerships, and a commitment to inclusivity, the Melbourne Children’s Campus Mental Health Strategy seeks to shape a future where mental health challenges are met with effective, compassionate, and readily accessible support for every child and young person across the Melbourne Children’s Campus.

Impact Milestones

2021

• Recruitment and onboarding of 14 staff to develop and build the Strategy Implementation Team.
• Development of an Interim Lived Experience Engagement Strategy to lay the foundations for seamless engagement of children and young people with lived experience of mental health concerns and recovery, and their parents, carers, and families.
• Soft launch of the Mental Health Central website with continued uploading of content throughout the life of the strategy.
• Integration of the strategy with the Mental Health Transformation Program within specialist RCH Mental Health Teams
• Implementing the recommendations of the Royal Commission into Victoria’s Mental Health System, including establishment of an integration team, regular meetings, and communications to stakeholders.

2022

• Development of the Lived Experience Advisor Network (LEAN). 
• Active engagement of over 100 people from across the Campus in advisory and working groups. 
• Completion of two funded research projects. 
• Models of care and program evaluation for better detection and support of child and family mental health. 
• Close to a full complement of staff in the Strategy Implementation Team (SIT) with 20 part time staff. 

2023

• Launched the world’s first evidence-based Clinical Practice Guideline for Anxiety in Children and Young People. 
• Continued development of Mental Health Central, the strategy website. 
• Engaged over 60 lived experience advisors in various strategy activities, including the Children’s Mental Health Gallery. 
• Strengthened collaboration between the Strategy Implementation Team, Steering Committee, and advisory groups. 

2024-2025

• Conclusion of pilots and projects, moving to scaling and sustainability beyond the life of the strategy.