Background Many children in out-of-home care (OoHC) have complex healthcare needs. This, paired with the complexity of the healthcare system, resulted in difficulty providing timely, coordinated and effective healthcare in a regional setting in Queensland, Australia. In response, a new model was developed which included the introduction of a unique health advisor (HA) role. This study explored key stakeholders’ perceptions – including facilitators and barriers – regarding the implementation of this new model of care delivery to children in OoHC.
Methods A qualitative study design using face-to-face interviews and focus groups was used to explore key stakeholders’ perspectives relating to issues faced by children in OoHC seeking healthcare and their experiences with the HA role. Purposive sampling was used to recruit participants from four key groups – carers, child safety officers (CSO), paediatricians and general practitioners (GPs). Thematic analysis using a reflexive approach was used to generate themes from qualitative data which was transcribed verbatim.
Findings The responses from interviews (n=20) and two focus groups (n=14) generated four key themes:
- Getting in the door: initial access to healthcare
- Who’s who in that big zoo: key providers of healthcare
- Navigating the maze: communication and collaboration
- Working together: coordination, advocacy and support
Discussion The majority of participants reported positive experiences with the new model, particularly relating to improved initial access to healthcare, communication and coordination; however, this varied according to level of engagement with the HA. The dual coordinator–clinician role of the HA was identified as particularly beneficial. Barriers to healthcare included lack of prioritisation and difficulties accessing mental health and allied health services.
Conclusions This study demonstrated the positive impact of the HA model and provides a blueprint for implementation in other healthcare services.