The Cairns Hospital and Health Service (CHHS) Renal Team, Aboriginal and Torres Strait Islander Health Unit (A&TSIHU) and Gurriny Yealamucka Aboriginal Health Corporation recognised the effects that displacement would have on the wellbeing of residents requiring dialysis during the COVID pandemic. They responded rapidly with a coordinated effort to sustainably increase the provision of haemodialysis within the community.
Through coordinated efforts and staff from all units picking up additional shifts, the number of residents able to dialyse on-country was doubled with a week. In the initial stages of the response the small team of Yarrabah nurses and Indigenous health workers were working 12 hour shifts to dialyse 16 patients in only four treatment spaces. It was clear from the outset that a sustained solution was needed. Clinicians within the service were supported by the A&TSIHU to successfully apply for COVID First Nations response funding to fund a workforce response and perform capital work to expand dialysis treatment spaces.
This service initiative used the principles of disaster management initially to rapidly flex up service delivery within the community. The renal service was delivered an ultimatum with approximately 48 hours’ notice. After this, Yarrabah residents leaving the community would be required to remain in Cairns as all attempts at pursuing exemptions from biosecurity restrictions were unsuccessful. Clinicians within the service felt that the impact of displacement on Yarrabah would significantly impact their wellbeing and needed to be avoided wherever possible.
It was apparent from the outset that a sustained response would be required, funding was sought through the First Nations COVID response to assist with providing a sustainable workforce model and capital improvements to the space to expand the capacity of the unit.
12) months on and beyond the biosecurity restrictions, the residents of Yarrabah on dialysis are all able to dialyse within their community, on a single shift. This has measurably improved their lifestyle on dialysis, saving about six hours of travel time a week for each resident.
Providing haemodialysis in community during COVID-19: supporting the people of Yarrabah
Summary
Aim
Care on Country
To minimise the risk of displacement and deliver care on country during biosecurity restrictions on human movement.
• To utilise COVID First Nations funding to deliver a sustained local response, with infrastructure improvements, to minimise the risk of unnecessary travel and exposure while there is a residual threat of COVID.
• To assess and sustainably retain successful business as usual (BAU) strategies implemented as part of the pandemic response.
• To create sustainable capacity to deliver haemodialysis closer to home.
Benefits
- zero disruption to care delivery throughout pandemic and in the face of biosecurity restrictions
- care delivered in community, avoiding the negative impact of displacement or isolation to access care
- proof of concept: this has provided a supported period to demonstrate the efficiency and cost benefit of enhancing service delivery in the community
- leadership to other services - this has promoted an evaluation from other local services to consider alternative strategies to deliver ambulatory care within the community.
Background
Biosecurity restrictions implemented during the COVID pandemic presented significant obstacles to accessing care for clients in affected communities. For the residents of Yarrabah requiring dialysis, this threatened to displace them from the community to continue to access life-sustaining haemodialysis.
The CHHS Renal Team, Aboriginal and Torres Strait Islander Health Unit (A&TSIHU) and Gurriny Yealamucka Aboriginal Health Corporation recognised the effects that displacement would have on the wellbeing of residents.