Telethon Trust Research Fellowships: How Australian-first Hospital in the Home initiative is driving change
Little Leo Piliae was not even two months old when his parents noticed he was having trouble breathing and rushed him to the hospital.
A series of infections meant Leo had to spend four nights in Perth Children’s Hospital, while his parents balanced the need to care for their other three children at home.
The family immediately accepted an offer to take part in a pilot program for a new service that gives WA children nearing the end of hospital the option to complete their recovery at home.
“He had RSV and rhinovirus at the same time and that was fine with him, but then he developed bronchiolitis which gave him trouble breathing,” says Leo’s mother, Caitlin.
“While I was in the hospital, my husband had to take time off from work and just be home (with the other kids) the entire time.”
Caitlin says the Hospital at Home initiative, which combines wearable monitors with daily home visits from pediatric nurses, was a perfect fit for her family.
“I was dying to get back home to be with the other kids; this was a great option for us.”
It’s a program she wouldn’t hesitate to recommend to other parents. “Absolutely – it provides a lot more peace of mind being home and not having to worry about them so much.”
Believed to be the first of its kind offered by a pediatric healthcare service in Australia, Hospital at Home, led by PCH doctor Simon Moore, is one of many research programs made possible by funding for Telethon Trust Research Fellowships.
This year, we celebrate the 40th anniversary of the fellowship program that has been a driving force in pediatric research.
Dr. is one of the last among the intellectuals who have received scholarships for a long time. Moore says this allowed him to devote time to his research project.
“We came up with the concept within our team that we could pilot this Hospital at Home remote monitoring service to see if it could work as a new way to provide care to families closer to their home,” he says.
“But also to take the pressure off the hospital, which is always bursting at the seams in the winter.”
As part of a 12-month feasibility study, it is investigating whether the program is a cost-effective and acceptable model of care for families and clinicians.
The program is only offered to children who are medically stable and close to discharge.
Children using the service are equipped with wearable monitoring devices that track their heart rate, temperature and oxygen saturation before leaving the hospital, and their families are guided on how to use these devices.
Patients are physically evaluated by nurses once a day and participate in at least one telehealth review each day.
The study, which aims to include approximately 1,000 families in the research, has already been credited with reducing disruptions to school and work life, as well as freeing up hospital beds.
“We have made quite a big impact on the hospital,” says Dr Moore. “Since we started, 630 patients have come to the service.”
This freed up more than 1,000 hospital beds.
In the four decades since Telethon began offering seed funding for early-career researchers, it has empowered 96 researchers to translate concepts into best-practice, world-changing pediatric care.
Another of these early beneficiaries was Meredith Borland in 2001; is currently a pediatric emergency physician and director of emergency medicine at PCH.
Professor Borland’s initial work on intranasal fentanyl for children in severe pain from acute fractures helped change pediatric pain relief practices in emergency departments around the world.
Previously, the only way to give children a strong painkiller was through an intravenous drip or injection; both took more than 30 minutes to take effect.
“We have determined that with fentanyl, which is a powerful analgesic like morphine, you can give it to a patient by spraying it into the nose, atomizing it, and get the benefit of the analgesic much faster, within 15 minutes,” says Professor Borland. “Seeing a problem and seeing a potential solution is a real opportunity to really try using Telethon to help you explore that in more detail, especially when you’re young and keen.”
In the 40 years since Tim Jones became WA’s first Telethon grantee, he has become internationally recognized for clinical research into childhood diabetes.
Professor Jones, now co-director of the department of medicine at PCH, still has the original typewritten letter he received in 1986 from then-popular TV personality Stuart Wagstaff congratulating him on being selected as the inaugural fellow.
“Before Telethon fellowships, there were no funds if you wanted to train in a specialty,” he says.
“It was my first year in pediatric endocrinology diabetes and I was able to combine that with some research projects at the same time. It was great.”
In the 1980s, it was common for children with diabetes to have convulsions when their blood sugar levels dropped too low.
“We’ve learned a lot about what causes this and how to prevent it, so we can’t see it anymore,” says Professor Jones.
He says Telethon funding has enabled the growth of a culture of research at PCH, raising the standard of care.
“The only way to improve things is to do research,” he says. “I’m incredibly lucky; I spend my mornings seeing patients and doing research at the same time. It’s a privilege.
“Families like it too; they want to know they’re going to a place that does the latest because they feel like they’re getting the best.”
