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Getting policy into practice at scale: Managing COVID-19 in the community

Published on 08 Dec, 2021 | Return|

When COVID-19 arrived in early 2020, the world scrambled to react to the complex, evolving situation. Health systems have always needed to balance local health needs with policy and priorities set at state and national levels. This balancing act became even more challenging in the pandemic because of continual policy changes as new evidence and strategies emerged.

From its beginning, HealthPathways has served to make locally-relevant clinical guidance that is useful to front line clinicians. Over recent years, the HealthPathways team has also been working to make it easier to get new evidence and policy into practice at scale.

Prior to the pandemic, Queensland Health leveraged the HealthPathways platform to standardise Clinical Prioritisation Criteria (CPCs) for outpatient services across all hospitals in the state. 

“There is a collegial approach to the whole of the Queensland health service that we didn’t have before.” - CPC coordinator.

More recently, HealthPathways has played an essential role in helping local health systems to get COVID-19 policy into practice across New Zealand and Australia.

International collaboration

Early in the pandemic Streamliners established regular video conferences between clinical editors across New Zealand and Australia to foster collaboration and sharing of clinical guidance between regional teams. This lead to the rapid development of a suite of pathways that translated rapidly evolving national, state, and local policy into a format that was easy for GPs to use at the front line.

“I think HealthPathways should be commended for having very, very clear messaging… frequently asked questions about ACE inhibitors, etcetera, and all the links to Department of Health, to college-based guidelines, and particularly around leaving from isolation… and they're localised around regions so it makes it very good in terms of testing centres etcetera. I mean the college put out a lot, the AMA put out a lot. It is almost too much information and too many websites, actually, but I actually think HealthPathways is the clearest place to get everything you want.”

Dr Tanya Robertson

“We have seen a huge amount of goodwill and collegiality amongst people working on HealthPathways across New Zealand and Australia, and this has accelerated the development of COVID-19 pathways for all health systems in the HealthPathways Community.”

Prof Michael Ardagh, Emergency Medicine Physician and Chair of Australasian HealthPathways COVID-19 Alignment Meeting.

New Zealand

In August 2021, when the Delta strain outbreak occurred, it became clear that New Zealand's national COVID-19 elimination strategy was at risk. Streamliners realised the urgency of developing pathways to support general practice teams to manage COVID-19 in the community.

We rapidly established a national team of expert clinical editors and technical writers to work on this, and reached out to the New Zealand Ministry of Health (MOH) for their support. The MOH was quick to recognise the importance of this work. They connected our team with national experts and committed to sponsoring the programme of COVID-19 pathway development until the end of 2022.

The team was able to draw on the experience of other GPs in the HealthPathways Community, particularly those who were managing cases in Melbourne, Australia.

“By leveraging the HealthPathways Community, the Ministry of Health has been able to rapidly develop clinical pathways to give general practice teams confidence to manage COVID-19 positive patients in the community.”

Dr Justine Lancaster, Chief Clinical Advisor, Primary Care, Ministry of Health.

Streamliners partnered with Mobile Health to produce a national webinar-based programme in collaboration with the New Zealand Ministry of Health and the Royal New Zealand College of General Practitioners. This created an opportunity for clinicians using HealthPathways to hear and ask questions about the service models described in the pathways. The first webinar was attended by over 1800 general practitioners, practice nurses, and other clinicians from across the country. By November 2021, the COVID-19 suite of pathways was being viewed around 10,000 times per week by general practice teams across New Zealand.

Streamliners plans to run more webinars of this kind in the future because it is a scalable way to support local HealthPathways teams to raise awareness and clinician engagement with HealthPathways.

New South Wales

As things got underway in New Zealand, we reached out to our friends at NSW Health to see if a similar solution would help their COVID-19 response. They quickly saw the benefit of a coordinated response across the state and agreed with our proposed approach.

As in New Zealand, Streamliners formed a team of expert clinical editors and technical writers to develop the pathways. NSW Health helped connect the team with the Agency for Clinical Innovation (ACI) and the Royal Australian College of General Practitioners (RACGP). The initial suite of pathways is now completed and the clinical editor team are actively involved with development of the model of care and GP education as this evolves.

“The collaboration between local teams across New South Wales has made it possible to develop and maintain locally-relevant guidance without everybody duplicating effort.”

Dr Louise Delaney, GP and HealthPathways Lead Clinical Advisor.

Supporting your local HealthPathways team in 2022

The COVID-19 pandemic accelerated collaboration across the HealthPathways Community. We are now starting to apply what we've learned in other areas. In New Zealand, for example, Streamliners established a national team to take a similar collaborative approach to developing a new suite of diabetes pathways. This is working well and we hope to do more of this in 2022. 

Please support your local team to become involved in collaborations with the wider HealthPathways Community - the strength of our community comes from broad participation.