Providing Enhanced Access to Child Health Services (PEACH) at Sydney Children's Hospital Network: a study protocol

Introduction: Children and young people (CYP) from priority populations in Australia have inequities in accessing healthcare, health outcomes and opportunities to lead healthy lives. Priority populations include CYP who are Aboriginal and/or Torres Strait Islander, culturally and linguistically diverse (born in a country where English is not an official language and/or speak a language other than English at home), with experience of being a refugee or asylum seeker, living in out-of-home care or with a disability. Providing Enhanced Access to Child Health Services (PEACH) is an organisation-wide quality improvement project that aims to achieve equivalent health outcomes in CYP from priority populations compared with their non-priority population peers.

Methods and analysis: PEACH creates an equity-focused learning health system using electronic medical record (eMR) patient data and qualitative methodology exploring staff and service user experiences. Five priority population advisory groups, consisting of staff and priority population service users, guide the research at the Sydney Children's Hospitals Network (SCHN), Australia's largest tertiary paediatric health service. Interviews, surveys and co-design workshops with service users (CYP and/or their parent/carer) and staff describe existing health inequities and inform the design and implementation of interventions to improve identification, provision of earlier and supported access to services and effect cultural change. The impact of PEACH on reducing inequity in care and outcomes will be measured by comparing data during and after implementation (2020-2027) with baseline data before implementation (2015-2019) and with national controls, controlling for potential confounding factors. Health access and outcome measures, including emergency and preventable hospitalisations, critical care admission, discharge against medical advice, readmission and extended length of stay, will be analysed and drawn into dashboards, driving continuous learning and improvement.

Ethics and dissemination: The SCHN Human Research Ethics Committee (2022/ETH00145) and Aboriginal Health and Medical Research Council (1920/22) have granted ethics approval. Research findings will be shared with service users, staff advisory groups and the wider children's healthcare sector through presentations, conferences and peer-reviewed journals.