1. Purpose

The purpose of this policy is to ensure that The Royal Children’s Hospital (RCH) delivers health care that is respectful of, and responsive to, the preferences, needs and values of consumers and provides a child safe environment.

Consumer-focused care (patient and family-centred care) is ‘an innovative approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnership among health care providers, patients and families. Patient and family-centred care applies to patients of all ages, and it may be practiced in any health care setting’.¹  

Child safety seeks positive approaches in the practical implementation of rights for children and young people in healthcare services³ in daily operation and policy and procedure development.

2. Definitions

• Consumer refers to patients (infants, children and adolescents), parents, carers and other family members. It may also include external providers, such as consumer groups, general practitioners and other health professionals.
• Carer means a person on whom another person is wholly or substantially dependent for ongoing care and attention, other than a person who provides that care and attention wholly or substantially on a commercial basis. 
• Child or young person refers to every human being from birth to the age of eighteen years unless under the law, majority is attained earlier.³
• Family refers to the group of people who constitute a child’s or young person’s family and is defined by the child or young person and those close to him or her. It is not necessarily limited to blood relatives.
• Child Abuse refers to any act committed against a child involving physical violence, sexual offences, serious emotional or psychological harm and serious neglect.⁴

3. Policy

The RCH is committed to delivering:

• Consumer-focused care (patient and family-centred) and this is underpinned by the Australian Charter of Health Care Rights and the National Safety and Quality in Health Services Standards: Standard 2 Partnering with Consumers.  

• A child safe environment where we have an obligation for healthcare providers to fulfil their responsibilities to children and young people by providing care and protection that takes into account children’s and young people’s rights, their evolving capacity, and the rights and responsibilities of parents/carers to provide direction and guidance to their children.³  

The key elements of consumer focused care in a child safe environment are:

• Respect
• Physical comfort
• Kept safe from all forms of harm (including physical violence, sexual abuse, emotional or psychological abuse and serious neglect)⁴
• Information and communication
• Education and creative play
• Continuity and transition
• Care coordination
• Involvement of family and carers
• Promotion of health and wellbeing   

The principles of the RCH philosophy of care include:   

• Promoting patient and family-centred care by involving patients, families and carers as partners in the provision of care, and to consider the best interests as the primary concern for all involved in his or her care.
• Respecting children and young people's needs and issues, such as developmental and educational needs, privacy and assisting children and young people to become active participants in their care; allowing them to participate in decision-making and, as appropriate to their capability, to make decisions about their care.
• Promoting a safe environment through the early identification and response to risks of child abuse in physical and online environments.
• Participation in education, play, creative activities and recreation even if this is difficult due to their illness or disability.
• Providing Information in a form that is understandable to parents, carers, children and young people.
• Listening to consumers by allowing children and young people to express their views, and to be heard and taken seriously.
• Monitoring consumer feedback by assessing patient care experiences, monitoring of feedback provided to the RCH and acting on consumer input.
• Involving consumers in quality improvement activities by incorporating consumers on clinical governance committees and quality improvement activities.
• Focusing on work environment, work culture and satisfaction of staff as an integral strategy for improving consumer-focused care and ensuring children’s and young people’s safety.
• Fostering a culture of learning within the organisation by learning from successes and failures, including events/incidents with poor outcomes (where open disclosure applies) to promote consumer-focused care and child safety. 

Code of Conduct in the delivery of care

• If in the course of providing treatment or care, an RCH staff member believes that another health service provider has placed or is placing a child/young person at serious risk of harm, the provider refers the matter to the Health Complaints Commissioner^1.
• We do not claim or represent that we are qualified, able or willing to cure illnesses, unless able to substantiate claims ¹.

The RCH will offer opportunities for children, young people, families and communities to participate actively in the planning and development of services. The RCH undertakes to offer methods of feedback and involvement to accommodate people's different abilities, needs and aptitudes.

Patients and families have the right to express feedback without fear of discrimination and to be informed of progress and outcome. Feedback is viewed as an opportunity for improvement. 

4. Other applicable policies/procedures (available on the Intranet)   

• Culturally Responsive Care Policy
• Care Planning and Implementation Policy
• Patient and Family Centred Care Procedure
• Child, Family and Community Participation Procedure
• Consumer Appointments on Committee Procedure
• Australian Charter of Healthcare Rights  

5. Related legislation 

• Age Discrimination Act 2004 (Commonwealth)
• Carer Recognition Act 2012 (Vic)
• Carer Recognition Act 2010 Guidelines
• Charter of Human Rights and Responsibilities Act 2006 (Vic)
• Child Wellbeing and Safety Act 2005 (Vic)
• Children Youth and Families Act 2005 (Vic)
• Disability Discrimination Act 1992 (Commonwealth)
• Equal Opportunity Act 2010 (Vic)
• Health Services (Conciliation and Review) Act 1987 (Vic)
• Health Complaints Act 2016 (Vic)
• Health Services Act 1988 (Vic)
• Mental Health Act 2014 (Vic)
• Multicultural Victoria Act 2011 (Vic)
• Racial and Religious Tolerance Act 2001 (Vic)
• Racial Discrimination Act 1975 (Commonwealth))
• Sex Discrimination Act 1984 (Commonwealth)
• Child Safety and Wellbeing Act 2005 (Vic) 
  

6. References

1. Health Complaints Act 2016 (Vic)
2. Institute for Patient- and Family-Centred Care website. Institute for Patient- and Family-Centred Care (Accessed 7 July 2010, at www.ipfcc.org).
3. Australian Commission on Safety and Quality in Health Service Standards: 
   Standard 2 Partnering with Consumers.
4. Charter on The Rights of Children and Young People in Healthcare Services in Australia – Children’s Hospitals Australasia.
5. Victorian Child Safe Standards 2015.