Creating a new cardiac service: the Brisbane experience

Objective: This article discusses the creation of a new paediatric cardiac surgical service via the merging of two units. Setting: In 2005, the Queensland Government made a commitment to improve health outcomes for Queensland's children. This pledge included a review of paediatric cardiology and paediatric cardiac surgery. A recent cluster of deaths following cardiac surgery at The Prince Charles Hospital (TPCH) and concerns expressed by clinicians regarding the adequacy of the service, resulted in the review being commissioned. A panel of well respected, eminent professionals were appointed with the brief to review the adequacy of paediatric cardiac services in Queensland, to determine the optimal configuration of the cardiac service and to also make recommendations to ensure a high quality of service in the future. Conclusion: The process of amalgamating the two units and creating a new cardiac service has increased output in terms of surgical cases. The care of cardiac children in Queensland is now undertaken from a major specialist children's hospital. However, the costs associated with the amalgamation have been high, particularly in terms of training staff and development of infrastructure. The dynamics of change whilst prioritised by management resulted in a highly stressful working environment and a number of staff resigned. Eighteen months post merge, the morale within the unit has improved and staff are working positively towards a cohesive unit.