Development, implementation and evaluation of a modernised Initial Service Response process in children’s health and development: lessons from rural and remote South Australia

Wendy Thiele1, Darlene Wyatt2, CHAD Forum and team members

1Country Health SA, Manager, Children’s Health and Development (CHAD) Programs, C/- Pt Augusta Hospital, Hospital Road Pt Augusta SA 5700,
2Country Health SA, Clinical Senior Social Worker, Pt Lincoln Health Service, Oxford Terrace, Pt Lincoln Sa 5606,


The only constant in health nowadays is change. Health services in rural and remote Australia too are not immune to this, especially with the introduction of the National Disability Insurance Scheme (NDIS). NDIS introduced opportunities for reform and one such area was the Initial Service Response process for the Children’s Health and Development (CHAD) Programs within Country Health SA Local Health Network (CHSALHN). Prior to the introduction of the Initial Service Response teams clinical intake processes was varied and shaped by historical practices, changed over time to meet evolving needs, staffing availability and local stakeholders’ needs and requirements, resulting in inefficiencies and variability at a systems level.


Using a collaborative, partnership approach between frontline allied health clinicians, managers and researchers, a modernised clinical intake process was developed, implemented and evaluated within CHSALHN sites. A customised initial service response conversation tool (iREWARDS instrument) was developed, which spearheaded the implementation process. Targeted change management strategies (such as site-visits and workshops) were also undertaken.


Quantitative and qualitative data from the sites support the value of and impact from the modernised Initial Service Response process. The results indicate improved timely access to allied health services and a consistent framework of service delivery across CHSALHN. While there were positive findings, some challenges also remain including managing parent expectations, timely and regular communication with key stakeholders and change fatigue.


Improving access to consistent and best practice allied health care in rural and remote regions is the cornerstone of quality health care. This initiative provides valuable lessons of how this can be achieved through a collaborative, partnership approach.


Wendy is an Occupational Therapist with 25 years’ experience working in paediatrics and mental health within various roles across South Australia. Wendy currently manages the Child Health and Development Programs for Country Health SA Local Health Network (CHSALHN).Since starting with CHSALHN in 2013, one of the most challenging parts of her role has been to develop consistent and timely services for children in rural South Australia.When she is not at work Wendy loves to connect with her family, her garden and her Art Quilting buddies.

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