How publishing in BMJ Open Quality & attending the International Forum on Quality and Safety helped advance a system-wide project

The Queensland Clinical Senate is an advisory body for Queensland Health that brings clinicians together to examine how the health system is working in practice. At the Adolescent to Young Adult Care: Doing Better meeting in December 2020, clinicians were clear that the system was falling short in terms of adolescent and young adult care. The Senate called for a co-designed strategy to address these gaps and improve care.

In response, Brianna McCoola, principal project officer for adolescents and young adults with the Queensland Child and Youth Clinical Network, led a nine-month co-designed process to close this gap.

McCoola and colleagues’ BMJ Open Quality article, “Co-designing recommendations to improve adolescent and young adult healthcare in Queensland”, documents the methodology and thematic analysis of consultations with clinicians, health professionals, leaders, non-government organisations, young people, and families.

McCoola explains that clinicians were “really worried about the safety of care for young people”, noting that most had “no dedicated training in youth healthcare” and that 15 to 17-year-olds often received care in adult services.

 Young people also reported that they often did not “feel believed, heard, [or] understood”.

Attending the International Forum on Quality and Safety in Healthcare over several years shaped both the development of the manuscript and McCoola’s confidence to publish it. She described her first Forum as the point at which hearing presentations “made it crystal clear to me as a clinician” that quality and safety offered the correct framing for a system-wide response to youth care. 

Successive Forums also supported her professional progression. After presenting a poster and then partaking in the closing plenary in Brisbane in 2024, she said the experience “helped me realise the calibre of what we did and what we produced”. Presenting the next phase of her work, subsequent to the strategy, in Canberra in 2025, co-designing a practice guide with young people showed her how the findings may be taken up beyond Queensland. In the post-presentation discussion, she recognised that “there were people in the room that might pick this up and use this in their clinical spaces”, which demonstrated to McCoola how the work is transferable across healthcare settings.

The Forum also provided evidence of its influence in practice. Hearing that colleagues had already seen and used her co-designed resources “has really inspired me to think about what can continue to be done as next steps”, and has shaped the direction she intends to take in her future policy work.

McCoola’s current focus is to “improve Queensland’s health response in the Youth Justice sector”, carrying forward the principles developed through the original study.

What is already known on this topic

Developing health service improvement initiatives, underpinned by co-design methodology with health professionals, patients and their families, leads to fit-for-purpose safe and quality sustainable improvements that have lasting positive effects on service delivery.

What this study adds

Adolescents and young adults are often not included in opportunities to participate meaningfully in improving health services, and are often classified as a hard-to-reach population. This study demonstrates the value of engaging with young people and their families, elevating what they need from health services to access safe, quality care that meets their needs.

How this study might affect research, practice or policy

This study outlines the methodology employed to engage young people in a meaningful project to co-design a statewide strategy to improve the quality and safety of healthcare. It also demonstrates the rich qualitative data the authors gathered using these methods, leading to a publication that discusses advanced adolescent and young adult healthcare in Queensland.

Jorǰa Campbell and Brianna McCoola from Queensland Health about their collaborative experience in creating a Practice Guide to Adolescent and Young Adult Care. Discussing around the project’s development, the co-creation process, and the importance of involving young people in healthcare projects.

Jorǰa and Brianna discuss the inception and execution of the book, which has significantly influenced practice changes within the Queensland health system. Sharing insights into the co-creation process with young people, the challenges faced, and the strategies used to ensure flexible and meaningful consumer engagement. Also, discussing their efforts to engage university departments and health networks, ensuring the guide is widely accepted and practically applied in healthcare settings.

Under the theme “The Power of Us: Strengthening Systems and Deepening Resilience to Improve Quality in Health and Care,” the programme brings together global leaders, innovators, and practitioners to share learning and drive real-world improvement.

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