Halton Healthcare Services was seeking innovative ways to create access to paediatric consultation across the three community hospital sites (Oakville, Milton and Georgetown). It was recognized that a significant percentage of emergency department visits at each of the 3 sites were paediatrics, and although telephone consultation was available to the 2 northern sites, there were clinical scenarios where an in-person consultation with a paediatrician was required. It was also recognized that having children stay in the emergency department or be admitted unnecessarily was a poor use of resources and resulted in decreased patient/family satisfaction. Many hospitals have an ‘after hours’ clinic however these clinics do not address the issue of children arriving after the clinic closes thus remaining in the Emergency Department over night or being admitted in order to be seen by paediatrics the next day. The Post Emergency Paediatric Clinic (PEPC) provides same-day or next day paediatric consultation for children referred from the three Emergency Departments at Halton Healthcare Services. The clinic is located at the larger Oakville site and allows children to be discharged home from all 3 of the Emergency Departments in a timely manner with the preliminary diagnostic work-up completed and a follow up appointment scheduled within 18 hours. The Post Emergency Paediatric Clinic initiative was originally evaluated as part of the pilot project in 2011 and an evaluation was conducted again in October 2012 – both via survey monkey. The survey included perceptions of all stakeholders including staff, physicians, and patients/families. Additionally, statistics such as percentage of patients hospitalized from the Post Emergency Paediatric Clinic and percentage of patient “No shows” are also collected and reviewed on a monthly basis. Benefits include – 1) creates capacity in the Emergency Department; 2) increases patient/family satisfaction; 3) aids in admission avoidance; 4) increases staff/physician satisfaction; 5) increases access to paediatrician consultation at sites with either no or limited paediatric coverage and 6) increased clinic efficiencies and for the paediatrician because the diagnostic work-up is available from the Emergency visit.
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