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Who comes to a paediatric medical outpatient clinic?
1Department of Paediatrics, Christchurch School of Medicine, Christchurch Hospital.
Insights
A clinical audit of 542 paediatric outpatients revealed that general practitioners most often referred children for cardiac murmurs and urinary issues. Specialist referrals focused on respiratory and orthopedic conditions, with many GP referrals resulting in a single visit.
Area of Science:
- Pediatric Medicine
- Clinical Auditing
- Healthcare Management
Background:
- Paediatric outpatient departments manage a high volume of new referrals.
- Referral patterns from general practitioners (GPs) and specialists to secondary care can vary.
- Understanding referral reasons and outcomes is crucial for optimizing healthcare delivery.
Purpose of the Study:
- To audit new patient referrals to a paediatric outpatient department.
- To analyze referral sources (GPs vs. specialists) and their associated conditions.
- To evaluate the outcomes of initial consultations and identify patterns in patient management.
Main Methods:
- A clinical audit was conducted over a six-month period.
- Data collected on all new (first referral) paediatric patients (n=542).
- Referral sources, presenting conditions, and consultation outcomes were recorded.
Main Results:
- 59% of referrals originated from general practitioners; the rest from specialists.
- GPs most frequently referred for cardiac murmurs and urinary tract problems.
- Specialists commonly referred for respiratory diseases (especially asthma) and hip/orthopaedic conditions.
- 44% of GP referrals resulted in a single consultation and discharge.
- A low rate of cross-referral between disciplines was observed.
Conclusions:
- Referral patterns differ significantly between general practitioners and paediatric specialists.
- A substantial proportion of general practitioner referrals to paediatrics may be resolved in a single visit.
- Opportunities exist to improve interdisciplinary communication and referral pathways within paediatric services.
Abstract:
A clinical audit was undertaken of all new patients (first referral) to a paediatric outpatient department over a six month period. There was a total of 542 children, of whom 59% were referred by a general practitioner and the remainder by paediatricians or other consultants. The conditions for which general practitioners most frequently referred children were cardiac murmurs and urinary tract problems, whereas respiratory disease, especially asthma, and hip and orthopaedic conditions were the common referrals from the specialists. Forty-four percent of general practitioner referrals were seen only once and then discharged, and there was a very low level of cross-referral to other disciplines.