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Development of an occupational-therapy-led paediatric burn telehealth review clinic
Debra Phillips1, Lauren Matheson2, Tilley Pain3
1Occupational Therapy Department, The Townsville Hospital and Health Service, PO Box 670, Townsville, Qld 4810, Australia debra.phillips@health.qld.gov.au.
Insights
A new telehealth clinic improved rehabilitation for rural children with burn injuries, reducing travel time and enhancing care continuity. This model offers equitable access to specialist services closer to home.
Area of Science:
- Pediatric Burn Rehabilitation
- Telehealth in Healthcare
- Rural Health Services
Background:
- Burn injuries are common in children, with rural and remote populations facing significant disadvantages in accessing specialist rehabilitation services.
- Existing models require extensive travel for pediatric burn patients to receive multidisciplinary care in metropolitan centers.
- Inequitable service delivery to rural and remote pediatric burn patients was identified through local audits.
Purpose of the Study:
- To develop and implement an Occupational Therapy (OT)-Led Paediatric Burn Telehealth Review Clinic (OTPB Clinic) at Townsville University Hospital (TUH).
- To provide accessible, ongoing burn rehabilitation closer to home for children in rural and remote areas.
- To improve service delivery and address inequities in pediatric burn care.
Main Methods:
- Established the OTPB Clinic with comprehensive guidelines for sustainability.
- Engaged allied health assistants and expanded the treating OT's scope of practice for efficient service delivery.
- Evaluated the clinic's impact using patient satisfaction surveys and clinical encounter data pre- and post-implementation.
Main Results:
- The OTPB Clinic commenced in 2017, reviewing 28 rural or remote pediatric burn patients.
- Review frequency increased from 20-week to 8-week intervals, significantly reducing travel time by approximately 12 hours per appointment.
- Families reported benefits including continuity of care and reduced time away from work, with less than 4% requiring surgical re-intervention.
Conclusions:
- The OT-Led Paediatric Burn Telehealth Review Clinic model successfully improved rehabilitation access and outcomes for rural and remote pediatric burn patients.
- The telehealth approach demonstrated significant reductions in patient travel burden and enhanced care continuity.
- The model is transferable to other tertiary referral burns services, offering a scalable solution for equitable pediatric burn care.
Context:
Burns are a common injury in children. Rural and remote children with burn injuries are disadvantaged if their burns require hospitalisation and specialist rehabilitation. Most specialist burn rehabilitation is provided in regional or metropolitan cities by a multidisciplinary team. Therefore, rural and remote burn patients are required to travel to access these services. This project aimed to develop an Occupational Therapy (OT)-Led Paediatric Burn Telehealth Review Clinic (OTPB Clinic) at Townsville University Hospital (TUH) to provide ongoing rehabilitation to rural and remote children after burn injury closer to home.
Issues:
Local audits identified inequitable service delivery to children from rural and remote areas after burn injury. A project officer was appointed to develop the OTPB Clinic, including comprehensive guidelines to support sustainability. An expanded scope role was undertaken by the treating OT, and allied health assistants were engaged to promote efficient service delivery.
Lessons Learned:
The OTPB Clinic commenced in 2017 and was evaluated using patient satisfaction surveys and number of clinical encounters pre- and post-implementation. During the implementation period, 28 rural or remote paediatric burn patients were reviewed. Review frequency increased from 20-week to 8-week intervals. Travel time was reduced by approximately 12 hours per appointment. Families identified numerous benefits of the clinic including continuity of care and reduced time away from work. Less than 4% of patients required re-engagement with paediatric surgeons for surgical intervention. The model has the potential to be transferred to other tertiary referral burns services.
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