Ms Claire Toose1, Ms Amy Hickey1, Ms Stephanie Wicks1, Dr Sonia Tran1
1The Children’s Hospital at Westmead, Westmead, Australia
For over ten years, The Children’s Hospital at Westmead has conducted a weekly scar management triage clinic, staffed by the dedicated Burns Registrar and a Burns Physiotherapist. This clinic aims to provide an efficient triage process to determine the need for ongoing scar management in children with identified risk factors for hypertrophic scarring at time of wound closure and discharge from the acute Burns service. The aim of this initiative is to reduce the number of healed wounds requiring “one more check” in the acute burns clinics by diverting them to a clinic specifically designed to assess their ongoing scar management needs. Referral criteria include: patients healing at 14-21 days post burn injury who have not already been commenced on active scar management treatment by the clinic Burns Physiotherapist; patients referred from peripheral hospitals for specialist review; and patients healed in ≤ 14 days post burn with identified risk factors for hypertrophic scarring or a wound showing signs that warrant further monitoring for scarring. Patients who receive skin grafting or have scar management interventions initiated while being managed in the acute burns clinic are excluded from this clinic and managed via the regular consultant clinic scar management pathway.
This project aims to evaluate the effectiveness of this clinic as a triage service and optimise the current service delivery model. Data has been gathered on all patients presenting to the clinic over a two year period, from January 2017 to January 2019. Retrospective analysis of this data will be presented evaluating trends in the types of patients accessing the service, attendance and non-attendance of patients, the proportion of patients discharged following initial consultation, and the proportion of patients requiring ongoing management based on the initial presentation to the clinic. Information gained from the retrospective review will inform the refinement of referral criteria and development of an educational strategy to optimise effectiveness of this service delivery initiative.
Claire is a Senior Physiotherapist at The Children’s Hospital at Westmead, working in both the inpatient and outpatient setting with children following burn injury, trauma and reconstructive surgery. Alongside her clinical work she is also very involved in research, project work, education and training.