Authors (including presenting author) :
Leung MCV(1), Chan LF(2), Chan CCC(3)
Affiliation :
(1), (2), (3), Li Ka Shing psychiatric outpatient clinic, Prince of Wales Hospital
Introduction :
The incidence of child abuse is noticed to have increased by 5 per cent during first six months of 2022 compared with same period last year, according to official figures, which have shocked the public and called for discussion of mandatory child abuse reporting mechanism.
Objectives :
Better identification of complex patients could help to improve the new case triage process and their care thereafter, and proactive collaboration with social worker could help to provide timely childcare support for those with suspected child abuse as noticed during the new case triage process.
Methodology :
With the use of LEAN model and multidisciplinary input from the psychiatrists, triage nurses and social worker, a "checklist of Nursing actions to New case patients after triage" is designed and adopted at the Li Ka Shing psychiatric outpatient clinic on 1 Nov. 2022 to streamline the workflow for those new case patients with complex needs as below: 1/ for patients with suspected child abuse, social worker is invited for conjoint interview with triage nurse for further assessment of childcare condition; 2/ for those urgent cases (Priority 1) with threatening score over 13 by the conventional new case triage form, the clinic-in-charge or specialist psychiatrist are to be informed for any additional expert advice before completion of the new case triage process and provision of the new case appointment.
Result & Outcome :
With the use of the nursing action checklist, the quality of the new case triage process is enhanced by 1/ clear documentation of both actions and outcomes to allow for awareness of changes in case of re-triage and to help promote effective collaboration within interdisciplinary team; 2/ regular review of compliance and monitoring of both desirable and undesirable outcomes with such practice. The patient safety is improved by timely input from on-site psychiatrists and social workers, and by extra time and effort from the triage nurse in collaboration with their family members, for those new case patients with suspected child abuse or those with poor mental condition and paramount risk to self or others.
