Leading Better Value Care
Local vignette – Northern Sydney LHD


Paediatric acute review clinic (non-admitted patients) – a clinician's perspective

By Megan Cluff

26 Apr 2021 Reading time approximately

What is important to know about your service?

The paediatric acute review clinic (PARC) is co-located within the paediatric ward and ambulatory care unit at Hornsby Ku-ring-gai Hospital. The clinic sees children up to the age of 16 years.

What organisational model do you use?

Paediatric acute review clinic (PARC) non-admitted patients.

Diagnostic testing
leads to
Acute management
leads to
Optimising health
leads to
Working with families

What is special about the way care is delivered that is valuable for others to know?

Babies (up to 12 months) are followed up, or return to hospital, for planned acute review within 24-hours of their departure from the emergency department through PARC.

The clinic operates Monday to Friday, 8:00am to 4.30pm, with 30 minute appointments. The clinic is staffed by one full-time equivalent (FTE) paediatric nurse with access to senior paediatricians or registrars.

Referrals to the clinic are made by the emergency department physician to the paediatric registrar/consultant through an electronic medical record (eMR) referral. The paediatric registrar/consultant can also refer directly to the clinic. Referrals can also be made from other hospitals as long they reside within the local health district (LHD). A paper form is available for this process.

The PARC nurse actively reviews emergency department presentations daily and initiates follow up for babies and their families with clinical and social risk factors. Most referrals are for acute general medical presentations and follow ups.

A companion document describes options for organisational models in bronchiolitis. One option is PARC – this vignette describes the model from a local perspective.

How does it make a difference?

Best care closer to home or at home allows families to be at home and recover quicker. All staff agree that children recover and are better placed within the home environment with their family.

What tips do you have for others?

  • PARC provides quick access to outpatient paediatricians and a safety net for discharges and ‘did not waits’ from the emergency department.
  • Hospital in the Home services can support PARC.
  • PARC requires a paediatric clinical nurse specialist or registered nurse with paediatric nursing experience.

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