Creation of a prolonged jaundice screening clinic.

Abstract

We describe a QI project for creating a prolonged jaundice (PJ) clinic with the aim of moving assessment of these vulnerable patients from an acute area to be seen in the right place at the right time by the right team. PJ screening is important to rule out serious rare underlying and treatable pathology in a timely manner. Previously patients were seen in our acute paediatric assessment unit (PAU). We set up a multidisciplinary team working group including midwifery, paediatrics, admin and outpatient teams. Challenges identified were: to establish a new referral pathway; Clinician availability for a clinic; Resource availability for a clinic; follow up pathway. We reviewed patient numbers and referral pathways and looked at ways to streamline the process for babies and their carers. Solutions were: weekly clinic sufficient for patient numbers; Physician Associates (PA) available for clinic and given required training; Paediatric consultant supervision. We planned post clinic MDT meetings to discuss feedback and minor changes using PDSA cycle. A weekly PJ clinic was created with an electronic referral system accessible to all midwives. This is expected to free up 360 hours/year from the PAU capacity which is now directed to acute patients. We have positive feedback from patients and staff. This project has established a new pathway for babies with PJ (see�figure 1) resulting in an improved patient journey with no additional cost or funding required.