1. New Referral Received: Outpatient Appointment Central Booking: Sends Family Form 1 To Family Family: Completes Family Form 1 To Central Booking Central Booking: Family Form 1 on PiMS Prepares Medical Record Files Family Form 1 To Medical Records Medical Records: Inserts a Birth History Inserts an Immunisation and Infectious Disease Record Doctor: Completes Birth History Completes Immunisation and Infectious Disease Record Assesses child Records on white continuation paper OPD Reception: Checks Family Form 1 completed Updates PiMS Medical Records: Medical Record sent to OPD Family: Completes Family Form 1 To OPD Reception Nurse or Administrator: Gives Family Form 2* Family: Completes Family Form 2 or Takes away to bring on admission Option Family to Pre-Admission Clinic Nurse: Reviews Family Form 2 with Family Annotates as necessary: Family Form 2 Birth History Immunisation and Infectious Disease Record Commences Patient Assessment Form * = Family Form 2 may be re- used for subsequent admissions for up to one year When a newly referred patient is to be seen as an outpatient, the following process takes place… The Central Booking Office receives and processes the new referral. The office sends an appointment to the parents/patient to be seen in Outpatients or on a ward. Family Form 1 is sent with the appointment – it is an essential registration document that parents need to complete and return.

2. New Referral Received: Outpatient Appointment Central Booking: Sends Family Form 1 To Family Family: Completes Family Form 1 To Central Booking Central Booking: Family Form 1 on PiMS Prepares Medical Record Files Family Form 1 To Medical Records Medical Records: Inserts a Birth History Inserts an Immunisation and Infectious Disease Record Doctor: Completes Birth History Completes Immunisation and Infectious Disease Record Assesses child Records on white continuation paper OPD Reception: Checks Family Form 1 completed Updates PiMS Medical Records: Medical Record sent to OPD Family: Completes Family Form 1 To OPD Reception Nurse or Administrator: Gives Family Form 2* Family: Completes Family Form 2 or Takes away to bring on admission Option Family to Pre-Admission Clinic Nurse: Reviews Family Form 2 with Family Annotates as necessary: Family Form 2 Birth History Immunisation and Infectious Disease Record Commences Patient Assessment Form * = Family Form 2 may be re- used for subsequent admissions for up to one year The parents completed Family Form 1 and return it to the Central Booking Office or other nominated department in a pre-paid envelope. The Central Booking Office records the information provided on Family Form 1 onto PiMS, files it with the referral letter in the patient’s medical records, and sends them to the Medical Records Department. The Medical Records Department prepares the patient’s medical record for the outpatient appointment. They insert a Birth History Form & Immunisation and Infectious Disease Record into the front of the patient’s record. The medical record is sent to the area where the patient will have their appointment.

3. New Referral Received: Outpatient Appointment Central Booking: Sends Family Form 1 To Family Family: Completes Family Form 1 To Central Booking Central Booking: Family Form 1 on PiMS Prepares Medical Record Files Family Form 1 To Medical Records Medical Records: Inserts a Birth History Inserts an Immunisation and Infectious Disease Record Doctor: Completes Birth History Completes Immunisation and Infectious Disease Record Assesses child Records on white continuation paper OPD Reception: Checks Family Form 1 completed Updates PiMS Medical Records: Medical Record sent to OPD Family: Completes Family Form 1 To OPD Reception Nurse or Administrator: Gives Family Form 2* Family: Completes Family Form 2 or Takes away to bring on admission Option Family to Pre-Admission Clinic Nurse: Reviews Family Form 2 with Family Annotates as necessary: Family Form 2 Birth History Immunisation and Infectious Disease Record Commences Patient Assessment Form * = Family Form 2 may be re- used for subsequent admissions for up to one year The receptionist in the area where the patient is having their outpatient appointment checks that Family Form 1 has been fully completed. They also check the patient’s details for changes to their circumstances and update PiMS where necessary. Parents/patients who have not returned a completed Family Form 1 are asked to complete one before the patient has their appointment. The doctor or other competent health care professional asks the past medical history of the patient. The birth part of this history is recorded on the Birth History Form. The patient’s immunisation & infectious disease history is recorded on the Immunisation & Infectious Disease Record. The rest of the assessment is recorded on white continuation paper. Communication support needs must be assessed to enable full participation in the assessment process and a complete assessment to be made.

4. New Referral Received: Outpatient Appointment Central Booking: Sends Family Form 1 To Family Family: Completes Family Form 1 To Central Booking Central Booking: Family Form 1 on PiMS Prepares Medical Record Files Family Form 1 To Medical Records Medical Records: Inserts a Birth History Inserts an Immunisation and Infectious Disease Record Doctor: Completes Birth History Completes Immunisation and Infectious Disease Record Assesses child Records on white continuation paper OPD Reception: Checks Family Form 1 completed Updates PiMS Medical Records: Medical Record sent to OPD Family: Completes Family Form 1 To OPD Reception Nurse or Administrator: Gives Family Form 2* Family: Completes Family Form 2 or Takes away to bring on admission Option Family to Pre-Admission Clinic Nurse: Reviews Family Form 2 with Family Annotates as necessary: Family Form 2 Birth History Immunisation and Infectious Disease Record Commences Patient Assessment Form * = Family Form 2 may be re- used for subsequent admissions for up to one year Some patients may be asked to attend a Pre-Admission Clinic on the same day as their outpatient appointment. Where this occurs, the Pre-Admission Clinic administrator checks the patient's records to ascertain if there is an existing current Family Form 2. If the patient has significantly changed, or the form has become illegible due to repeated admissions, the parents may be asked to complete a new form.

5. New Referral Received: Outpatient Appointment Central Booking: Sends Family Form 1 To Family Family: Completes Family Form 1 To Central Booking Central Booking: Family Form 1 on PiMS Prepares Medical Record Files Family Form 1 To Medical Records Medical Records: Inserts a Birth History Inserts an Immunisation and Infectious Disease Record Doctor: Completes Birth History Completes Immunisation and Infectious Disease Record Assesses child Records on white continuation paper OPD Reception: Checks Family Form 1 completed Updates PiMS Medical Records: Medical Record sent to OPD Family: Completes Family Form 1 To OPD Reception Nurse or Administrator: Gives Family Form 2* Family: Completes Family Form 2 or Takes away to bring on admission Option Family to Pre-Admission Clinic Nurse: Reviews Family Form 2 with Family Annotates as necessary: Family Form 2 Birth History Immunisation and Infectious Disease Record Commences Patient Assessment Form * = Family Form 2 may be re- used for subsequent admissions for up to one year If there is not a current Family Form 2, the administrators of the Pre-Admission Clinic give the parents this form to complete prior to seeing the nurse for their appointment. The patient should be actively engaged whenever possible, encouraged to provide information for themselves, and to be involved in the assessment process. Family Form 2 may be reused for up to one year and annotated for subsequent admissions.

6. New Referral Received: Outpatient Appointment Central Booking: Sends Family Form 1 To Family Family: Completes Family Form 1 To Central Booking Central Booking: Family Form 1 on PiMS Prepares Medical Record Files Family Form 1 To Medical Records Medical Records: Inserts a Birth History Inserts an Immunisation and Infectious Disease Record Doctor: Completes Birth History Completes Immunisation and Infectious Disease Record Assesses child Records on white continuation paper OPD Reception: Checks Family Form 1 completed Updates PiMS Medical Records: Medical Record sent to OPD Family: Completes Family Form 1 To OPD Reception Nurse or Administrator: Gives Family Form 2* Family: Completes Family Form 2 or Takes away to bring on admission Option Family to Pre-Admission Clinic Nurse: Reviews Family Form 2 with Family Annotates as necessary: Family Form 2 Birth History Immunisation and Infectious Disease Record Commences Patient Assessment Form * = Family Form 2 may be re- used for subsequent admissions for up to one year The Nurse at the Pre-Admission Clinic reviews the information provided by the parents/patient on the Family Form 2, completing any outstanding aspects, and records any additional information on PiMS. This may be delegated to the ward administrator. The nurse also reviews the birth, immunisation & infectious disease history annotating the appropriate records as required. The rest of the assessment is recorded on the Patient Assessment Form. Members of the multi-disciplinary team are responsible for the recording of any additional data they identify on PiMS. You have now reached the end of this demo