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102
The following is an analysis of cases dealt with from January to December, 1927 —
No. of new cases referred by school doctors 252
No. of new cases referred by the receiving room 505
No. of cases discharged or lapsed 305
Queen's
Hospital Outpatients
department.
Since an assistant organiser was appointed to work in the out-patients department
of the Queen's Hospital for Children, Hackney Road, in September, 1924,
two others have been added, so that at least one session is worked with each of
the surgeons and physicians, with the exception of one who has recently changed
his day. Six sessions are devoted to the casualty department.
This newest venture in the casualty department, begun in September, 1927,
is proving useful as a measure of increased co-operation between the casualty or
out-patients department and the school treatment centres. The numbers of new
patients attending in the out-patients department are not high compared with
those at treatment centres owing to the fact that every case has already been dealt
with in the casualty department or specially referred by the school care committees
or by other medical authorities for specialist advice. Eight new school cases at
a medical session is about the average, and between 35 and 40 old cases, but the
current file in the case of one physician alone is 500, and each child is kept under
observation and reported upon periodically to the care committees.
Two or three new school orthopaedic cases may attend per session, but the
discharges are even fewer, so the file continues to increase slowly. There are some
280 current orthopaedic cases. The current vision file, which includes external
eye cases, numbers about 550. The total attendance for school children for the first
four weeks of the term beginning January, 1928, is—new cases, 49; old cases, 120;
making a total of 168. Thirty-six pairs of glasses were ordered, and during the
same period 38 pairs, most of them of course ordered before this time, have been
obtained. The aural department remains fairly stationary at about 250 cases,
as there are practically as many discharges each week as there are new cases. In
the other surgical departments and in the skin department the position is similar.
The casualty numbers are from 6 to 25 new, and 20 to 60 old cases each session, and
there are over 500 on the current file already.
In the out-patients department the assistant organiser's work consists chiefly
in following up the cases, keeping the honorary secrtaries of the care committees
informed of new ones, the non-attendance of old ones and inviting their co-operation
in getting them back for treatment. The reports on home conditions are frequently
required by the doctors, particularly in cases where medical treatment fails to bring
about the desired result.
A large number of rheumatic children is dealt with, and it is necessary for the
assistant organiser to impress upon the parents the importance of regular attendance
even though the patient seems better. In the orthopaedic department, particularly
the importance of regular attendance has to be pressed. The orthopaedic surgeon
says gratefully that now "he never loses a case," and though this is not literally
true, the action of the care committees and the friendly talks to parents at the
hospital have resulted in much improved attendances. In the vision department it has
been found a great boon to have a responsible officer to see that the children have
the glasses ordered and to ensure the attendance of cases due to return in three to
six months.
Owing to the following up done in all departments attendances are much more
regular and the treatment recommended by the specialists is thereby proving far
more effectual.
It should be mentioned how extremely courteous the surgeons and physicans
have been since the L.C.C. scheme started, and they have expressed their appreciation
of the work done from time to time. The care committees also find it extremely