Dr Karen McLean


Dr McLean is a behavioural and developmental paediatrician who implemented the Pathway to Good Health Clinic at RCH. She is undertaking her PhD exploring how children entering out-of-home care get their health needs identified and addressed, including an audit of the RCH clinic, a data linkage, retrospective (5 year), state-wide cohort study (supported by a Learning System Grant) and a foster and kinship carers’ study.


Health needs and timeliness of assessment of children entering out-of-home care attending a multi-disciplinary clinic (Poster Presentation)

Studies show that children and young people entering out-of-home care (OOHC) have high health needs in all domains: physical, mental and developmental. Identifying needs and addressing needs early leads to better outcomes, but this has been challenging for this population. Expert bodies and Australian and Victorian Government policy, including the National Standards for out-of-home care, recommend routine assessment upon entry to OOHC. The Pathway to Good Health (PTGH) program was established to provide such assessments. GPs were recruited to provide an initial health check, and dedicated multi-disciplinary clinics were set up in some metropolitan and regional areas.

We audited the clinic records of the first 119 PTGH patients at the Royal Children’s Hospital clinic to determine the extent and range of health needs, the timeliness of health visits and recommendations made.

Less than one third of children were referred into clinic according to nationally recommended timelines, and less than a quarter were seen by three months following entry to OOHC. 31% of 0-2 year old children did not have up-to-date immunisations when seen in clinic. 87% of all children had physical health concerns. Over 50% had mental health concerns identified (76% of 7-to-12 year olds). In children aged 3-6 years, 64% had behavioural problems and 77% had developmental problems identified. The most frequent recommendations were for mental health services, paediatric care, audiology and speech therapy.

To adequately identify and address health needs for children entering OOHC, timely access to a range of health services is needed.

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