Dr Sarah Fraser¹, Associate Professor Tamara Mackean², Professor Julian Grant³, Dr Kate Hunter⁴, Dr Courtney Ryder², Dr Janet Kelly⁵, Professor Andrew Holland⁶, Dr Bronwyn Griffin⁷, Professor Kathleen Clapham⁸, Associate Professor Warwick Teague⁹, Ms Anne Darton¹⁰, Professor Rebecca Ivers¹

¹University Of New South Wales, Sydney, Australia, ²Flinders University, Adelaide, Australia, ³Charles Sturt University, Bathurst, Australia, ⁴The George Institute for Global Health, Sydney, Australia, ⁵University of Adelaide, Adelaide, Australia, ⁶The University of Sydney, Sydney, Australia, ⁷Griffith University, Brisbane, Australia, ⁸University of Wollongong, Wollongong, Australia, ⁹University of Melbourne , Melbourne, Australia, ¹⁰Agency for Clinical Innovation, Sydney, Australia

Abstract:

Background

Quality and safety in Australian healthcare is inequitably distributed, highlighted by gaps in the provision of quality care for Aboriginal and Torres Strait Islander children. Burns have potential for long-term adverse outcomes, and quality care, including culturally safe care, is critical to recovery. This study aimed to develop and apply an Aboriginal Patient Journey Mapping (APJM) tool to investigate the quality of healthcare systems for burn care with Aboriginal and Torres Strait Islander children.

Study Design

Interface research methodology, using biomedical and cultural evidence, informed the modification of an existing APJM tool. The tool was then applied to the journey of one family accessing a paediatric tertiary burn care site. Data were collected through yarning with the family, case note review and clinician interviews. Data were analysed using Emden’s core story and thematic analysis methods. Reflexivity informed consideration of the implications of the APJM tool, including its effectiveness and efficiency in eliciting information about quality and cultural safety.

Results

Through application of a modified APJM tool, gaps in quality care for Aboriginal and Torres Strait Islander children and families were identified at the individual, service and system levels. Engagement in innovative methodology incorporating more than biomedical standards of care, uncovered critical information about the experiences of culturally safe care in complex patient journeys.

Conclusion

Based on our application of the tool, APJM can identify and evaluate specific aspects of culturally safe care as experienced by Aboriginal and Torres Strait Islander peoples and be used for quality improvement.

Biography:

Sarah is a registered nurse with experience in clinical governance within Aboriginal primary health care service across South Australia. Sarah’s PhD and research focuses on quality and safety in healthcare systems for burn care being accessed by Aboriginal and Torres Strait Islander children and families across Australia. Sarah is currently a research fellow with UNSW.