“Its All Very Complex!”

Ms Nicole Alexander1, Ms Alison Baillie2, Ms Anna  Lucia3

1The Royal Children’s Hospital , Parkville , Australia, 2The Royal Children’s Hospital , Parkville , Australia, 3The Royal Children’s Hospital , Parkville , Australia


This eco map is a visual presentation of the complex systems surrounding a child who experienced a 20% flame burn to his neck, chest and arm and the linkages made to ensure best outcomes during and post admission at The Royal Children’s Hospital.
The patient presented with an intellectual disability and significant speech delay. The extent of his cognitive and speech delay was not fully understood by his family which initially impacted on our care. He has a complex social situation including history of family violence, substance abuse, and limited supports. He resides with his father and mother resides interstate.
This visual map highlights the complexity surrounding this patient and the multiple interventions accessed during his admission at RCH.
The complex nature of this patient resulted in non-compliance in post burns care with limited participation in therapy. Despite thorough discharge planning, minimal compliance continued in relation to stretches and scar management. He has significant bilateral anterior axilla and neck contractures resulting in restricted movement and limited function.
The ongoing work with this patient and family post discharge are represented with local supports working closely with the patient, family and RCH. This patient faces life long consequences in his physical appearance and mobility if the next stage of his treatment is not successful. By linking with local supports, networks and services our goal is to best prepare the patient and family both emotionally and developmentally for the next stage of his recovery and to reduce the risk of continued non-compliance post-surgery.


Anna has been a Social Worker for the past 18 years across community and health and worked within the Burns Unit at The Royal Children’s Hospital as a Senior Social Worker for the past 4 years.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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