Patient journey mapping to investigate quality and cultural safety in burn care for Aboriginal and Torres Strait Islander children and families – development, application and implications

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



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.


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.


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.


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.

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