Community Co-ordinated burn care: Implementing Holistic burn care through a culturally safe integrated model.

We are trialing a combination of three initiatives, these being Burn Care training being provided by The Statewide burn injury service, establishment of a hub and spoke model of care, and delivery of an integrated model of care. The Burn Care training, provided by the NSW Statewide Burn Injury Service, is a one day in person workshop conducted at participating Aboriginal Community Controlled Health Service. The one-day workshop covers mechanism of burn injury and first aid, burn assessment, burn pain management, pediatric burn management, wound management, including fixation and retention of dressings, social and emotional wellbeing, impact of burns, referral processes, burn complications and burn prevention. The training is supported with power point slides, which are also available online should participants want to refresh. Program fidelity is monitored through observation of the workshops and feedback obtained by participant evaluation at the workshop. Participants are staff from participating Aboriginal Community Controlled Health Services (e.g. Practice manager, Nursing staff, Doctors, Aboriginal Health Workers and students). The first training began in July 2023, and training will continue to be offered to Aboriginal Community Controlled Health Services in NSW until July 2026. The hub and spoke model of care is a proven model of delivery of ongoing care for people with complex health conditions. It refers to a network service delivery arrangement where an anchor or main health provider (the hub) which offers a full array of services is complemented by secondary establishments (spokes) which offer a more limited-service array. In this instance, the hub is the burns service at The Children's Hospital at Westmead, and the spokes are the participating Aboriginal Community Controlled Health Services. The burn service at The Children's Hospital at Westmead continue to offer their specialised burn services and the participating Aboriginal Community Controlled Health Services will be able to apply their new knowledge and skills in the care and management of burn injuries and will refer to the specialised burn services when required. Strategies to monitor effectiveness of the hub and spoke include presentations to the satellite services and consequent referrals to the hub service. The hubs services are not required to complete a minimum number of presentations from the spoke services. The Hub and spoke model of care will be initiated from the first ACCHS and will end at the completion of data collection (30 months). The third intervention is the integrated model of care which involves health providers, local community health services and the family to ensure communication and coordination within the health care delivery. The integrated model of care includes the ACCHS connecting with the specialists burn service at The Children's Hospital at Westmead to seek advice regarding burn care management, possible referrals via telehealth and direct phone calls. Similarly, staff at The Children's Hospital at Westmead are encouraged to contact ACCHS when children have been hospitalized and being prepared for discharge. There is no prescriptive form of case management in this model of care, the focus is on improving continuity of care through improving communication between the services. The duration of this model of care will be 30 months. This will be monitored by tracking burn presentations to services by yarning with families, yarning with health workers at participating Aboriginal Health Services and conducting interviews with members of the multi-disciplinary team at the Burns Unit. Health services are encouraged to communicate with each other through posters, newsletters, pamphlets and regular meetings with the research team.