Thursday, 24 March 2016

Burns registry provides crucial evidence for best practice for burns care

THE Burns Registry of Australia and New Zealand (BRANZ) housed here at SPHPM is providing crucial data to burn units across the region, improving practice and outcomes for patients, according to research published this week in the Medical Journal of Australia (MJA).

SPHPM Adjunct Senior Lecturer and Director of the Victorian Adult Burns Service Dr Heather Cleland (pictured) discussed this week in the MJA the key findings of the first four years of data from the BRANZ, revealing significant variation in treatments and outcomes between specialised burns unit across the country.

Dr Cleland was the lead author of the latest BRANZ study published this week in the MJA, and accompanying the paper was an MJA ‘InSight’ article, video and podcast. In these, Dr Cleland discusses the vital need for such data, given the evidence of variations in practice and outcomes that were identified.

“We have significant differences - not only in inputs and outcomes - and we really need to get a better understanding of what the influences for these are,” Dr Cleland said.

To date, use of the Burns registry has successfully resulted in improved burns service planning, along with driving key changes to community awareness and burns prevention campaigns. She said the registry has been vital in advancing and improving burns treatment, but it could go further in providing crucial evidence-based standards of care for all burns units in the region.

The researchers examined four basic features of burn care in Australia and New Zealand from July 2010 to June 2014: two management items, rates of admission to intensive care units and rates of skin grafting; and two outcome measures, length of hospital stay and mortality.

The authors found that despite the highly centralised delivery of care to patients with severe or complex burn injuries there was considerable variation in practice. The study also provided evidence of significant variations in outcomes that are not explained by simple differences in casemix alone.

“It is highly likely that some aspects of the treatment that we deliver to burns patients are not as good as other aspects,” Dr Cleland said.

Nearly three-quarters (74 per cent) of patients underwent at least one surgical procedure, the authors found. However, there were significant differences between units in skin grafting rates.

Surgical management impacts on long term scarring outcomes and the study indicated that the rates of grafting differ between units.

BRANZ was established in 2009 to monitor and benchmark quality of care in specialist burn units in the two countries; and in 2013 the Australian and New Zealand Burn Association (ANZBA) launched the Burns Quality Improvement Program to develop evidence-based standards of care and to provide a quality improvement framework for improving care.

“The information provided by BRANZ provides a unique opportunity for significantly improving the quality of care for burns patients in Australia and New Zealand,” the authors concluded.

To read more about the study, you can access the paper here.

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