BackgroundPatient satisfaction is an important outcome measure guiding quality improvement in the healthcare setting while the patient-centred care movement places increasing importance on patient engagement in clinical decision-making. However, the concept of patient satisfaction is not clearly defined, and beliefs of patients are not always evident in health surveys. Researchers rarely follow up on surveys to explore patient views and what they mean in greater depth. This study set out to examine perceptions of hospital care, through in-depth, qualitative data capture and as a result, to gather rich, patient-driven information on user experience and satisfaction in the Australian healthcare setting; and identify influencing factors.MethodsFocus groups were undertaken in four St Vincent’s Health Australia (SVHA) hospitals in 2017 where participants discussed responses to eight questions from the Press Ganey Patient Experience Survey. Thirty people who were inpatients at SVHA.ResultsGood communication and high-quality information at arrival and discharge were found to be important to patients. Communication breakdown was also evident, further exacerbated by a range of environmental factors such as sharing a room with others. Overall, patients’ felt that while their spiritual needs were well-supported by the hospital staff at all SVHA hospitals, it was the clinical teams prioritised their emotional needs. Good communication and environments can improve patient experience and follow-up at home is vital.ConclusionsPatient-centred care needs careful planning with patients involved at entry and exit from hospital. Focused communication, environmental changes, attending to complaints, and clearer discharge strategies are recommended.

Objective: To examine the magnitude, 10-year temporal trends and treatment cost of intentional injury hospitalisations of children aged ≤16 years in Australia.Method: A retrospective examination of linked hospitalisation and mortality data for children aged ≤16 years during 1 July 2001 to 30 June 2012 with self-harm or assault injuries. Negative binomial regression examined temporal trends.Results: There were 18,223 self-harm and 13,877 assault hospitalisations, with a treatment cost of $64 million and $60.6 million, respectively. The self-harm hospitalisation rate was 59.8 per 100,000 population (95%CI 58.96-60.71) with no annual decrease. The assault hospitalisation rate was 29.9 per 100,000 population (95%CI 29.39-30.39) with a 4.2% annual decrease (95%CI -6.14--2.31, p<0.0001). Poisoning was the most common method of self-harm. Other maltreatment syndromes were common for children ≤5 years of age. Assault by bodily force was common for children aged 6-16 years. Conclusions:Health professionals can play a key role in identifying and preventing the recurrence of intentional injury. Psychosocial care and access to support services are essential for self-harmers. Parental education interventions to reduce assaults of children and training in conflict de-escalation to reduce child peer-assaults are recommended.Implications for public health: Australia needs a whole-of-government and community approach to prevent intentional injury.

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Aim Globally, burns remain a significant public health issue that disproportionately affect young children. The current study examines the 10‐year epidemiological profile of burn hospitalisations, hospital treatment cost and health outcomes by age group for children ≤16 years in Australia. Methods National, population‐based, linked hospital and mortality data from 1 July 2002 to 30 June 2012 were used to identify burn‐related hospitalisations. Age‐standardised hospitalisation rates and hospital treatment costs were estimated. Results There were 25 098 children aged ≤16 years hospitalised after sustaining a burn. The age‐standardised hospitalisation rate was 54.4 per 100 000 (95% confidence interval (CI): 53.7–55.1). Children aged 1–5 years had the highest burn hospitalisation rate (105.6 per 100 000; 95% CI: 103.8–107.3). The burn hospitalisation rate of infants <1 year declined by 3.1% per annum (95% CI: −4.84, −1.37, P < 0.001). Contact with heat and other substances, hot drinks, food, fats and cooking oils was the most common burn mechanism, and the home was the most common place of occurrence for children ≤10 years. Exposure to the ignition of highly flammable material was the most common burn mechanism for children aged 11–16 years. There were 7260 hospital readmissions within 28 days and 11 deaths within 30 days of the index burn hospitalisation. Total hospital treatment costs were estimated at $168 million. Conclusions Childhood burns continue to account for a large proportion of hospitalised morbidity. To assist in reducing burn hospitalisations, the development, implementation and resourcing of national multi‐sectorial childhood injury prevention is needed in Australia.

Objective: To audit the facilities for chemical decontamination, with special reference to cyanide poisoning, in all major accident and emergency departments in the UK. Method: A simple postal questionnaire was used to audit planning, premises, equipment, protection for staff, and stocks of specific antidotes to cyanide poisoning. Results: 227 questionnaires from 261 departments (87%) were returned and used in the survey. Of the 227 departments who responded, 151 (66%) had a written plan; 168 (74%) departments had premises for decontamination; 55 (24%) were judged to have satisfactory premises; 146 (64%) departments had a shower or hose for decontamination; 60 (26%) departments had a decontamination trolley suitable for "stretcher" patients; 203 (89%) had some protective equipment for staff but only 77 (34%) had complete protection-that is, goggles, chemical resistant clothing, and breathing apparatus. In the authors' opinion only seven (3%) departments had satisfactory premises and equipment to treat "stretcher" patients and full protection for staff. A further 11 (5%) departments were equipped to manage ambulant patients at a similar level. Some 205 (90%) departments stocked one or more antidotes to cyanide and 77 (34%) stocked all four antidotes. Thirty four (15%) departments held all four antidotes to cyanide and had full protection for staff. Only five (2%) departments had satisfactory premises and equipment to treat "stretcher" patients, full protection for staff, and at least three of four antidotes. Conclusions: Most departments had some equipment for chemical decontamination. However, there were major inconsistencies in the range of equipment held and these limited its usefulness. Only a small minority of departments was satisfactorily equipped to deal with a serious chemical incident.