Cultural safety in hospitals: validating an empirical measurement tool to capture the Aboriginal patient experience

2020 ◽  
Vol 44 (2) ◽  
pp. 205
Author(s):  
Elissa Elvidge ◽  
Yin Paradies ◽  
Rosemary Aldrich ◽  
Carl Holder
Keyword(s):  
Patient Perspective ◽  
New South ◽  
New South Wales ◽  
Performance Measure ◽  
Cultural Safety ◽  
Measurement Tool ◽  
Local Health ◽  
Validity And Reliability ◽  
South Wales ◽  
Aboriginal Patient

ObjectiveThe aim of the present study was to develop a scale to measure cultural safety in hospitals from an Aboriginal patient perspective. MethodsThe Cultural Safety Survey was designed to measure five key characteristics of cultural safety that contribute to positive hospital experiences among Aboriginal hospital patients. Investigators developed a range of different methods to assess the validity and reliability of the scale using a sample of 316 participants who had attended a New South Wales hospital in the past 12 months. Targeted recruitment was conducted at two hospital sites. Opportunistic recruitment took place through a local health district, discharge follow-up service and online via social media. ResultsThe Cultural Safety Survey Scale was a robust measurement tool that demonstrated a high level of content and construct validity. ConclusionThe Cultural Safety Survey Scale could be a useful tool for measuring cultural safety in hospitals from the Aboriginal patient perspective. What is known about the topic?There are increasing calls by governments around the world for health institutions to enhance the cultural safety of their services as one way of removing access barriers and increasing health equity. However, currently there are no critical indicators or systematic methods of measuring cultural safety from the patient perspective. What does this paper add?The cultural safety scale, an Australian first, presents the first empirically validated tool that measures cultural safety from the Aboriginal patient perspective. What are the implications for practitioners?This measurement model will allow hospitals to measure the cultural safety of their services and ascertain whether current efforts aimed to improve cultural safety are resulting in Aboriginal patients reporting more culturally safe experiences. Over time it is hoped that the tool will be used to benchmark performance and eventually be adopted as a performance measure for hospitals across New South Wales.

scholarly journals A multi-organisation aged care emergency service for acute care management of older residents in aged care facilities

2015 ◽  
Vol 39 (5) ◽  
pp. 514 ◽  
Author(s):  
Jane Conway ◽  
Sophie Dilworth ◽  
Carolyn Hullick ◽  
Jacqueline Hewitt ◽  
Catherine Turner ◽  
...  
Keyword(s):  
New South ◽  
Point Of Care ◽  
New South Wales ◽  
Aged Care ◽  
Residential Aged Care ◽  
Local Health ◽  
South Wales ◽  
Care Assessment ◽  
Care Facilities ◽  
Aged Care Facilities

This case study describes a multi-organisation aged care emergency (ACE) service. The service was designed to enable point-of-care assessment and management for older people in residential aged care facilities (RACFs). Design of the ACE service involved consultation and engagement of multiple key stakeholders. The ACE service was implemented in a large geographical region of a single Medicare Local (ML) in New South Wales, Australia. The service was developed over several phases. A case control pilot evaluation of one emergency department (ED) and four RACFs revealed a 16% reduction in presentations to the ED as well as reductions in admission to the hospital following ED presentation. Following initial pilot work, the ACE service transitioned across another five EDs and 85 RACFs in the local health district. The service has now been implemented in a further 10 sites (six metropolitan and four rural EDs) across New South Wales. Ongoing evaluation of the implementation continues to show positive outcomes. The ACE service offers a model shown to reduce ED presentations and admissions from RACFs, and provide quality care with a focus on the needs of the older person.

Junior clinical academic psychiatrists in Australia: The University of New South Wales initiative

2018 ◽  
Vol 27 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Adith Mohan ◽  
Adam Bayes ◽  
Perminder S Sachdev ◽  
Gordon Parker ◽  
Philip B Mitchell
Keyword(s):  
New South ◽  
New South Wales ◽  
Local Health ◽  
Specialty Training ◽  
Research Engagement ◽  
Track Record ◽  
South Wales ◽  
Entry Points ◽  
The University ◽  
Health Districts

Objective: We examined current pathways of training for junior clinical academic psychiatrists in Australia. An initiative of the School of Psychiatry, University of New South Wales, is described from the perspective of two junior clinical academics. Conclusions: Australia has limited defined clinical academic pathways for psychiatrists when compared internationally. Numerous challenges for junior psychiatrists entering academia include tensions between clinical and academic roles, reduced remuneration, difficulty building a competitive track record and a scarcity of funding. Potential solutions lie with universities and local health districts partnering to fund clinical academic roles and offering flexible entry points across specialty training. Fostering research engagement in junior psychiatrists will develop the next generation of clinical academics with benefit for clinical and academic domains.

Case Study

2011 ◽  
pp. 191-203
Author(s):  
E. Saurman ◽  
D. Perkins ◽  
D. Lyle ◽  
M. Patfield ◽  
R. Roberts
Keyword(s):  
Mental Health ◽  
Health Service ◽  
New South ◽  
New South Wales ◽  
Health Staff ◽  
Local Health ◽  
Rural And Remote ◽  
South Wales ◽  
Western Area ◽  
Area Health

The MHEC-RAP project involves the innovative application of video conferencing to mental health assessment in rural NSW. The preliminary evaluation findings of the project are presented. Mental health emergencies in rural and remote settings cause particular problems and are not amenable to conventional health service solutions. Patients and local health care staff may be isolated from specialist mental health staff and from acute inpatient services. Decisions to transport patients for specialist assessments or treatment may be required at night or at weekends and may involve families, police, ambulance services and local health staff. Such decisions need to be made promptly but carefully and the ability to obtain a specialist assessment may assist in making a decision about how best to care for the patient bearing in mind the need to provide a responsive, high quality and safe service to patients and local clinicians. In this chapter we examine a novel approach which uses audio-visual technology to conduct remote emergency mental health patient assessment interviews and provide consultations to local clinicians in rural communities in western NSW. The Mental Health Emergency Care – Rural Access Project or ‘MHEC-RAP’ was developed in 2007 following a series of consultations held in rural towns and implemented in 2008 within the Greater Western Area Health Service (GWAHS), New South Wales, Australia. GWAHS is a primary example of a rural and remote health service. It serves 287,481 people (8.3% of whom are Indigenous Australians) in an area that is 445,197sq km or 55% of the state of New South Wales (Australian Bureau of Statistics, 2001; Greater Western Area Health Service, 2007, 2009). The communities within GWAHS are mostly small, the towns are widely dispersed and local services are “limited by distance, expense, transport, and the difficulty of recruiting health professionals to these areas” (Dunbar, 2007 page 587). The chapter focuses on the design of the service, its implementation and its performance in the first year. We conclude with a discussion about the service, its broader relevance, transferability and its sustainability.

scholarly journals Healthy choices in New South Wales health facilities for staff and visitors: a policy evaluation

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Trevena ◽  
E Munn ◽  
L King ◽  
M Thomas ◽  
L Shepherd ◽  
...  
Keyword(s):  
Policy Evaluation ◽  
New South ◽  
New South Wales ◽  
Evaluation Study ◽  
Health Facilities ◽  
Local Health ◽  
Healthy Weight ◽  
Food Outlets ◽  
South Wales ◽  
The Right

Abstract Issue Obesity and its determinants are risk factors for most leading causes of chronic diseases. In New South Wales (NSW), Australia, 1 in 2 adults and more than 1 in 5 children are above a healthy weight. As a key symbolic part of a suite of health eating policies, the NSW Ministry of Health implemented a Healthy Food and Drink in NSW Health facilities for Staff and Visitors Framework (Framework) across 18 Local Health Districts (LHDs). Many countries are grappling to understand the effectiveness of obesity prevention policies. Description 2: This policy evaluation synthesised evaluation study findings and internal records to assess the effectiveness of the Framework in achieving implementation targets: a) the removal of sugar-sweetened drinks (SSDs) from sale (Dec 2017), b) implementation of 12 food-based practices (Dec 2018). Results The overall implementation package was appropriate for the large, geographically dispersed, decentralised health system (160 health facilities; 927 food outlets;76 retailers) and variable retail arrangements. The Ministry provided LHDs with overall direction, phasing, and monitoring; the LHDs had local leadership, governance, cross-functional support and autonomy to implement in a way to suit them. Accountability and pace of implementation was driven most notably by monitoring and reporting using an electronic tool (PHIMS-N), and a 'network of practice' that was pivotal to problem solving. SSDs were removed from 96% (n = 606) of applicable food outlets; overall average achievement of all practices was high at 82% (22.4 SD). Nine in 10 (92%) consumers support the Framework, and retailers are accepting of its targets. Lessons: This was the right policy at the right time, with well-orchestrated implementation. Annual monitoring and reporting enabled by PHIMS-N is unique in this type of policy implementation and essential for tracking progress, informing decision making, and ensuring accountability. Key messages Implementation of the Framework has resulted in the removal of SSDs from sale, increased availability of healthier foods and decreased unhealthy foods as measured by 12 food-based practices. The Framework is feasible and effective in influencing retail practices in health facilities, has high consumer support for its goals, and overall acceptability and adoption amongst retailers.

Building a Gymnasium¾Building Health in Lake Cargelligo

1995 ◽  
Vol 1 (1) ◽  
pp. 94
Author(s):  
Joy Northey
Keyword(s):  
Community Health ◽  
Rural Community ◽  
New South ◽  
New South Wales ◽  
Health Staff ◽  
Local Health ◽  
Health Issues ◽  
Combined Approach ◽  
South Wales ◽  
The Town

Lake Cargelligo is a small, isolated rural community in the centre of New South Wales with a population of 2000, of these 60% live in the town. The project to build a gymnasium was the result of a combined approach to improve the health and fitness of the community by hospital and community health staff and by the community at large. It was the outcome of a series of innovative approaches to addressing local health issues.

scholarly journals Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014

2016 ◽  
Vol 7 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Tony Merritt ◽  
◽  
Kirsty Hope ◽  
Michelle Butler ◽  
David Durrheim ◽  
...  
Keyword(s):  
New South ◽  
New South Wales ◽  
Aged Care ◽  
Local Health ◽  
Antiviral Prophylaxis ◽  
South Wales ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Influenza Outbreaks ◽  
Health Districts

Using the Tailoring Immunization Programmes guide to improve child immunisation in Umina, New South Wales: we could still do better

2020 ◽  
Vol 26 (4) ◽  
pp. 325
Author(s):  
Katarzyna Bolsewicz ◽  
Susan Thomas ◽  
Donna Moore ◽  
Colleen Gately ◽  
Andrew Dixon ◽  
...  
Keyword(s):  
Socioeconomic Factors ◽  
Service Providers ◽  
Vaccine Coverage ◽  
New South ◽  
New South Wales ◽  
World Health ◽  
Local Health ◽  
South Wales ◽  
Immunisation Service ◽  
Immunization Programmes

In the Central Coast Local Health District of New South Wales, Australia, childhood immunisation (CI) rates are around 95%, but pockets of underimmunisation exist. Using the World Health Organization’s Tailoring Immunization Programmes, we identified areas of potential low vaccine coverage using Australian Immunisation Register (AIR) data (2016–18) and investigated factors that influence CI. Individual and group interviews with carers, community members and service providers (n=52 participants) were conducted. Data were analysed thematically and the themes presented to stakeholders for feedback before finalisation. During 2018, Umina had 218 children at least 1 month overdue for at least one vaccination. Five themes emerged: (1) broader socioeconomic factors may apply pressures that influence CI; (2) parents largely supported immunisation and knew of its benefits to their children and the community; (3) immunisation service providers are committed, experienced and collaborate with community partners; (4) there is potential to increase access to free immunisation services in Umina; and (5) AIR data and reminder systems could be better used to inform service delivery and prompt parents before immunisations are due. This study identified opportunities to improve CI coverage in Umina and new information useful in developing a tailored immunisation strategy. Awareness of the pressures socioeconomic factors may have on families could help plan and deliver supportive primary health care that includes equitable access to immunisation.

Use of routinely collected data in reporting falls in hospitals in a local health district in New South Wales, Australia

2016 ◽  
Vol 46 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Lieu Thi Thuy Trinh ◽  
Helen Achat ◽  
Hassan Assareh
Keyword(s):  
Information Exchange ◽  
Health Information Exchange ◽  
New South ◽  
New South Wales ◽  
International Classification Of Diseases ◽  
Information Management System ◽  
Local Health ◽  
Data Set ◽  
South Wales ◽  
Icd 10

Objective: To examine the quality of the two routinely collected sets of data, the Incident Information Management System (IIMS) and the health information exchange (HIE) in hospitals in New South Wales, Australia. Method: IIMS records indicating a fall and its location were examined. HIE data were examined using International Classification of Diseases (ICD)-10-AM codes W00-W19 and an indicator, ‘onset of the condition’ for falls in hospital. If onset of the condition was not recorded, ICD-10-AM code for place of occurrence (Y92.22 = Health service area) immediately following ICD-10-AM code for the fall was used. Comprehensive criteria were applied to exclude records of earlier documented falls. IIMS and HIE data were linked. Characteristics of falls that were recorded in one data set but not in the other were determined. Results: Between January 2010 and December 2014, 8647 falls in hospitals were recorded in IIMS, 2169 were recorded in HIE and 9338 were recorded in either data set (rate of 3.2 falls per 1000 bed days). IIMS captured 93% and HIE captured 23% of these falls. Of the falls recorded in HIE, 677 (31%) were not recorded in IIMS. These were more likely to be subsequent falls, by patients who were female, younger than 65 years, who underwent a non-allied health procedure or had length of stay less than 1 week. Conclusions: IIMS captured the vast majority of falls in hospitals but failed to report one-third of falls recorded in HIE.

scholarly journals Smoking Cessation during the Second Half of Pregnancy Prevents Low Birth Weight among Australian Born Babies in Regional New South Wales

2021 ◽  
Vol 18 (7) ◽  
pp. 3417
Author(s):  
Pramesh Raj Ghimire ◽  
Julie Mooney ◽  
Louise Fox ◽  
Lorraine Dubois
Keyword(s):  
Smoking Cessation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
New South ◽  
New South Wales ◽  
Public Hospitals ◽  
Local Health ◽  
Future Health ◽  
Smoking During Pregnancy ◽  
South Wales

Smoking during pregnancy is a modifiable risk behavior of adverse health outcomes including low birth weight (LBW), and LBW is a key marker of newborns immediate and future health. This study aimed to examine the association between smoking cessation during the second half of pregnancy and LBW among babies born in Southern New South Wales Local Health District (SNSWLHD). Routinely collected perinatal data on singleton live births for the period 2011–2019 in five public hospitals of SNSWLHD were utilized. Multivariate logistic regression models were fitted to examine the association between smoking cessation during the second half of pregnancy and LBW. Analyses showed that mothers who ceased smoking during the second half of pregnancy were 44% less likely to have LBW babies (adjusted odds ratio (aOR) = 0.56; 95% confidence interval (CI): 0.34, 0.94) compared to those who continued smoking throughout pregnancy. Mothers who reported an average daily dose of 1–10 or >10 cigarettes during the second half of pregnancy were significantly more likely to have babies with LBW than those who ceased smoking during the second half of pregnancy. Early identification of smoking behavior and promotion of smoking-cessation intervention for risk populations including pregnant women within the older age bracket (35–49 years) is imperative to reduce LBW.

Nurse-led pre-exposure prophylaxis: a non-traditional model to provide HIV prevention in a resource-constrained, pragmatic clinical trial

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 595 ◽  
Author(s):  
Heather-Marie A. Schmidt ◽  
Ruthy McIver ◽  
Rebecca Houghton ◽  
Christine Selvey ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
New South ◽  
New South Wales ◽  
Models Of Care ◽  
Rapid Expansion ◽  
Local Health ◽  
South Wales ◽  
Public Clinics ◽  
Sexual Health Clinics ◽  
Exposure Prophylaxis

There is little evidence and no standardised model for nurse-led HIV pre-exposure prophylaxis (PrEP). In 2016, public sexual health clinics in the state of New South Wales (NSW), Australia, participating in the population-scale PrEP access trial Expanded PrEP Implementation In Communities in New South Wales (EPIC-NSW) were authorised to adopt a nurse-led model of PrEP provision in order to facilitate the rapid expansion of PrEP access to more than 8000 participants in under 2 years without additional resources. The model has been implemented successfully in public clinics in 10 of 14 local health districts, with widespread support and no serious safety events reported. With the increasing importance of PrEP as an HIV prevention tool, non-traditional models of care, including nurse-led PrEP, are needed.

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