Improving the Service to Aboriginal and Torres Strait Islanders through Innovative Practices Between Aboriginal Hospital Liaison Officers and Social Workers in Hospitals in Victoria, Australia†

2020 ◽  
Author(s):  
Helen Bnads ◽  
Elizabeth Orr ◽  
C John Clements
Keyword(s):  
First Nations ◽  
Social Workers ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Public Hospitals ◽  
Cultural Safety ◽  
Colonial Legacy ◽  
Torres Strait ◽  
First Nations People

Abstract Aboriginal and Torres Strait Islanders have suffered violence and extreme prejudice in every walk of life as a result of the European colonisation of Australia. We acknowledge the ongoing colonial legacy to this suffering and discuss how cultural safety is a solution to overcoming some elements of the disadvantages that still beset Aboriginal and Torres Strait Islander people in terms of accessing health care. Accessible and culturally safe health services are critical in reducing health inequalities for First Nations’ people because of the burden of ill-health they experience. ‘Cultural safety’ in this context refers to approaches that strengthen and respectfully engage with Aboriginal and Torres Strait Islander cultures in mainstream services. Alongside holistic Indigenous health and primary prevention approaches, a broad range of medical, socio-cultural and allied health support is needed to alleviate these inequalities. In this article, we describe how the working relationship between Aboriginal Hospital Liaison Officers and Social Workers in public hospitals in Victoria, Australia, contributes to cultural safety, and thereby improves the quality of care and a reduction in discharges against medical advice by Aboriginal patients. We conclude that elements of this model may be applicable to improving care for First Nation peoples in other countries.

scholarly journals Release of the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
James M. Gerrard ◽  
Shirley Godwin ◽  
Vivienne Chuter ◽  
Shannon E. Munteanu ◽  
Matthew West ◽  
...  
Keyword(s):  
Health Outcomes ◽  
First Nations ◽  
Torres Strait Islander ◽  
Collective Responsibility ◽  
Cultural Safety ◽  
Main Body ◽  
Torres Strait ◽  
The Impact ◽  
Torres Strait Islander Health ◽  
Safety Strategy

Abstract Background Developing since colonisation, Australia’s healthcare system has dismissed an ongoing and successful First Nations health paradigm in place for 60,000 years. From Captain James Cook documenting ‘very old’ First Nations Peoples being ‘far more happier than we Europeans’ and Governor Arthur Phillip naming Manly in admiration of the physical health of Gadigal men of the Eora Nation, to anthropologist Daisy Bates’ observation of First Nations Peoples living ‘into their eighties’ and having a higher life expectancy than Europeans; our healthcare system’s shameful cultural safety deficit has allowed for an Aboriginal and Torres Strait Islander child born in Australia today to expect to live 9 years less than a non-Indigenous child. Disproportionately negative healthcare outcomes including early onset diabetes-related foot disease and high rates of lower limb amputation in Aboriginal and Torres Strait Islander Peoples contribute to this gross inequity. Main body In 2020, the Australian Health Practitioner Regulation Authority released the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020–2025 - empowering all registered health practitioners within Australia to provide health care to Aboriginal and Torres Strait Islander Peoples that is inclusive, respectful and safe, as judged by the recipient of care. This recently released strategy is critically important to the podiatry profession in Australia. As clinicians, researchers and educators we have a collective responsibility to engage with this strategy of cultural safety. This commentary defines cultural safety for podiatry and outlines the components of the strategy in the context of our profession. Discussion considers the impact of the strategy on podiatry. It identifies mechanisms for podiatrists in all settings to facilitate safer practice, thereby advancing healthcare to produce more equitable outcomes. Conclusion Aboriginal and Torres Strait Islander Peoples access health services more frequently and have better health outcomes where provision of care is culturally safe. By engaging with the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, all registered podiatrists in Australia can contribute to achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples.

Culturally safe health care practice for Indigenous Peoples in Australia: A systematic meta-ethnographic review

2021 ◽  
pp. 135581962110418
Author(s):  
Stephanie De Zilva ◽  
Troy Walker ◽  
Claire Palermo ◽  
Julie Brimblecombe
Keyword(s):  
Health Care ◽  
Indigenous Peoples ◽  
Health Care Services ◽  
Torres Strait Islander ◽  
Indigenous Health ◽  
Cultural Knowledge ◽  
Cultural Safety ◽  
Care Practice ◽  
Health Care Practice ◽  
Torres Strait

Objectives Culturally safe health care services contribute to improved health outcomes for Aboriginal and Torres Strait Islander Peoples in Australia. Yet there has been no comprehensive systematic review of the literature on what constitutes culturally safe health care practice. This gap in knowledge contributes to ongoing challenges providing culturally safe health services and policy. This review explores culturally safe health care practice from the perspective of Indigenous Peoples as recipients of health care in Western high-income countries, with a specific focus on Australian Aboriginal and Torres Strait Islander Peoples. Methods A systematic meta-ethnographic review of peer-reviewed literature was undertaken across five databases: Ovid MEDLINE, Scopus, PsychINFO, CINAHL Plus and Informit. Eligible studies included Aboriginal and Torres Strait Islander Peoples receiving health care in Australia, had a focus on exploring health care experiences, and a qualitative component to study design. Two authors independently determined study eligibility (5554 articles screened). Study characteristics and results were extracted and quality appraisal was conducted. Data synthesis was conducted using meta-ethnography methodology, contextualised by health care setting. Results Thirty-four eligible studies were identified. Elements of culturally safe health care identified were inter-related and included personable two-way communication, a well-resourced Indigenous health workforce, trusting relationships and supportive health care systems that are responsive to Indigenous Peoples’ cultural knowledge, beliefs and values. Conclusions These elements can form the basis of interventions and strategies to promote culturally safe health care practice and systems in Australia. Future cultural safety interventions need to be rigorously evaluated to explore their impact on Indigenous Peoples’ satisfaction with health care and improvements in health care outcomes.

Transforming First Nations’ health governance in British Columbia

2016 ◽  
Vol 21 (4) ◽  
pp. 229-244 ◽  
Author(s):  
John O’Neil ◽  
Joe Gallagher ◽  
Lloy Wylie ◽  
Brittany Bingham ◽  
Josee Lavoie ◽  
...  
Keyword(s):  
British Columbia ◽  
Health System ◽  
First Nations ◽  
Indigenous Health ◽  
Service Planning ◽  
Cultural Safety ◽  
Health Governance ◽  
Content Type ◽  
Governance Process ◽  
First Nations People

Purpose The purpose of this paper is to present a study of the transformation of First Nations’ health governance, describing the development of partnerships between First Nations and provincial and federal governments for co-creating solutions to address First Nations’ health inequities in British Columbia (BC). The paper frames this transformation in the context of a Canada-wide reconciliation initiative stimulated by the Truth and Reconciliation Commission. Design/methodology/approach This qualitative case study was a joint initiative between Simon Fraser University and the BC First Nations Health Authority (FNHA), involving interviews with senior leaders within the BC health system, FNHA and First Nations communities. In addition, a policy roundtable was held in February 2015 which gathered 60 participants for further dialogue on the process. Findings Key themes included: partnership and relationships, governance and reciprocal accountability, First Nations perspectives on health and wellness, and quality and cultural safety. Findings indicate that significant transformational changes have happened in the relationship between First Nations and the mainstream health system. The creation of the FNHA has led to more representation for First Nations people at all levels of governance and health service planning, which will ultimately lead to more culturally safe health services that incorporate a First Nations perspective of wellness. Social implications The transformation of First Nations health governance in BC can serve as an example in other indigenous health settings both within Canada and internationally. Originality/value This paper describes a transformative health governance process in First Nations communities that is an historical first in Canada.

scholarly journals An Aboriginal and Torres Strait Islander Cardiac Rehabilitation program delivered in a non-Indigenous health service (Yeddung Gauar): a mixed methods feasibility study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicole Freene ◽  
Roslyn Brown ◽  
Paul Collis ◽  
Chris Bourke ◽  
Katharine Silk ◽  
...  
Keyword(s):  
Health Service ◽  
Health Professionals ◽  
Cultural Awareness ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Indigenous Health ◽  
Cultural Safety ◽  
Awareness Training ◽  
Aboriginal Women ◽  
Torres Strait

Abstract Background There is limited evidence of Aboriginal and Torres Strait Islander people attending cardiac rehabilitation (CR) programs despite high levels of heart disease. One key enabler for CR attendance is a culturally safe program. This study evaluates improving access for Aboriginal and Torres Strait Islander women to attend a CR program in a non-Indigenous health service, alongside improving health workforce cultural safety. Methods An 18-week mixed-methods feasibility study was conducted, with weekly flexible CR sessions delivered by a multidisciplinary team and an Aboriginal and/or Torres Strait Islander Health Worker (AHW) at a university health centre. Aboriginal and Torres Strait Islander women who were at risk of, or had experienced, a cardiac event were recruited. Data was collected from participants at baseline, and at every sixth-session attended, including measures of disease risk, quality-of-life, exercise capacity and anxiety and depression. Cultural awareness training was provided for health professionals before the program commenced. Assessment of health professionals’ cultural awareness pre- and post-program was evaluated using a questionnaire (n = 18). Qualitative data from participants (n = 3), the AHW, health professionals (n = 4) and referrers (n = 4) was collected at the end of the program using yarning methodology and analysed thematically using Charmaz’s constant comparative approach. Results Eight referrals were received for the CR program and four Aboriginal women attended the program, aged from 24 to 68 years. Adherence to the weekly sessions ranged from 65 to 100%. At the program’s conclusion, there was a significant change in health professionals’ perception of social policies implemented to ‘improve’ Aboriginal people, and self-reported changes in health professionals’ behaviours and skills. Themes were identified for recruitment, participants, health professionals and program delivery, with cultural safety enveloping all areas. Trust was a major theme for recruitment and adherence of participants. The AHW was a key enabler of cultural authenticity, and the flexibility of the program contributed greatly to participant perceptions of cultural safety. Barriers for attendance were not unique to this population. Conclusion The flexible CR program in a non-Indigenous service provided a culturally safe environment for Aboriginal women but referrals were low. Importantly, the combination of cultural awareness training and participation in the program delivery improved health professionals’ confidence in working with Aboriginal people. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) 12618000581268, http://www.ANZCTR.org.au/ACTRN12618000581268.aspx, registered 16 April 2018.

scholarly journals Cultural safety for First Nations people in aged care

2021 ◽  
pp. 1-7
Author(s):  
Linda Michelle Deravin ◽  
Judith Anderson ◽  
Nicole Mahara
Keyword(s):  
First Nations ◽  
Aged Care ◽  
Cultural Safety ◽  
Nations People ◽  
First Nations People

scholarly journals In the pursuit of equity: COVID-19, data and Aboriginal and Torres Strait Islander people in Australia

2021 ◽  
Vol 37 (1) ◽  
pp. 37-45
Author(s):  
Kalinda Griffiths ◽  
Ian Ring ◽  
Richard Madden ◽  
Lisa Jackson Pulver
Keyword(s):  
Public Health ◽  
Torres Strait Islander ◽  
Self Determination ◽  
Quality Of Data ◽  
Success Story ◽  
Torres Strait Islander People ◽  
Pandemic Planning ◽  
The Future ◽  
Torres Strait

Since March 2020 in Australia, there has been decisive national, and state and territory policy as well as community led action involving Aboriginal and Torres Strait Islander people as information about COVID-19 arose. This has resulted in, what could only be framed as a success story in self-determination. However, there continues to be issues with the quality of data used for the surveillance and reporting of Aboriginal and Torres Strait Islander people during the pandemic. This article discusses some of the important events in pandemic planning regarding Aboriginal and Torres Strait Islander people and how this relates to surveillance and monitoring in the emerging and ongoing threat of COVID-19 within Aboriginal and Torres Strait Islander communities. The authors also identify some of the data considerations required in the future to monitor and address public health.

scholarly journals Culturally safe and sustainable solution for Closing the Gap-registered patients discharging from a tertiary public hospital

2020 ◽  
Vol 44 (2) ◽  
pp. 200
Author(s):  
Scott Mitchell ◽  
Hayley Michael ◽  
Stephanie Highden-Smith ◽  
Vivian Bryce ◽  
Sean Grugan ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Public Hospital ◽  
Torres Strait Islander ◽  
Culturally Sensitive ◽  
Public Hospitals ◽  
Smooth Transition ◽  
Cardiac Care ◽  
Funding Model ◽  
Closing The Gap ◽  
Torres Strait

This case study describes the development, implementation and review of a sustainable and culturally sensitive procedure for a hospital-funded discharge medicine subsidy for Aboriginal and Torres Strait Islander patients registered with the Closing the Gap (CTG) program discharging from a public hospital. A 7-day fully subsidised medication supply was approved to be offered to Aboriginal and Torres Strait Islander patients admitted under cardiac care teams, including cardiology and cardiothoracic surgery patients. Patients were offered the option of a 7-day supply free of cost to them or a full Pharmaceutical Benefits Scheme (PBS) supply if preferred. A general practitioner (GP) appointment was organised within 7 days of discharge to ensure patients received ongoing supply of their medications as well as timely clinical review after discharge. Over a 34-month period from September 2015 to June 2018, 535 Aboriginal and Torres Strait Islander patients were admitted to the hospital under cardiac care teams. Of these patients, 296 received a subsidised discharge medication supply with a total cost of A$6314.56 to the hospital over the trial period, with a mean cost of A$21.26 per discharge. The provision of subsidised medications through the CTG program has improved the continuity of care for Aboriginal and Torres Strait Islander patients. The culturally sensitive approach is well received and has allowed smooth transition back to the community. This site-specific and state-based funding model was found to be financially sustainable at a public hospital. What is known about the topic?The CTG PBS program is not applicable to discharge prescriptions from public hospitals. As such, patients are required to either leave the hospital with no medicines or leave the hospital with medicines for which they have to pay full PBS price. This creates a huge financial barrier to the care for CTG-registered patients in the acute care setting. What does this paper add?A sustainable solution to the problem was found via a state-funded model while providing a supportive team to ensure GP follow-up and continuity of care after discharge. What are the implications for practitioners?If similar approvals are granted and supported at other public hospital sites, practitioners will be afforded one less barrier to provide patient-centred care for Aboriginal and Torres Strait Islander patients.

scholarly journals What Matters 2 Adults: a study protocol to develop a new preference-based wellbeing measure with Aboriginal and Torres Strait Islander adults (WM2Adults)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kirsten Howard ◽  
Kate Anderson ◽  
Joan Cunningham ◽  
Alan Cass ◽  
Julie Ratcliffe ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Torres Strait Islander People ◽  
Validity Testing ◽  
Conditional Logit ◽  
Health And Wellbeing ◽  
Best Worst Scaling ◽  
Descriptive System ◽  
Torres Strait ◽  
Candidate Item

Abstract Background Understandings of health and wellbeing are culturally bound. Many Aboriginal and Torres Strait Islander people perceive wellbeing and quality of life (QOL) differently from the Western biomedical models of health underpinning existing QOL instruments. Any instrument to measure the wellbeing of Aboriginal and Torres Strait Islander people should be culturally appropriate and safe, include relevant dimensions, and be informed by their own values and preferences. Existing QOL instruments do not meet these standards. This study will generate a new preference-based wellbeing measure, WM2Adults, for Aboriginal and Torres Strait Islander adults, underpinned by their values and preferences. Methods A mixed methods approach will be used; we will employ decolonising methodologies, privilege Aboriginal and Torres Strait Islander voices and perspectives, and adopt a strengths-based approach rather than a deficit lens. Yarning Circles will be conducted with Aboriginal and Torres Strait Islander people across Australia. A candidate item pool will be developed from these data, on which psychometric analysis and validity testing will be undertaken to develop a descriptive system. Following finalisation of the descriptive system, wellbeing states will be valued using a quantitative preference-based approach (best-worst scaling) with a diverse sample of Aboriginal and Torres Strait Islander adults (n = 1000). A multinomial (conditional) logit framework will be used to analyse responses and generate a scoring algorithm for the new preference-based WM2Adults measure. Discussion The new wellbeing measure will have wide applicability in assessing the effectiveness and cost-effectiveness of new programs and services for Aboriginal and Torres Strait Islander people. Results will be disseminated through journals, conferences and policy forums, and will be shared with Aboriginal and Torres Strait Islander communities, organisations and research participants.

Review of the cultural safety of a national Indigenous point-of-care testing program for diabetes management

2016 ◽  
Vol 22 (4) ◽  
pp. 368 ◽  
Author(s):  
Mark Shephard ◽  
Christopher O'Brien ◽  
Anthony Burgoyne ◽  
Jody Croft ◽  
Trevor Garlett ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Diabetes Management ◽  
Health Workers ◽  
Point Of Care ◽  
Cultural Safety ◽  
Medical Services ◽  
Indigenous Australians ◽  
Point Of Care Testing ◽  
Group Setting ◽  
Torres Strait

In Australia, Aboriginal and Torres Strait Islander people have approximately three-fold higher rates of diabetes than non-Indigenous Australians. Point-of-care testing, where pathology tests are conducted close to the patient, with results available during the patient consultation, can potentially deliver several benefits for both the Indigenous client and the health professional team involved in their care. Currently, point-of-care testing for diabetes management is being conducted in over 180 Aboriginal and Torres Strait Islander Medical Services as part of a national program called Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS). The cultural safety of the Program was reviewed by sourcing the views of the QAAMS Indigenous Leaders Team in a focus group setting and by surveying the point-of-care testing operators enrolled in QAAMS, via an electronic questionnaire. The current study confirms that QAAMS remains a culturally safe program that fills a permanent and positive niche within the Indigenous health sector. The study demonstrates that QAAMS provides a convenient and accessible ‘one-stop’ pathology service for Indigenous clients with diabetes and empowers Aboriginal Health Workers to have a direct role in the care of their diabetes clients.

Sign in / Sign up

Export Citation Format

Share Document