scholarly journals Patient Journey Mapping To Investigate Quality and Cultural Safety in Burn Care for Aboriginal and Torres Strait Islander Children and Families – Development, Application and Implications

2021 ◽  
Author(s):  
Sarah Fraser ◽  
Tamara Mackean ◽  
Julian Grant ◽  
Kate Hunter ◽  
Courtney Ryder ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Quality Care ◽  
Adverse Outcomes ◽  
Cultural Safety ◽  
Standards Of Care ◽  
Children And Families ◽  
Patient Journey ◽  
Burn Care ◽  
Torres Strait ◽  
Safe Care

Abstract Background Quality and safety in Australian healthcare is inequitably distributed, highlighted by gaps in the provision of quality care for Aboriginal and Torres Strait Islander children. Burns have potential for long-term adverse outcomes, and quality care, including culturally safe care, is critical to recovery. This study aimed to develop and apply an Aboriginal Patient Journey Mapping (APJM) tool to investigate the quality of healthcare systems for burn care with Aboriginal and Torres Strait Islander children. Study Design Interface research methodology, using biomedical and cultural evidence, informed the modification of an existing APJM tool. The tool was then applied to the journey of one family accessing a paediatric tertiary burn care site. Data were collected through yarning with the family, case note review and clinician interviews. Data were analysed using Emden’s core story and thematic analysis methods. Reflexivity informed consideration of the implications of the APJM tool, including its effectiveness and efficiency in eliciting information about quality and cultural safety. Results Through application of a modified APJM tool, gaps in quality care for Aboriginal and Torres Strait Islander children and families were identified at the individual, service and system levels. Engagement in innovative methodology incorporating more than biomedical standards of care, uncovered critical information about the experiences of culturally safe care in complex patient journeys. Conclusion Based on our application of the tool, APJM can identify and evaluate specific aspects of culturally safe care as experienced by Aboriginal and Torres Strait Islander peoples and be used for quality improvement.

scholarly journals “This is My Boy’s Health! Talk Straight to Me!” Perspectives on Accessible and Culturally Safe Care Among Aboriginal and Torres Strait Islander Patients of Clinical Genetics Services

2020 ◽  
Author(s):  
Philippa Dalach ◽  
Ravi Savarirayan ◽  
Gareth Baynam ◽  
Julie McGaughran ◽  
Emma Kowal ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Clinical Genetics ◽  
Torres Strait Islander People ◽  
Patient Journey ◽  
Service Engagement ◽  
Genetics Services ◽  
Clinical Genetics Services ◽  
Torres Strait ◽  
Safe Care

Abstract BackgroundAboriginal and Torres Strait Islander people do not enjoy equal access to specialist health services that adequately meet their needs. Clinical genetics services are at the vanguard of realising the health benefits of genomic medicine. As the field continues to expand in clinical utility and implementation it is critical that Aboriginal and Torres Strait Islander people are able to participate and benefit equally to avoid further widening of the existing health gap. This is the first study to explore barriers to accessing clinical genetics services among Aboriginal and Torres Strait Islander people, which has been acknowledged as a key strategic priority in Australian genomic health policy.MethodsA participatory design process engaged a majority-Aboriginal Project Reference Group and Aboriginal End-User Group. 63 semi-structured interviews were conducted with Aboriginal and/or Torres Strait Islander people who had accessed the government-funded clinical genetics service in Western Australia, Queensland or the Northern Territory between 2014-2018. The sample included patients, parents and carers. Participants were asked to recount their ‘patient journey’, from referral through to post-appointment and reflect on their perceptions of genetics and its implications for the health of themselves and their families. Analysis tracked chronological service engagement, followed by an inductive thematic approach. ResultsBarriers to access and engagement were present at each stage of the patient journey. These included challenges in obtaining a referral, long waiting periods, limited genetic literacy, absence of Aboriginal support services, communication challenges and lack of adequate psychosocial support and follow-up after attendance. Participants’ overall experiences of attending a genetic health service were varied, with positive perceptions tied closely to a diagnosis being achieved. The experience of (and expectation for) recognition of cultural identity and provision of culturally safe care was low among participants. Unaddressed concerns continued to cause significant distress in some people years after their appointment took place.ConclusionsThere is significant scope for improving the care provided to Aboriginal and Torres Strait Islander people at clinical genetics services. Immediate attention to minimising logistical barriers, developing relationships with Aboriginal Community Controlled Health Services and providing practical and specific cultural safety training for practitioners is required at the service-level. Our findings strongly support the development of guidelines or policies recognising the collective cultural needs of Aboriginal and Torres Strait Islander people in relation to genomic health care.

scholarly journals “This is my boy’s health! Talk straight to me!” perspectives on accessible and culturally safe care among Aboriginal and Torres Strait Islander patients of clinical genetics services

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Philippa Dalach ◽  
Ravi Savarirayan ◽  
Gareth Baynam ◽  
Julie McGaughran ◽  
Emma Kowal ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Clinical Genetics ◽  
Torres Strait Islander People ◽  
Patient Journey ◽  
Service Engagement ◽  
Genetics Services ◽  
Clinical Genetics Services ◽  
Torres Strait ◽  
Safe Care

Abstract Background Aboriginal and Torres Strait Islander people do not enjoy equal access to specialist health services that adequately meet their needs. Clinical genetics services are at the vanguard of realising the health benefits of genomic medicine. As the field continues to expand in clinical utility and implementation, it is critical that Aboriginal and Torres Strait Islander people are able to participate and benefit equally to avoid further widening of the existing health gap. This is the first study to explore barriers to accessing clinical genetics services among Aboriginal and Torres Strait Islander people, which has been acknowledged as a key strategic priority in Australian genomic health policy. Methods A participatory design process engaged a majority-Aboriginal Project Reference Group and Aboriginal End-User Group. 63 semi-structured interviews were conducted with Aboriginal and/or Torres Strait Islander people who had accessed the government-funded clinical genetics service in Western Australia, Queensland or the Northern Territory between 2014 and 2018. The sample included patients, parents and carers. Participants were asked to recount their ‘patient journey’, from referral through to post-appointment and reflect on their perceptions of genetics and its implications for the health of themselves and their families. Analysis tracked chronological service engagement, followed by an inductive thematic approach. Results Barriers to access and engagement were present at each stage of the patient journey. These included challenges in obtaining a referral, long waiting periods, limited genetic literacy, absence of Aboriginal support services, communication challenges and lack of adequate psychosocial support and follow-up after attendance. Participants’ overall experiences of attending a genetic health service were varied, with positive perceptions tied closely to a diagnosis being achieved. The experience of (and expectation for) recognition of cultural identity and provision of culturally safe care was low among participants. Unaddressed concerns continued to cause significant distress in some people years after their appointment took place. Conclusions There is significant scope for improving the care provided to Aboriginal and Torres Strait Islander people at clinical genetics services. Immediate attention to minimising logistical barriers, developing relationships with Aboriginal Community Controlled Health Services and providing practical and specific cultural safety training for practitioners is required at the service-level. Our findings strongly support the development of guidelines or policies recognising the collective cultural needs of Aboriginal and Torres Strait Islander people in relation to genomic health care.

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.

An appreciative inquiry to identify the continuing education needs of Aboriginal and Torres Strait Islander health practitioners in regional Queensland

2020 ◽  
pp. 1-11
Author(s):  
Julie-Anne Martyn ◽  
Ann Woolcock
Keyword(s):  
Continuing Education ◽  
Appreciative Inquiry ◽  
Torres Strait Islander ◽  
Quality Care ◽  
Career Aspirations ◽  
Future Research ◽  
Advisory Group ◽  
Health Practitioners ◽  
Torres Strait ◽  
Torres Strait Islander Health

Abstract Aboriginal and Torres Strait Islander health practitioners (Practitioners) have a broad scope of practice and play a pivotal role in addressing health disparities for Aboriginal and Torres Strait Islander people. Practitioners are required to maintain knowledge and skill levels to provide ongoing quality care. However, continuing education (CE) opportunities for Practitioners in regional areas are limited and little is known about the types of CE best suited to Practitioners. This study aimed to identify the CE needs of Practitioners working in a South-East Queensland region in Australia. Participatory action research and appreciative inquiry were combined in this multi-staged study. A local Aboriginal and Torres Strait Islander advisory group provided cultural guidance for the study design and implementation. Supervisors and Practitioners from two Aboriginal Medical Services consented to participate. In stage one of this study, the supervisors were interviewed and the Practitioners contributed to focus groups. The Practitioners prioritised their CE needs in the second study stage using a questionnaire. The participants identified Practitioner CE needs and group 2 listed their career aspirations and the best practitioners were described as ‘Deadly’. The Deadly practitioner had diverse practice knowledge, skills and attributes. The Practitioners had career aspirations beyond their role and a desire to learn. However, their career advancement was stifled by a lack of CE opportunities. CE in regional areas is limited. Practitioners are disadvantaged by exclusion. Enhancing CE opportunities for Practitioners will positively impact the health of regional Aboriginal and Torres Strait Islander communities by building social capital. Therefore, future research on Practitioner roles and CE is needed.

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.

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.

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.

Assessing cultural safety in Aboriginal and Torres Strait Islander Health

2021 ◽  
Author(s):  
Liz Withall ◽  
Courtney Ryder ◽  
Tamara Mackean ◽  
Wendy Edmondson ◽  
David Sjoberg ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Cultural Safety ◽  
Torres Strait ◽  
Torres Strait Islander Health
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