scholarly journals Putting Policy into Practice: How Three Cancer Services Perform against Indigenous Health and Cancer Frameworks

2022 ◽  
Vol 19 (2) ◽  
pp. 633
Author(s):  
Emma V. Taylor ◽  
Marilyn Lyford ◽  
Lorraine Parsons ◽  
Michele Holloway ◽  
Karla Gough ◽  
...  
Keyword(s):  
Health Services ◽  
Indigenous People ◽  
Best Practice ◽  
Torres Strait Islander ◽  
Care Pathway ◽  
Indigenous Health ◽  
Traffic Light ◽  
Optimal Care ◽  
Cancer Services ◽  
Torres Strait

Improving cancer outcomes for Indigenous people by providing culturally safe, patient-centred care is a critical challenge for health services worldwide. This article explores how three Australian cancer services perform when compared to two national best practice guidelines: the National Aboriginal and Torres Strait Islander Cancer Framework (Cancer Framework) and the National Safety and Quality Health Service (NSQHS) User Guide for Aboriginal and Torres Strait Islander Health (User Guide). The services were identified through a nationwide project undertaken to identify cancer services providing treatment to Indigenous cancer patients. A small number of services which were identified as particularly focused on providing culturally safe cancer care participated in case studies. Interviews were conducted with 35 hospital staff (Indigenous and non-Indigenous) and 8 Indigenous people affected by cancer from the three services. The interviews were analysed and scored using a traffic light system according to the seven priorities of the Cancer Framework and the six actions of the NSQHS User Guide. While two services performed well against the User Guide, all three struggled with the upstream elements of the Cancer Framework, suggesting that the treatment-focused Optimal Care Pathway for Aboriginal and Torres Strait Islander People with Cancer (Cancer Pathway) may be a more appropriate framework for tertiary services. This article highlights the importance of a whole-of-organisation approach when addressing and embedding the six actions of the User Guide. Health services which have successfully implemented the User Guide are in a stronger position to implement the Cancer Framework and Cancer Pathway.

scholarly journals A National Priority: Improving Outcomes for Aboriginal and Torres Strait Islander People With Cancer Through an Optimal Care Pathway

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 243s-243s
Author(s):  
J. Chynoweth ◽  
B. Daveson ◽  
M. McCambridge ◽  
J. Coutts ◽  
H. Zorbas ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Care Pathway ◽  
Indigenous Health ◽  
Indigenous Australians ◽  
Evidence Based ◽  
Culturally Appropriate ◽  
Torres Strait Islander People ◽  
Optimal Care ◽  
Leadership Group ◽  
Torres Strait

Background and context: Cancer survival rates in Australia are among the best in the world, yet Aboriginal and Torres Strait Islander (indigenous) people continue to experience disparities in the distribution and burden of cancer, and unwarranted variations in outcomes. Indigenous Australians are 40% more likely to die of cancer than non-Indigenous Australians. Cancer Australia developed the National Aboriginal and Torres Strait Islander Cancer Framework (the framework), which identified 7 national priorities to address disparities in cancer outcomes experienced by indigenous Australians. An ongoing collaboration with indigenous Australians was integral to developing this shared agenda. Priority 5 in the framework highlights the need to ensure indigenous Australians affected by cancer receive optimal and culturally appropriate treatment, services, and supportive and palliative care. Aim: To improve cancer outcomes for indigenous Australians through the development and national endorsement of a population-specific Optimal Care Pathway (OCP) to guide the delivery of consistent, safe, high-quality, culturally appropriate and evidence-based care. Strategy/Tactics: Cancer Australia formed a partnership with the Victorian Department of Health and Human Services (DHHS) to address Priority 5 and develop the OCP. The approach to development was underpinned by Cancer Australia's Model of Engagement for Aboriginal and Torres Strait Islander People and guided by the national Leadership Group on Aboriginal and Torres Strait Islander Cancer Control (Leadership Group). Program/Policy process: Cancer Australia, in collaboration with DHHS: • reviewed experiences of care and the framework's comprehensive evidence base • developed a draft OCP to complement tumor-specific pathways • facilitated an Expert Working Group, comprising indigenous health sector leaders and consumers to refine and validate the draft OCP • undertook national public consultation, including with the indigenous health sector and community, health professionals and professional colleges • received an indication of support to proceed to endorsement from the Leadership Group. Outcomes: The first population-specific OCP for Aboriginal and Torres Strait Islander people with cancer received national endorsement. It will guide the delivery of consistent, safe, high-quality, culturally appropriate and evidence-based care. What was learned: Key elements of optimal care include: addressing the cultural appropriateness of the healthcare environment; improving cross-cultural communication; relationship building with local community; optimizing health literacy; recognition of men's and women's business; and the need to use culturally appropriate resources. The national priority in the framework informed and unified high-level direction, which was integral to effective OCP development and endorsement. The evidence-based, step-wise development approach contributed to its relevance, utility and quality.

scholarly journals Optimal Cancer Care for Aboriginal and Torres Strait Islander People: A Shared Approach to System Level Change

2020 ◽  
pp. 108-114 ◽  
Author(s):  
Jennifer Chynoweth ◽  
Meaghan M. McCambridge ◽  
Helen M. Zorbas ◽  
Jacinta K. Elston ◽  
Robert J.S. Thomas ◽  
...  
Keyword(s):  
Health Services ◽  
Health Professionals ◽  
Cancer Care ◽  
Torres Strait Islander ◽  
Care Pathway ◽  
System Level ◽  
Culturally Appropriate ◽  
Torres Strait Islander People ◽  
Cultural Appropriateness ◽  
Torres Strait

PURPOSE To improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care. METHODS An iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the Indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers. RESULTS The OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men’s and women’s business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway. CONCLUSION The development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with Indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.

The Centre of Clinical Research Excellence in Aboriginal and Torres Strait Islander Health: An Operational Rationale and Some Reflections on Progress so far

2006 ◽  
Vol 12 (2) ◽  
pp. 97 ◽  
Author(s):  
Glenn Giles ◽  
Merridy Malin ◽  
Peter Harvey
Keyword(s):  
Health Services ◽  
Clinical Research ◽  
Indigenous People ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Health Council ◽  
Torres Strait ◽  
Research Excellence ◽  
Torres Strait Islander Health

The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.

Aboriginal and Torres Strait Islander Health — Current Policy Issues

1998 ◽  
Vol 26 (1) ◽  
pp. 18-24
Keyword(s):  
Indigenous People ◽  
Torres Strait Islander ◽  
Health Problems ◽  
Australian Bureau ◽  
Government Policies ◽  
Current Policy ◽  
Policy Issues ◽  
Torres Strait ◽  
Australian Bureau Of Statistics ◽  
Torres Strait Islander Health

This article addresses Aboriginal and Torres Strait Islander health problems and critically investigates current government policies which are attempting to raise the health standards of these Indigenous people. Particular emphasis will be placed on the Queensland Aboriginal and Torres Strait Islander population, which, according to the Australian Bureau of Statistics census in 1986, stood at just over 61,000 or 2.4 per cent of the State's population.

Exploring Leave Events for Aboriginal and Torres Strait Islander People From Australian Tertiary Services: A Systematic Literature Review

2020 ◽  
Author(s):  
Julieann Coombes ◽  
Syazlin Sazali ◽  
Tamara Mackean ◽  
Margaret Banks ◽  
Nilva Egana ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Primary Objective ◽  
Google Scholar ◽  
Evidence Based ◽  
Torres Strait Islander People ◽  
Policy Document ◽  
Manual Search ◽  
Preventative Measures ◽  
Torres Strait

Abstract Objective The primary objective of this systematic review was to identify contributing causes to leave events from health services for Australian patients. The second objective was to identify evidence based preventative measures for effectively reducing leave events, which could be implemented. Study design Articles published in Australia were included if they reported on Aboriginal and/or Torres Strait Islander people and other Australians who leave health services prior to being seen or discharged by a medical professional. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed, and data were extracted with standardised tools.Data sources MEDLINE and Google Scholar were searched for relevant publications from May 27th to June 30th, 2020. The search returned 30 relevant records. Nine additional records were identified by manual search in Google Scholar. References of included articles were searched. From these articles, 11 met the inclusion criteria. Of these 5 were from New South Wales, 2 from Western Australia, 1 each from Queensland and Northern Territory, two were conducted nationally. Data synthesis Four studies used a retrospective cohort method, one included patient interviews,(1) Four cohort studies and two systematic reviews were included. Two government reports and one health policy document were included in this review. All studies were from Australia using mixed methods.Conclusions This review identified causes for, and evidence based preventative measures that have been or could be implemented to reduce Leave Events and describes additional terms and definitions used for Leave Events.

Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services

Sexual Health ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. 320 ◽  
Author(s):  
Mary Ellen Harrod ◽  
Sophia Couzos ◽  
James Ward ◽  
Mark Saunders ◽  
Basil Donovan ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Clinical Encounter ◽  
Current Approach ◽  
Research Network ◽  
Torres Strait Islander People ◽  
Remote Communities ◽  
Aboriginal Community ◽  
Torres Strait ◽  
Concurrent Testing

Background Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.

What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce?

2013 ◽  
Vol 37 (1) ◽  
pp. 112 ◽  
Author(s):  
Karen Watson ◽  
Jeanine Young ◽  
Margaret Barnes
Keyword(s):  
Child Health ◽  
Health Services ◽  
Cultural Awareness ◽  
Torres Strait Islander ◽  
Health Workers ◽  
Overall Acceptability ◽  
Torres Strait ◽  
Use Of Health Services ◽  
Torres Strait Islander Health

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship. What is known about the topic? Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this population. What does this paper add? Through consultation with a sample of Indigenous child health workers and child health workers key areas necessary to provide support for the individuals working in these roles have been identified. What are the implications for practitioners? The findings from this study will inform policy and program development in order to more comprehensively support health workers in the community and contribute towards workforce development and satisfaction, recruitment and retention.

Bicultural Stress: An Aboriginal Community Perspective

1996 ◽  
Vol 2 (2) ◽  
pp. 78 ◽  
Author(s):  
Christine Salisbury ◽  
Sue Follent
Keyword(s):  
Public Health ◽  
Health Services ◽  
Cultural Sensitivity ◽  
Torres Strait Islander ◽  
Public Mental Health ◽  
Stressful Events ◽  
Public Health Services ◽  
Stress Symptoms ◽  
Torres Strait ◽  
Barriers To Use

A survey was designed to assess and to compare the levels of stress being experienced by Aboriginal and Torres Strait Islander and non-Aboriginal respondents. The survey covered a range of areas including demographics, access to transport, drug and alcohol use, use of public services, identification of stressful events in the past 12 months and a self evaluation of stress symptoms. The groups were matched by age, sex and income. The results showed differences between the stressful events and stress symptoms reported by the two groups, with the Aboriginal and Torres Strait Islander group reporting considerably higher levels. There were significant differences in access to transport and use of public health facilities. The barriers to the use of public health services were identified. A major finding was that 69% of the Aboriginal and Torres Strait Islander sample experienced more than one loss through death compared to 5% of the non-Aboriginal sample in the previous 12 months. It was concluded that the Aboriginal and Torres Strait Islander sample experienced more stressful events, had more stress related symptoms and used public mental health services less than the non-Aboriginal sample. The barriers to use of services were a lack of cultural sensitivity and the discomfort experienced by the Aboriginal and Torres Strait Islander sample when accessing services. A partnership with the Aboriginal and Torres Strait Islander community is required to develop a public health service that is acceptable and useful to the Aboriginal and Torres Strait Islander sample.

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