Abstract: It is now universally acknowledged that Australia needs to do much more to improve the health of Aboriginal people and, by doing so, to close the unacceptable life expectancy gap between Aboriginal and non-Aboriginal people. Aboriginal patients from remote areas have special needs when interacting with health systems, and these needs must be met for safe care practices and optimal health outcomes to be achieved. A growing body of evidence suggests that relatively small modifications to existing systems and practices can lead to substantial improvements in health outcomes for these Aboriginal people. This quality improvement, action research project aimed to establish if Aboriginal people living in remote areas who need to travel to a major metropolitan hospital for life-saving cardiac surgery benefit from improved arrangements around their journey to and from the hospital. The research was based in the cardio-thoracic ward at Flinders Medical Centre, Bedford Park, South Australia, and was partly funded by the Cooperative Research Centre for Aboriginal Health (CRCAH). It included the trial of a pilot Remote Area Nurse Liaison Service during the first half of 2007. Results from the research project demonstrated that improved cultural competency in a clinical setting led to: • improved clinical/cultural liaison; • increased cultural respect for remote area Aboriginal patients; • improved patient care; • enhanced patient safety; • reduced travel costs; • less disruption in the hospital system; and • improved hospital efficiencies. These outcomes have already created opportunities to influence national healthcare policy, most notably through a well-received submission to a 2007 Senate Inquiry (Parliament of Australia 2007). Recommendations for future action include: • Creating clinical/cultural liaison positions within hospital units to track remote area Aboriginal patients throughout their trajectory of care from their homelands to the hospital setting and then back to their homelands. These positions would be in addition to Aboriginal liaison officers already operating in the public health sector. • Putting a formal process in place to prepare remote area Aboriginal patients both for their journey and their treatment. • Providing a full-time Aboriginal interpreter/translation service within hospitals, including on weekends. • Improving the Northern Territory’s (NT) Patient Assistance Transport Scheme (PATS), both in its operation and its funding. • Transferring the Remote Area Nurse Liaison Service to other disciplines that provide health services to Aboriginal people. • Using the research findings as a basis for reviewing the hospital accreditation standards of practice for Aboriginal inpatients in all Australian hospitals. • Funding further research to identify the health outcomes of an improved patient journey for Aboriginal people living in remote areas.
Lawrence, M., Dodd, Z., Mohor, S., Dunn, S., de Crespigny, C., Power, C., MacKean, L., 2009, Improving the patient journey: Achieving positive outcomes for remote Aboriginal cardiac patients, Report, viewed 06 December 2023, https://www.nintione.com.au/?p=2801.