Linking community with key research implementation activities Improving the Culture of Hospitals Project John Willis Project Manager Improving the Culture of Hospitals Project LaTrobe University Congress Lowitja March 2010

Literature review Cultural sensitivity needs to take a system wide approach to be effective Systemic change is required not just training Continuous Quality Improvement (CQI) has been effective in improving health care for non-Aboriginal Australians CQI can be adapted to be culturally specific and requires involvement of Aboriginal staff and community There needs to be a cultural shift in the way hospitals approach quality

Background Aboriginal & Torres Strait Islander Accreditation Report (Renhard & Anderson, 2002) Data accuracy due to two factors Effectiveness of admin practices and systems Preparedness of ATSI people to identify Link b/w data accuracy and status disclosure means we need to develop culturally safe services To bring about organisational change, need explicit accountability framework accompanied by data collection and analysis Level of effectiveness of relationships with Aboriginal communities will be determined by the absence or presence of management systems

Background (cont.) Improving the Culture of Hospitals Project (Renhard, Chong, Willis, Clarke & Wilson, 2010) Examined successful Aboriginal and Torres Strait Islander programs within a quality improvement framework Information used to generate Framework and Toolkit which includes tools and guidelines for each step of the quality improvement process Aim is to bring about and sustain cultural change within the hospital environment to improve cultural sensitivity

ICHP Learning's Helped us think about building relationships with the communities in a strategic way not just in terms of developing an antenatal leaflet. This Toolkit explicitly identifies consultation with Aboriginal and Torres Strait Islander communities which is often missed in other processes.’ We need more resources like this that help us gather information from families and people…that help us say ‘tell us your story’ rather than rely on complaints procedures.

ICHP Learning's Hospital executive made this comment: We need EQuIP to include a standard that specifically refers to Aboriginal and Torres Strait Islander cultural sensitivity. It could be framed in a cultural way like ‘how well is the Aboriginal patient’s milieu taken into account in the provision of care’… and then links the Toolkit as a resource… to assist hospital staff to respond to the standard.

Project Recommendations 1. Senior hospital staff should undertake training 2. Health funding agreements should: a) Recommend the use of the ICHP Framework and Toolkit including the establishment of a national Aboriginal CQI clearing house b) Hospital funding agreements should include training for AHLO CQI training program and maintenance of network of Aboriginal CQI workers 3. Commonwealth, state and territory health funding should provide funds for further research and development ICHP Framework and Toolkit. 4. Australian Council of Healthcare Standards (ACHS) should include Aboriginal specific standards and include reference to ICHP Framework and Toolkit 5. An evaluation of Aboriginal specific CQI process and tools should be conducted in two years

Knowledge Transfer First round table meeting: with ACHS and high level jurisdictional staff from the Commonwealth, states and territories responsible for acute care policy monitoring and development to explore the findings from the project Second round table meeting: with ACHS and key ICHP stakeholders, predominantly Aboriginal and Torres Strait Islander staff to provide feedback on draft Aboriginal specific standards

Outcomes The knowledge transfer activity has: Facilitated key Aboriginal and Torres Strait Islander project stakeholders in providing expert feedback to ACHS Provided ACHS with broader Aboriginal and Torres Strait Islander feedback than their original process Provided ACHS with the experience of how to engage with the Aboriginal & Torres Strait Islander sector Facilitated General Manager of Hospital hearing the issues first hand from key Aboriginal & Torres Strait Islander people