The ICHP was funded by the Cooperative Research Centre for Aboriginal Health, now known as the Cooperative Research Centre for Aboriginal and Torres Strait Islander Health CRCATSIH), project managed by the Australian Institute for Primary Care, La Trobe University along with partner organisations The University of Melbourne (Onemda, Vichealth Koori Health Unit) and the Aboriginal Health Council of South Australia. The project has been guided by an Advisory Committee consisting of representatives from the Aboriginal Health Council of South Australia, The University of Melbourne, St.Vincent’s Hospital (Melbourne), La Trobe University, Royal Adelaide Hospital, Government of South Australia (Department of Health), Office of Aboriginal and Torres Strait Islander Health and the Tasmanian Department of Health and Human Services.
The aim of this project was to examine successful Aboriginal and Torres Strait Islander programs undertaken by hospitals, within a quality improvement framework. This information was used, as well as the experience of Aboriginal and Torres Strait Islander people, to explore what would support replicating and sustaining this type of work across a wide range of hospital environments. The project developed a Framework and Toolkit to assist in facilitating the organisational cultural change required to undertake this work effectively.
The ICHP has provided hospitals with a culturally appropriate quality improvement process along with a set of evidence-based tools and guidelines to facilitate a sustainable approach to Aboriginal health. The capacity of hospitals to respond more effectively to Aboriginal patients is increased by making Aboriginal health a quality issue. This will not only build the capacity of hospitals to improve their response to Aboriginal communities but also improve their effectiveness in engaging with a range of other patients with complex needs.
Clearly the Framework, Toolkit and Training Program for Aboriginal staff has been found to be essential, important, credible, practical, useful, and timely. The capacity of Aboriginal staff and communities to engage in a meaningful and effective way with hospital reform has been increased by this process. The ICHP has increased the involvement and effectiveness of non-Aboriginal clinical staff by engaging them in projects that require them to work alongside Aboriginal staff and Aboriginal communities to improve hospital service delivery to Aboriginal patients. The potential to establish a process for continuous quality improvement for cultural reform in hospitals has been increased by the ICHP, which provides a systematic approach for local communities to develop strategies in partnership with the hospital in their area. This process will take time but will build the capacity and sustainability of both hospitals and their local communities to make a difference in Aboriginal health.
As a result of this project and the initial Round Table meeting to discuss project findings, ACHS approached the CRCATSIH to provide expert feedback on their draft Aboriginal standards to be included in the next version of EQUiP. Key stakeholders involved in this project have been involved in providing that feedback and the CRCATSIH will continue to work in partnership with ACHS as the standards are rolled out and implemented across Australian hospitals. To assist this discussion, we need to look at a selection of hospitals over a longer period of time .
In conclusion, hospitals need senior management to support this work as a priority and to ensure Aboriginal staff are trained to facilitate the process. It is recommended that further longitudinal research is undertaken to look at hospitals over the long term to build evidence that supports the involvement of quality and safety units in cultural sensitivity improvements. Finally, the inclusion of Aboriginal-specific standards in the ACHS EQuIP accreditation system, informed by Aboriginal key stakeholder organisations, is seen as a key driver to assist this change, and a much welcomed development.
John Willis (Project Manager), Alwin Chong, Angela Clarke, Monica Lawrence, Gai Wilson