Action 1.21 states
The health service organisation has strategies to improve the cultural awareness and cultural competency of the workforce to meet the needs of its Aboriginal and Torres Strait Islander patients
Intent
Health service organisations provide a supportive environment and clear processes for the workforce to explore the cultural needs of Aboriginal and Torres Strait Islander patients.
Reflective question
How does the health service organisation work to meet the needs of Aboriginal and Torres Strait Islander patients?
Key tasks
- Ensure that actions to improve cultural competency are implemented and monitored for effectiveness.
- Review the organisation’s education and training policies and programs to ensure that they adequately cover cultural competency and monitor workforce participation in training.
- Review and maintain the organisation’s targets regarding the participation of Aboriginal and Torres Strait Islander peoples in the health workforce across clinical, managerial, support and advocacy roles.
Strategies for improvement
Hospitals
Having an effective culture in place means that an organisation has a defined set of values and principles, and demonstrates behaviours, attitudes, policies and structures that enable it to work effectively.1
Health service organisations should acknowledge and be respectful of the cultural factors and complex kinship relationships that exist in the local Aboriginal and Torres Strait Islander community.2
Aboriginal and Torres Strait Islander peoples do not always see mainstream health services as offering them a safe and secure place to get well. In many instances, they experience3:
- Isolation from community and kin
- Language barriers in understanding health messages and difficulty in informing clinicians of their needs
- Financial difficulties in gaining access to treatments (for example, travel costs) and funding the costs of the treatment
- Perceived inferior treatment.
To improve the cultural competency of both the workforce and the organisation, consider4:
- Incorporating culturally specific requirements into recruitment processes, or including Aboriginal and Torres Strait Islander peoples on the interview panel
- Addressing cultural competency as part of performance review processes
- Ensuring that the workforce participates in cultural competency activities and training in a variety of learning formats, such as training exercises, reflective practice and face-to-face training whenever possible
- Providing access to ongoing learning for individuals through training, professional development, critical reflection and practice improvement
- Providing cultural competency training that is developed in collaboration with the local Aboriginal and Torres Strait Islander communities and includes content relevant to those communities
- Monitoring and reporting on the implementation and effectiveness of the cultural competency program to the governing body or management
- Implementing follow-up strategies (including counselling, performance improvement or more stringent approaches when necessary) if a culturally appropriate approach is not adopted
- Expanding the Aboriginal and Torres Strait Islander workforce and supporting them to fulfil their role as cultural mentors
- Incorporating cultural competency into policies and program development
- Collaborating with partner communities about service and facility design, delivery and evaluation, and to seek feedback on, and improve, cultural competency.
Further strategies are available in the
Examples of evidence
Select only examples currently in use:
- Evidence of assessment of the workforce’s needs for cultural competency and cultural awareness training
- Training documents on Aboriginal and Torres Strait Islander cultural awareness and cultural competency
- Policy documents in which the needs of Aboriginal and Torres Strait Islander patients are recognised
- Review and evaluation reports of cultural awareness education and training programs
- Committee and meeting records in which the cultural needs of Aboriginal and Torres Strait Islander patients are discussed, and strategies to meet their needs are monitored or evaluated
- Employment documents that detail the roles and responsibilities of Aboriginal support officers
- Strategies for increasing employment opportunities for Aboriginal and Torres Strait Islander peoples in the organisation
- Data analysis and evaluation of feedback from the workforce and consumers about the workforce’s cultural competency and cultural awareness.
Day Procedure Services
Having an effective culture in place means that an organisation has a defined set of values and principles, and demonstrates behaviours, attitudes, policies and structures that enable it to work effectively.1
Health service organisations should acknowledge and be respectful of the cultural factors and complex kinship relationships that exist in the local Aboriginal and Torres Strait Islander community.2
Day procedure services may have a small Aboriginal and Torres Strait Islander patient population. For many Aboriginal and Torres Strait Islander peoples receiving care in a day procedure service, their risk of harm will be similar to that of the general patient population using the service. However, Aboriginal and Torres Strait Islander peoples do not always see mainstream health services as offering them a safe and secure place to get well. In many instances, they experience3:
- Isolation from community and kin
- Language barriers in understanding health messages and difficulty in informing clinicians of their needs
- Financial difficulties in gaining access to treatments (for example, travel costs) and funding the costs of the treatment
- Perceived inferior treatment.
To improve the cultural competency of both the workforce and the organisation, consider4:
- Incorporating culturally specific requirements into recruitment processes, or including Aboriginal and Torres Strait Islander peoples on the interview panel
- Addressing cultural competency as part of performance review processes
- Ensuring that the workforce participates in cultural competency activities and training in a variety of learning formats, such as training exercises, reflective practice and face-to-face training whenever possible
- Providing access to ongoing learning for individuals through training, professional development, critical reflection and practice improvement
- Providing cultural competency training that is developed in collaboration with the local Aboriginal and Torres Strait Islander communities and includes content relevant to those communities
- Monitoring and reporting on the implementation and effectiveness of the cultural competency program to the governing body or management
- Implementing follow-up strategies (including counselling, performance improvement or more stringent approaches when necessary) if a culturally appropriate approach is not adopted
- Expanding the Aboriginal and Torres Strait Islander workforce and supporting them to fulfil their role as cultural mentors
- Incorporating cultural competency into policies and program development
- Collaborating with partner communities about service and facility design, delivery and evaluation, and to seek feedback on, and improve, cultural competency.
Further strategies are available in the
Examples of evidence
Select only examples currently in use:
- Evidence of assessment of the workforce’s needs for cultural competency and cultural awareness training
- Training documents on Aboriginal and Torres Strait Islander cultural awareness and cultural competency
- Policy documents in which the needs of Aboriginal and Torres Strait Islander patients are recognised
- Review and evaluation reports of cultural awareness education and training programs
- Committee and meeting records in which the cultural needs of Aboriginal and Torres Strait Islander patients are discussed, and strategies to meet their needs are monitored or evaluated
- Employment documents that detail the roles and responsibilities of Aboriginal support officers
- Strategies for increasing employment opportunities for Aboriginal and Torres Strait Islander peoples in the organisation
- Data analysis and evaluation of feedback from the workforce and consumers about the workforce’s cultural competency and cultural awareness.
MPS & Small Hospitals
Having an effective culture in place means that an organisation has a defined set of values and principles, and demonstrates behaviours, attitudes, policies and structures that enable it to work effectively.1
MPSs and small hospitals should:
- Ensure that actions to improve cultural competency are implemented and monitored for effectiveness
- Review the organisation’s education and training policies and programs to ensure that they adequately cover cultural competency, and monitor workforce participation in training
- Review and maintain the organisation’s targets for the participation of Aboriginal and Torres Strait Islander peoples in the health workforce across clinical, managerial, support and advocacy roles.
Health service organisations should acknowledge and be respectful of the cultural factors and complex kinship relationships that exist in the local Aboriginal and Torres Strait Islander community.2
Aboriginal and Torres Strait Islander peoples do not always see mainstream health services as offering them a safe and secure place to get well. In many instances, they experience3:
- Isolation from community and kin
- Language barriers in understanding health messages and difficulty in informing clinicians of their needs
- Financial difficulties in gaining access to treatments (for example, travel costs) and funding the costs of the treatment
- Perceived inferior treatment.
To improve the cultural competency of both the workforce and the organisation, consider4:
- Incorporating culturally specific requirements into recruitment processes, or including Aboriginal and Torres Strait Islander peoples on the interview panel
- Addressing cultural competency as part of performance review processes
- Ensuring that the workforce participates in cultural competency activities and training in a variety of learning formats, such as training exercises, reflective practice and face-to-face training whenever possible
- Providing access to ongoing learning for individuals through training, professional development, critical reflection and practice improvement
- Providing cultural competency training that is developed in collaboration with the local Aboriginal and Torres Strait Islander communities and includes content relevant to those communities
- Monitoring and reporting on the implementation and effectiveness of the cultural competency program to the governing body or management
- Implementing follow-up strategies (including counselling, performance improvement or more stringent approaches when necessary) if a culturally appropriate approach is not adopted
- Expanding the Aboriginal and Torres Strait Islander workforce and supporting them to fulfil their role as cultural mentors
- Incorporating cultural competency into policies and program development
- Collaborating with partner communities about service and facility design, delivery and evaluation, and to seek feedback on, and improve, cultural competency.
Further strategies are available in the
Examples of evidence
Select only examples currently in use:
- Evidence of assessment of the workforce’s needs for cultural competency and cultural awareness training
- Training documents on Aboriginal and Torres Strait Islander cultural awareness and cultural competency
- Policy documents in which the needs of Aboriginal and Torres Strait Islander patients are recognised
- Review and evaluation reports of cultural awareness education and training programs
- Committee and meeting records in which the cultural needs of Aboriginal and Torres Strait Islander patients are discussed, and strategies to meet their needs are monitored or evaluated
- Employment documents that detail the roles and responsibilities of Aboriginal support officers
- Strategies for increasing employment opportunities for Aboriginal and Torres Strait Islander peoples in the organisation
- Data analysis and evaluation of feedback from the workforce and consumers about the workforce’s cultural competency and cultural awareness.
Hospitals
Having an effective culture in place means that an organisation has a defined set of values and principles, and demonstrates behaviours, attitudes, policies and structures that enable it to work effectively.1
Health service organisations should acknowledge and be respectful of the cultural factors and complex kinship relationships that exist in the local Aboriginal and Torres Strait Islander community.2
Aboriginal and Torres Strait Islander peoples do not always see mainstream health services as offering them a safe and secure place to get well. In many instances, they experience3:
- Isolation from community and kin
- Language barriers in understanding health messages and difficulty in informing clinicians of their needs
- Financial difficulties in gaining access to treatments (for example, travel costs) and funding the costs of the treatment
- Perceived inferior treatment.
To improve the cultural competency of both the workforce and the organisation, consider4:
- Incorporating culturally specific requirements into recruitment processes, or including Aboriginal and Torres Strait Islander peoples on the interview panel
- Addressing cultural competency as part of performance review processes
- Ensuring that the workforce participates in cultural competency activities and training in a variety of learning formats, such as training exercises, reflective practice and face-to-face training whenever possible
- Providing access to ongoing learning for individuals through training, professional development, critical reflection and practice improvement
- Providing cultural competency training that is developed in collaboration with the local Aboriginal and Torres Strait Islander communities and includes content relevant to those communities
- Monitoring and reporting on the implementation and effectiveness of the cultural competency program to the governing body or management
- Implementing follow-up strategies (including counselling, performance improvement or more stringent approaches when necessary) if a culturally appropriate approach is not adopted
- Expanding the Aboriginal and Torres Strait Islander workforce and supporting them to fulfil their role as cultural mentors
- Incorporating cultural competency into policies and program development
- Collaborating with partner communities about service and facility design, delivery and evaluation, and to seek feedback on, and improve, cultural competency.
Further strategies are available in the
Examples of evidence
Select only examples currently in use:
- Evidence of assessment of the workforce’s needs for cultural competency and cultural awareness training
- Training documents on Aboriginal and Torres Strait Islander cultural awareness and cultural competency
- Policy documents in which the needs of Aboriginal and Torres Strait Islander patients are recognised
- Review and evaluation reports of cultural awareness education and training programs
- Committee and meeting records in which the cultural needs of Aboriginal and Torres Strait Islander patients are discussed, and strategies to meet their needs are monitored or evaluated
- Employment documents that detail the roles and responsibilities of Aboriginal support officers
- Strategies for increasing employment opportunities for Aboriginal and Torres Strait Islander peoples in the organisation
- Data analysis and evaluation of feedback from the workforce and consumers about the workforce’s cultural competency and cultural awareness.
Day Procedure Services
Having an effective culture in place means that an organisation has a defined set of values and principles, and demonstrates behaviours, attitudes, policies and structures that enable it to work effectively.1
Health service organisations should acknowledge and be respectful of the cultural factors and complex kinship relationships that exist in the local Aboriginal and Torres Strait Islander community.2
Day procedure services may have a small Aboriginal and Torres Strait Islander patient population. For many Aboriginal and Torres Strait Islander peoples receiving care in a day procedure service, their risk of harm will be similar to that of the general patient population using the service. However, Aboriginal and Torres Strait Islander peoples do not always see mainstream health services as offering them a safe and secure place to get well. In many instances, they experience3:
- Isolation from community and kin
- Language barriers in understanding health messages and difficulty in informing clinicians of their needs
- Financial difficulties in gaining access to treatments (for example, travel costs) and funding the costs of the treatment
- Perceived inferior treatment.
To improve the cultural competency of both the workforce and the organisation, consider4:
- Incorporating culturally specific requirements into recruitment processes, or including Aboriginal and Torres Strait Islander peoples on the interview panel
- Addressing cultural competency as part of performance review processes
- Ensuring that the workforce participates in cultural competency activities and training in a variety of learning formats, such as training exercises, reflective practice and face-to-face training whenever possible
- Providing access to ongoing learning for individuals through training, professional development, critical reflection and practice improvement
- Providing cultural competency training that is developed in collaboration with the local Aboriginal and Torres Strait Islander communities and includes content relevant to those communities
- Monitoring and reporting on the implementation and effectiveness of the cultural competency program to the governing body or management
- Implementing follow-up strategies (including counselling, performance improvement or more stringent approaches when necessary) if a culturally appropriate approach is not adopted
- Expanding the Aboriginal and Torres Strait Islander workforce and supporting them to fulfil their role as cultural mentors
- Incorporating cultural competency into policies and program development
- Collaborating with partner communities about service and facility design, delivery and evaluation, and to seek feedback on, and improve, cultural competency.
Further strategies are available in the
Examples of evidence
Select only examples currently in use:
- Evidence of assessment of the workforce’s needs for cultural competency and cultural awareness training
- Training documents on Aboriginal and Torres Strait Islander cultural awareness and cultural competency
- Policy documents in which the needs of Aboriginal and Torres Strait Islander patients are recognised
- Review and evaluation reports of cultural awareness education and training programs
- Committee and meeting records in which the cultural needs of Aboriginal and Torres Strait Islander patients are discussed, and strategies to meet their needs are monitored or evaluated
- Employment documents that detail the roles and responsibilities of Aboriginal support officers
- Strategies for increasing employment opportunities for Aboriginal and Torres Strait Islander peoples in the organisation
- Data analysis and evaluation of feedback from the workforce and consumers about the workforce’s cultural competency and cultural awareness.
MPS & Small Hospitals
Having an effective culture in place means that an organisation has a defined set of values and principles, and demonstrates behaviours, attitudes, policies and structures that enable it to work effectively.1
MPSs and small hospitals should:
- Ensure that actions to improve cultural competency are implemented and monitored for effectiveness
- Review the organisation’s education and training policies and programs to ensure that they adequately cover cultural competency, and monitor workforce participation in training
- Review and maintain the organisation’s targets for the participation of Aboriginal and Torres Strait Islander peoples in the health workforce across clinical, managerial, support and advocacy roles.
Health service organisations should acknowledge and be respectful of the cultural factors and complex kinship relationships that exist in the local Aboriginal and Torres Strait Islander community.2
Aboriginal and Torres Strait Islander peoples do not always see mainstream health services as offering them a safe and secure place to get well. In many instances, they experience3:
- Isolation from community and kin
- Language barriers in understanding health messages and difficulty in informing clinicians of their needs
- Financial difficulties in gaining access to treatments (for example, travel costs) and funding the costs of the treatment
- Perceived inferior treatment.
To improve the cultural competency of both the workforce and the organisation, consider4:
- Incorporating culturally specific requirements into recruitment processes, or including Aboriginal and Torres Strait Islander peoples on the interview panel
- Addressing cultural competency as part of performance review processes
- Ensuring that the workforce participates in cultural competency activities and training in a variety of learning formats, such as training exercises, reflective practice and face-to-face training whenever possible
- Providing access to ongoing learning for individuals through training, professional development, critical reflection and practice improvement
- Providing cultural competency training that is developed in collaboration with the local Aboriginal and Torres Strait Islander communities and includes content relevant to those communities
- Monitoring and reporting on the implementation and effectiveness of the cultural competency program to the governing body or management
- Implementing follow-up strategies (including counselling, performance improvement or more stringent approaches when necessary) if a culturally appropriate approach is not adopted
- Expanding the Aboriginal and Torres Strait Islander workforce and supporting them to fulfil their role as cultural mentors
- Incorporating cultural competency into policies and program development
- Collaborating with partner communities about service and facility design, delivery and evaluation, and to seek feedback on, and improve, cultural competency.
Further strategies are available in the
Examples of evidence
Select only examples currently in use:
- Evidence of assessment of the workforce’s needs for cultural competency and cultural awareness training
- Training documents on Aboriginal and Torres Strait Islander cultural awareness and cultural competency
- Policy documents in which the needs of Aboriginal and Torres Strait Islander patients are recognised
- Review and evaluation reports of cultural awareness education and training programs
- Committee and meeting records in which the cultural needs of Aboriginal and Torres Strait Islander patients are discussed, and strategies to meet their needs are monitored or evaluated
- Employment documents that detail the roles and responsibilities of Aboriginal support officers
- Strategies for increasing employment opportunities for Aboriginal and Torres Strait Islander peoples in the organisation
- Data analysis and evaluation of feedback from the workforce and consumers about the workforce’s cultural competency and cultural awareness.
References
- Dudgeon P, Wright M, Coffin J. Talking it and walking it: cultural competence. J Aus Indig Iss 2010;13(3):29–44.
- Ware VA. Improving the accessibility of health services in urban and regional settings for Indigenous people. Canberra: Australian Institute of Health and Welfare; 2013 (accessed Oct 2017).
- Dwyer J, Kelly J, Willis E, Glover J, Glover J, Mackean T, et al. Managing two worlds together: city hospital care for country Aboriginal people. Melbourne: Lowitja Institute; 2011.
- Australian Commission on Safety and Quality in Health Care. Cultural competence in caring for Aboriginal and Torres Strait Islander consumers. Sydney: ACSQHC; 2016 (accessed Sep 2017).
Resources
The NSQHS Standards include six specific actions to improve safety, quality and experience of care for Aboriginal and Torres Strait Islander peoples. The User Guide for Aboriginal and Torres Strait Islander Health provides further information for health service organisations to implement the six actions. The Commission undertakes to continually improve the evidence base and resources which inform these actions and to support health service organisations to implement the actions.
This fact sheet outlines the outcomes of the national survey conducted by the Australian Commission on Quality and Safety in Health Care.
The NSQHS Standards include six specific actions to improve safety, quality and experience of care for Aboriginal and Torres Strait Islander peoples. The User Guide for Aboriginal and Torres Strait Islander Health provides further information for health service organisations to implement the six actions. The Commission undertakes to continually improve the evidence base and resources which inform these actions and to support health service organisations to implement the actions. This report contributes to the implementation of the Aboriginal and Torres Strait Islander Action 1.21 of the NSQHS Standards, the health service organisation has strategies to improve the cultural awareness and cultural competency of the workforce to meet the needs of its Aboriginal and Torres Strait Islander patients.
This report explores the available literature on cultural safety training delivered by health service organisations and the attributes of high-quality cultural safety training programs. The review includes a detailed analysis of the survey results collected from health service organisations regarding their cultural safety training programs. The report concludes with recommendations to improve cultural safety training delivered by health service organisations for their staff.