Action 2.13

Review the current level of partnership with Aboriginal and Torres Strait Islander communities

This may involve reviewing:

• Policies or processes that aid access to culturally appropriate and safe health care for Aboriginal and Torres Strait Islander peoples in the community
• The involvement of Aboriginal and Torres Strait Islander peoples on boards or advisory committees involved in the design and evaluation of health care
• The presence of Aboriginal health workers or community liaison officers in the workforce
• Whether information for consumers is culturally appropriate, including the organisation’s charter of rights and patient information brochures
• Linkages with local Aboriginal and Torres Strait Islander communities and consumer organisations.

Develop an approach to partnering with Aboriginal and Torres Strait Islander communities

If the organisation has an embedded approach for partnering with Aboriginal and Torres Strait Islander communities, review the framework and processes against the strategies recommended below to determine whether any changes are needed.

If the organisation does not have an embedded approach for partnering with Aboriginal and Torres Strait Islander communities, develop a framework and associated processes to ensure that Aboriginal and Torres Strait Islander peoples who use services receive health care that meets their needs.

Strategies for partnering with Aboriginal and Torres Strait Islander communities may include:

• Speaking with elders and other community leaders to understand the cultural considerations and healthcare needs of the local Aboriginal and Torres Strait Islander community; engaging and building long-term relationships with well-respected senior members of a community can increase service acceptance¹
• Engaging with the broader community, rather than focusing on individual consumer engagement approaches; use engagement strategies that fit with Aboriginal and Torres Strait Islander community life, including informal gatherings such as yarning circles, bingo or sharing a meal²⁴
• Employing Aboriginal and Torres Strait Islander peoples in positions such as Aboriginal health workers, liaison officers, family support workers, or education and training officers who can help engagement with local Aboriginal and Torres Strait Islander communities; if the organisation lacks the capacity to employ such positions, engage directly with members of the local Aboriginal and Torres Strait Islander communities to act as champions in support of building partnerships with the organisation^{2, 3}
• Developing specific policies or procedures to ensure Aboriginal and Torres Strait Islander representation in governance and planning activities
• Hosting culturally safe advisory groups or committees¹
• Partnering with local Aboriginal and Torres Strait Islander organisations and agencies.

Adapt existing consumer programs and resources for Aboriginal and Torres Strait Islander peoples

English is not the first language of many Aboriginal and Torres Strait Islander peoples. These consumers may also face difficulties in understanding information provided by the organisation because of poor general and individual health literacy.

Strategies to adapt programs and resources include:

• Engaging with members of Aboriginal and Torres Strait Islander communities to review consumer programs and resources, and provide guidance on ways to adapt the material to be culturally safe and appropriate
• Reducing the amount of content in information brochures and resources, and supplementing this with culturally specific graphics or audiovisual aids to support understanding.

Create a culturally safe environment for Aboriginal and Torres Strait Islander peoples who use the organisation’s services

Bringing together the cultures of a health service organisation and the local Aboriginal and Torres Strait Islander communities can improve access to health care for Aboriginal and Torres Strait Islander peoples.⁴ Strategies for this may include:

• Providing cultural competency training so that all members of the workforce understand the historical and contemporary factors that may affect the willingness of Aboriginal and Torres Strait Islander peoples to partner with the organisation²; this is an important first step in understanding the cultural considerations of the local Aboriginal and Torres Strait Islander communities¹
• Incorporating cultural symbols into the service setting, such as⁵:
  • flying the Aboriginal flag and the Torres Strait Islander flag in a prominent location
  • respectfully displaying cultural artwork or artefacts
  • mounting a plaque that recognises the traditional owners of the land on which the organisation is located
• Participating in and acknowledging major cultural events, such as National Aborigines and Islanders Day Observance Committee (NAIDOC) week or Reconciliation Day
• Allocating a space that can be used for the spiritual and cultural needs of Aboriginal and Torres Strait Islander patients, their families and communities.

Develop respectful relationships

In some Aboriginal and Torres Strait Islander communities, the cultural concept of health may be different from the biomedical model adopted by the organisation. Be aware of this when seeking consumer feedback and input into health service design.

Engaging with Aboriginal and Torres Strait Islander communities means developing a relationship built on trust and integrity. Allow enough time and resources to form this relationship.

Further strategies are available in

NSQHS Standards User guide for Aboriginal and Torres Strait Islander health

2017

Guide, user guide or guidelines

This action applies to day procedure services that commonly provide care for Aboriginal and Torres Strait Islander peoples. These services should refer to NSQHS Standards Guide for Hospitals, NSQHS Standards Accreditation Workbook and NSQHS Standards User Guide for Aboriginal and Torres Strait Islander Health for detailed implementation strategies and examples of evidence for this action. 

Day procedure services that rarely provide care for Aboriginal and Torres Strait Islander peoples, or when the risk of harm for these patients is the same as for the general patient population, should manage the specific risk of harm, and provide safe and high-quality care for these patients through the safety and quality improvement systems that relate to their whole patient population. 

Day procedure services need to implement strategies to improve the cultural awareness and cultural competency of the workforce under Action 1.21, and identify Aboriginal and Torres Strait Islander patients under Action 5.8.

If MPSs and small hospitals are to better meet the health needs of local Aboriginal and Torres Strait Islander peoples, they need to work in partnership with these communities and understand and observe local cultural principles.

MPSs or small hospitals that are part of a local health network or private hospital group should adopt or adapt and use the established framework for partnering with local Aboriginal and Torres Strait Islander communities. This includes adapting existing consumer resources or programs to be culturally appropriate for local Aboriginal and Torres Strait Islander communities.

Small hospitals that are not part of a local health network or private hospital group should develop mechanisms for determining the diversity of the consumers who use the services and the local community by⁶:

• Building relationships directly with members of the local Aboriginal and Torres Strait Islander communities to act as advisors and champions
• Forming partnerships with local Aboriginal and Torres Strait Islander organisations and agencies
• Sourcing culturally appropriate health information resources for Aboriginal and Torres Strait Islander peoples.

Bringing together the cultures of a health service organisation and the local Aboriginal and Torres Strait Islander communities can improve access to health care for Aboriginal and Torres Strait Islander Australians.⁴ Strategies for this may include:

• Identifying Aboriginal and Torres Strait Islander communities within the catchment and the relevant cultural protocols to guide partnerships
• Identifying key contacts, elders and opinion leaders in the Aboriginal and Torres Strait Islander communities and contacting them
• Establishing and implementing mechanisms for forming and maintaining partnerships with Aboriginal and Torres Strait Islander communities and representative organisations.

Further strategies are available in

NSQHS Standards User guide for Aboriginal and Torres Strait Islander health

2017

Guide, user guide or guidelines