Action 1.4: Implementing and monitoring targeted strategies

Implement specific strategies and actions. These may include:

• Developing an Aboriginal and Torres Strait Islander Health Action Plan
• Using Aboriginal and Torres Strait Islander health impact statements and declarations throughout the organisation
• Establishing or reviewing the organisation’s Aboriginal and Torres Strait Islander employment strategy and set targets
• Introducing a cultural competency or capability strategy
• Collaborating and formalising relationships with Aboriginal community controlled health services21
• Adopting or adapting an Aboriginal and Torres Strait Islander identification strategy
• Improving the environment of the health service organisation to be welcoming for Aboriginal and Torres Strait Islander people
• Improving care coordination to recognise the complex health needs of Aboriginal and Torres Strait Islander patients, including spiritual and cultural needs.

In collaboration with the Aboriginal and Torres Strait Islander community:

• Develop a monitoring framework to identify what, when and how data are to be collected
• Apply or adapt national, and state and territory performance measures, such as those established in the national Aboriginal and Torres Strait Islander Health Performance Framework⁷, and in state and territory performance and reporting frameworks²⁸; these measures include:
  • identification rates
  • waiting times and ‘did not wait’ rates by triage level
  • rates of discharge against medical advice by ward or unit
  • in-hospital mortality rates
  • patient satisfaction rates
  • rates of unplanned readmissions
• Select a set of measures to be reported to the governing body
• Collect, analyse and report on indicators to the board, governing body, workforce and community.

Successful implementation of this strategy will be supported by, or rely on, the following actions:

Action 1.8a - The health service organisation uses organisation-wide quality improvement systems that identify safety and quality measures, and monitor and report performance and outcomes.

Action 1.8c - The health service organisation implements and monitors safety and quality improvement strategies.

Use the monitoring and reporting framework to monitor achievements against the organisation’s safety and quality priorities for Aboriginal and Torres Strait Islander people, and use the information generated to improve safety and quality. This framework should²⁹:

• Apply or adapt national and/or state or territory indicators, such as those developed to monitor the Closing the Gap initiatives, as the basis of a dashboard of indicators
• Develop local indicators, if necessary
• Select a broad indicator set, in collaboration with Aboriginal and Torres Strait Islander people
• Monitor Aboriginal and Torres Strait Islander communities’ perceptions of the health service organisation by engaging widely with the community and representing organisations, as well as with patients
• Establish routine monitoring processes, with documentation of clear reporting structures to ensure accountability
• Establish a reporting schedule and format for the governing body, the workforce, and the Aboriginal and Torres Strait Islander community
• Report process and outcome measures, with a non-Indigenous comparison, to demonstrate disparities
• Use the data collected from the organisation’s quality improvement processes in each of the NSQHS Standards, including Actions 2.2, 3.2, 4.2, 5.2, 6.2, 7.2 and 8.2.

Successful implementation of this strategy will be supported by, or rely on, the following actions:

Action 1.1f - The governing body monitors the action taken that results from the analysis of clinical incidents.

Action 1.1g - The governing body reviews, reports, and monitors the organisation’s progress on safety and quality performance.

Action 1.8a - The health service organisation uses organisation-wide quality improvement systems that identify safety and quality measures, and monitor and report performance and outcomes.

Action 1.9c - The health service organisation ensures that timely reports on safety and quality systems, and performance are provided to consumers and the local community.

Action 1.10b - The health service organisation uses clinical and other data collections to support risk assessments.

• Identify and allocate resources to ensure effective implementation of strategies
• Clearly articulate resource commitments in organisation-wide strategic and business plans and business cases.

• Identify and support change champions who promote and embed changes across the health service organisation, and across all levels of management. They must include both Aboriginal and Torres Strait Islander employees and non- Indigenous employees.

Implement policies, procedures, strategies and protocols using a whole-of-organisation approach to change management, with support from clinical and non-clinical leaders.¹

Successful implementation of this strategy will be supported by, or rely on, the following actions:

Action 1.1a - The governing body provides leadership to develop a culture of safety and quality improvement, and satisfies itself that this culture exists within the organisation.

Action 1.7a - The health service organisation uses a risk management approach to set out, review, and maintain the currency and effectiveness of policies, procedures and protocols.