Action 1.04

Although the governing body is responsible for ensuring that the organisation’s priorities consider the specific health needs of Aboriginal and Torres Strait Islander peoples, management is responsible for designing, implementing and monitoring the strategies to achieve these priorities. Strategies for improvement may include:

• Forming sustainable partnerships with local Aboriginal and Torres Strait Islander peoples by working with local communities to understand and acknowledge their healthcare needs, and the risks and barriers to accessing health care, and developing strategies and priorities for improved care delivery
• Providing flexibility in health service delivery and the patient journey; flexible health service organisations are more likely to be person centred and, as a result, increase patient engagement and participation in their care
• Employing Aboriginal and Torres Strait Islander peoples at all levels of the health service, and supporting and empowering them, which can improve the cultural competency of an organisation; Aboriginal and Torres Strait Islander liaison officers are key to supporting and advocating for Aboriginal and Torres Strait Islander patients, and with Aboriginal and Torres Strait Islander clinicians and interpreters
  • improve the quality of care provided
  • reduce the rate of discharge against medical advice
  • provide cultural mentors for non-Indigenous members of the workforce
• Monitoring safety and quality for Aboriginal and Torres Strait Islander peoples; health service organisations should have goals or targets in place for the care of their Aboriginal and Torres Strait Islander patients, and should routinely measure and report on specific performance indicators related to those goals and targets.

Identify and develop strategies

Strategies have the greatest chance of being effective when:

• The Aboriginal and Torres Strait Islander community is actively engaged in the development, implementation and evaluation of strategies
• Interventions are multidisciplinary and operate across services
• The organisation promotes collaboration with Aboriginal and Torres Strait Islander community controlled health services and adopts a holistic model of health and wellbeing.

To develop appropriate strategies, organisations need to:

• Accurately identify the Aboriginal and Torres Strait Islander peoples who are accessing care
• Agree on measures for analysing health outcomes and risks facing Aboriginal and Torres Strait Islander patients
• Engage with the workforce in planning, designing and implementing improvement strategies
• Evaluate the effectiveness of the changes that are put in place
• Routinely report on improvement initiatives to the governing body, clinicians and the local Aboriginal and Torres Strait Islander communities.

Examples of strategies may include:

• Establishing mechanisms to review and develop tailored care plans for Aboriginal and Torres Strait Islander peoples who frequently use the health service
• Reviewing the appropriateness and effectiveness of models of care for Aboriginal and Torres Strait Islander peoples, including options to provide care using outreach services
• Developing a workforce and employment strategy that sets targets and identifies how to increase or maintain the participation of Aboriginal and Torres Strait Islander peoples in the health workforce across clinical, managerial, support and advocacy roles
• Coordinating early discharge planning that considers the need for community social and health services
• Providing information materials in Aboriginal and Torres Strait Islander languages, if appropriate
• Coordinating service provision using flexible hours of service delivery (that is, outside a 9-to-5 working day).^{1, 2}

Further strategies are available in the

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 the advice for hospitals and the

NSQHS Standards User guide for Aboriginal and Torres Strait Islander health

2017

Guide, user guide or guidelines

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.

Health service organisations are responsible for designing, implementing and monitoring the strategies to achieve the priorities set by the governing body to improve the health of Aboriginal and Torres Strait Islander peoples. Strategies for improvement may include:

• Forming sustainable partnerships with local Aboriginal and Torres Strait Islander peoples by working with local communities to understand and acknowledge their healthcare needs, and the risks and barriers to accessing health care, and developing strategies and priorities for improved care delivery
• Providing flexibility in health service delivery and the patient journey; flexible health service organisations are more likely to be person centred and, as a result, increase patient engagement and participation in their care
• Employing Aboriginal and Torres Strait Islander peoples at all levels of the health service, and supporting and empowering them, which can improve the cultural competency of an organisation
• Monitoring safety and quality for Aboriginal and Torres Strait Islander peoples; health service organisations should have goals or targets for the care of their Aboriginal and Torres Strait Islander patients, and should routinely measure and report on specific performance indicators related to those goals and targets.

Other specific strategies may include:

• Establishing mechanisms to review and develop tailored care plans for Aboriginal and Torres Strait Islander peoples who often use the health service
• Reviewing the appropriateness and effectiveness of models of care for Aboriginal and Torres Strait Islander peoples, including options to provide care using outreach services
• Developing a workforce and employment strategy that sets targets and identifies how to increase or maintain the participation of Aboriginal and Torres Strait Islander peoples in the health workforce across clinical, managerial, support and advocacy roles
• Coordinating early discharge planning that considers the need for community social and health services
• Providing information materials in Aboriginal and Torres Strait Islander languages, if appropriate
• Coordinating service provision using flexible hours of service delivery (that is, outside a 9-to-5 working day)^{1, 2}
• Discussing the safety and quality issues facing Aboriginal and Torres Strait Islander patients with the workforce, especially members of the Aboriginal and Torres Strait Islander health workforce, and Aboriginal and Torres Strait Islander consumers or community representatives
• Reviewing the scope and effectiveness of strategies in place to improve care for Aboriginal and Torres Strait Islander peoples.

Further strategies are available in the

NSQHS Standards User guide for Aboriginal and Torres Strait Islander health

2017

Guide, user guide or guidelines