Role of Aboriginal Health Workers and Liaison Officers in quality care in the Australian acute care setting: a systematic review
Tamara Mackean A , Elizabeth Withall A C , Judith Dwyer B and Annabelle Wilson AA Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia. Email: tamara.mackean@flinders.edu.au; annabelle.wilson@flinders.edu.au
B Health Care Management, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia. Email: judith.dwyer@flinders.edu.au
C Corresponding author. Email: liz.withall@flinders.edu.au
Australian Health Review 44(3) 427-433 https://doi.org/10.1071/AH19101
Submitted: 30 April 2019 Accepted: 29 August 2019 Published: 14 January 2020
Abstract
Objective The aim of this study was to identify the contribution of Aboriginal Health Workers and Liaison Officers (AHWLOs) to quality of care in the acute health care setting in Australia.
Methods A systematic review of peer-reviewed literature focused on the role of AHWLOs and quality processed and quality outcomes. Authors undertook study selection based on inclusion criteria and performed quality assessment using critical appraisal tools from the Joanna Briggs Institute.
Results The search revealed limited literature that met the inclusion criteria, namely four quantitative studies and one mixed-methods study. The settings of the included studies were mental health and cardiac care units within various hospitals. The studies indicated that AHWLOs may have a positive effect on communication between healthcare professionals and patients, rates of discharge against medical advice and continuity of care. Methodological constraints among the included studies made it difficult to establish specific contributions of AHWLOs to quality care markers across acute care units.
Conclusions The role of AHWLOs in providing quality care in the acute care setting has received minimal research. The limited existing research highlights the importance of the AHWLO role. For example, AHWLOs may influence patient communication, discharge against medical advice and continuity of care within mental health and cardiac care units. Further, because of methodological constraints among the limited studies, research into the role of AHWLOs in these and other acute care settings is needed to assess effects on a range of specific clinical quality markers.
What is known about the topic? Aboriginal and Torres Strait Islander people experience unacceptable health inequities. AHWLOs are a unique workforce introduced to increase access to culturally safe care and, ultimately, help to address these inequities.
What does this paper add? This review explores the current evidence for the contribution of AHWLOs to quality care in the acute care setting. The findings suggest that these professionals may improve communication between patients and medical staff, improve continuity of care and reduce patient discharge against medical advice. However, these findings highlight that the use of quality care markers across acute care settings is needed to generate tangible evidence to help establish the legitimacy of these health professionals.
What are the implications for practitioners? AHWLOs have a place in the acute care team. Although further research is required to expand the preliminary evidence base of their effect on quality acute care, this workforce should be supported at the individual, organisational and policy levels to enhance the health and well-being of one the most vulnerable communities in Australia.
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