‘We get so task orientated at times that we forget the people’: staff communication experiences when caring for Aboriginal cardiac patients
Janet Kelly
A B C D , Anna Dowling A B , Katharine McBride A B , Wendy Keech A B and Alex Brown A B
A Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, PO Box 11060, North Terrace, Adelaide, SA 5001, Australia. Email: anna.dowling@sahmri.com; katharine.mcbride@sahmri.com; wendy.keech@sahmri.com; alex.brown@sahmri.com
B Aboriginal Health Research Group, Sansom Institute for Health Research, University of South Australia, Frome Road, Adelaide, SA 5001, Australia.
C Adelaide Nursing School, Adelaide Health and Medical Sciences Building, The University of Adelaide, North Terrace, Adelaide, SA 5005, Australia.
D Corresponding author. Email: janet.kelly@sahmri.com
Australian Health Review 44(1) 1-6 https://doi.org/10.1071/AH17290
Submitted: 3 January 2018 Accepted: 12 September 2018 Published: 23 November 2018
Journal Compilation © AHHA 2020 Open Access CC BY-NC-ND
Abstract
Objective The aim of this study was to describe the experiences of communication for staff providing cardiac care for Aboriginal and Torres Strait Islander patients in hospital and discuss potential improvements.
Methods Focus group discussions were performed with 58 multidisciplinary staff who provide care for Aboriginal and Torres Strait Islander cardiac patients in two metropolitan and two regional hospitals in South Australia and Northern Territory. Inductive thematic analysis was undertaken to identify staff perceptions of communication challenges and strategies for improvement.
Results There were five key themes: (1) communication is central to good care; (2) communication within busy clinical environments; (3) supporting a strong Aboriginal workforce; (4) a cultural as well as clinical focus; and (5) particular challenges working with patients from remote areas.
Conclusions Providing effective communication that is both clinically and culturally appropriate is often challenging within a busy and non-adaptive hospital environment. Moving beyond clinical tasks, increased Aboriginal and Torres Strat Islander health workforce and cultural competency, supporting coordinated care and improved skills are required to meet the communication needs of Aboriginal and Torres Strait Islander patients.
What is known about this topic? Communication between patients, their families and hospital staff is crucial for health care quality and safety. There is little understanding of the challenges and opportunities for staff to meet the communication needs of Aboriginal and Torres Strait Islander cardiac patients to address disparities in acute care settings.
What does this paper add? This paper discusses the barriers and potential improvements, as identified by hospital staff providing care to Aboriginal and Torres Strait Islander cardiac patients in both metropolitan and regional settings.
What are the implications for practitioners? Practitioners should be trained and supported in providing both clinically and culturally safe care for Aboriginal and Torres Strait Islander patients. This requires adequate time, two-way communication and resources to support and facilitate effective communication.
References
[1] Brown A, O’Shea RL, Mott K, McBride KF, Lawson T, Jennings GLR. A strategy for translating evidence into policy and practice to close the gap – developing essential service standards for Aboriginal and Torres Strait Islander Cardiovascular Care. Heart Lung Circ 2015; 24 119–25.| A strategy for translating evidence into policy and practice to close the gap – developing essential service standards for Aboriginal and Torres Strait Islander Cardiovascular Care.Crossref | GoogleScholarGoogle Scholar |
[2] Australian Institute of Health and Welfare (AIHW). Better cardiac care measures for Aboriginal and Torres Strait Islander people: first national report 2015. Catalogue no. IHW 156. Canberra: AIHW; 2015.
[3] Australian Commission on Safety and Quality in Health Care (ACSQHC). Health literacy: taking action to improve safety and quality. Sydney: ACSQHC; 2014.
[4] Australian Commission on Safety and Quality in Health Care (ACSQHC). Acute coronary syndromes clinical care standard. Sydney: ACSQHC; 2014.
[5] National Heart Foundation of Australia, Australian Healthcare and Hospitals Association. Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack. Melbourne: National Heart Foundation of Australia; 2010.
[6] Brown A, O’Shea RL, Mott K, McBride KF, Lawson T, Jennings GLR. Essential service standards for equitable national cardiovascular care for Aboriginal and Torres Strait Islander people. Heart Lung Circ 2015; 24 126–41.
| Essential service standards for equitable national cardiovascular care for Aboriginal and Torres Strait Islander people.Crossref | GoogleScholarGoogle Scholar |
[7] Shahid S, Finn L, Thompson S. Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting. Med J Aust 2009; 190 574–9.
[8] Taylor KP, Thompson SC, Smith JS, Dimer L, Ali M, Wood MM. Exploring the impact of an Aboriginal Health Worker on hospitalised Aboriginal experiences: lessons from cardiology. Australian Health Review 2009; 33 549–57.
| Exploring the impact of an Aboriginal Health Worker on hospitalised Aboriginal experiences: lessons from cardiology.Crossref | GoogleScholarGoogle Scholar |
[9] Artuso S, Cargo M, Brown A, Daniel M. Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC Health Serv Res 2013; 13 83
| Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
[10] Australian Bureau of Statistics (ABS).2016 census - counting persons, place of usual residence. Canberra: ABS; 2018.
[11] Dwyer J, Willis E, Kelly J. Hospitals caring for rural Aboriginal patients: holding response and denial. Aust Health Rev 2014; 38 546–51.
| Hospitals caring for rural Aboriginal patients: holding response and denial.Crossref | GoogleScholarGoogle Scholar |
[12] Australian Commission on Safety and Quality in Health Care (ACSQHC). National safety and quality health service standards. 2nd edn. Sydney: ACSQHC; 2017.
[13] Lawrence M, Dodd Z, Mohor S, Dunn S, de Crespigny C, Powel C, MacKean L. Improving the Patient Journey: Achieving Positive Outcomes for Remote Aboriginal Cardiac Patients. Darwin: Cooperative Research Centre for Aboriginal Health. 2009.
[14] Brown AE, Middleton PF, Fereday JA, Pincombe JI. Cultural safety and midwifery care for Aboriginal women – a phenomenological study. Women Birth 2016; 29 196–202.
| Cultural safety and midwifery care for Aboriginal women – a phenomenological study.Crossref | GoogleScholarGoogle Scholar |
[15] Dietsch E, Shackleton P, Davies C, McLeod M, Alston M. ‘You can drop dead’: midwives bullying women. Women Birth 2010; 23 53–9.
| ‘You can drop dead’: midwives bullying women.Crossref | GoogleScholarGoogle Scholar |
[16] Anderson K, Cunningham J, Devitt J, Preece C, Cass A. ‘Looking back to my family’: Indigenous Australian patients’ experience of hemodialysis. BMC Nephrol 2012; 13 114
| ‘Looking back to my family’: Indigenous Australian patients’ experience of hemodialysis.Crossref | GoogleScholarGoogle Scholar |
[17] Burnette L, Kickett M. ‘You are just a puppet’: Australian Aboriginal people’s experience of disempowerment when undergoing treatment for end-stage renal disease. Ren Soc Aust J 2009; 5 113–18.
[18] Shahid S, Finn L, Bessarab D, Thompson SC. ‘Nowhere to room…nobody told them’: logistical and cultural impediments to Aboriginal peoples’ participation in cancer treatment. Aust Health Rev 2011; 35 235–41.
| ‘Nowhere to room…nobody told them’: logistical and cultural impediments to Aboriginal peoples’ participation in cancer treatment.Crossref | GoogleScholarGoogle Scholar |
[19] Australian Commission on Safety and Quality in Health Care (ACSQHC). Summary of development and testing of the AHPEQS, December 2017. Sydney: ACSQHC; 2017. Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2017/12/AHPEQS-development-summary-Dec-2017.pdf [verified 21 September 2018].
[20] Stamp G, Champion S, Anderson G, Warren B, Stuart-Butler D, Doolan J, Boles C, Callaghan L, Foale A, Muyambi C. Aboriginal maternal and infant care workers: partners in caring for Aboriginal mothers and babies. Rural Remote Health 2008; 8 883
[21] The Wardliparingga Aboriginal Research Unit of the South Australian Health and Medical Research Institute. National Safety and Quality Health Service Standards user guide for Aboriginal and Torres Strait Islander health. Sydney: Australian Commission on Safety and Quality in Health Care; 2017. Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2017/12/National-Safety-and-Quality-Health-Service-Standards-User-Guide-for-Aboriginal-and-Torres-Strait-Islander-Health.pdf [verified 21 September 2018].
[22] Downing R, Kowal E, Paradies Y. Indigenous cultural training for health workers in Australia. International Journal for Quality in Health Care 2011; 23 247–57.
| Indigenous cultural training for health workers in Australia.Crossref | GoogleScholarGoogle Scholar |
[23] Lin I, Green C, Bessarab D. ‘Yarn with me’: applying clinical yarning to improve clinician-patient communication in Aboriginal health care. Aust J Prim Health 2016; 22 377–82.
| ‘Yarn with me’: applying clinical yarning to improve clinician-patient communication in Aboriginal health care.Crossref | GoogleScholarGoogle Scholar |
