Cultural change improves outcomes for Aboriginal and/or Torres Strait Islander peoples

Metro North Health multidisplanyary team and Aboriginal and/or Torres Strait Islander Health Workers.

The Royal Brisbane Women’s Hospital (RBWH) Emergency Department (ED) incorporated an Aboriginal and/or Torres Strait Islander Senior Health Worker (SHW) into the multidisciplinary team. This provided direct and immediate, culturally sensitive, clinical support to First Nations patients presenting to the Emergency Department, also role modelled culturally sensitive behaviours for health professionals in the Emergency Department.

Between January and June 2022, the Senior Health Worker Model of Care:

Advanced the transformation of the Emergency Department into a culturally safe environment that considers the social and emotional wellbeing of Aboriginal and/or Torres Strait Islander peoples, visitors and staff.
Delivered culturally sensitive clinical care and follow-up for Aboriginal and/or Torres Strait Islander peoples and their families.

Over 6-months:

The proportion of Aboriginal and/or Torres Strait Islander peoples having incomplete Emergency Department visits (including did not wait and left after treatment commenced) dropped from 1 in 8 to 1 in 16.
When the Senior Health Worker was on shift (7am – 3pm) there were no patients requiring security interventions.
Of the 296 patients with incomplete visits, the Senior Health Worker attempted follow up with 120 patients, and successfully contacted 39.
For Aboriginal and/or Torres Strait Islander peoples with mental health issues requiring suicide prevention support, a referral pathway was established with the Kurbingui Youth and Family Development – National Suicide Prevention Trial Social Emotional Wellbeing Program. Other referral pathways include Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHS) and General Practitioners (GPs).
Designed and tailored a clinically relevant Cultural Practice Program that is immersive and contemporary of the issues in the Emergency Department.

Within 6 months, this highly visible and innovative role of Senior Health Worker has already delivered profound benefits to Aboriginal and/or Torres Strait Islander peoples. The position has earned staunch support from clinicians and community services. The strong interest that this position has attracted from other Emergency Departments across Queensland, highlights both the lack of existing solutions and the eagerness to adopt interventions that work. Following completion of the project, the RBWH executive team provided ongoing funding to continue the role.

The Aboriginal and/or Torres Strait Islander Senior Health Worker presented at the promoting value-based care in ED’s (PROV-ED) Pitchfest 2022, this initiative was selected for a state-wide rollout to other emergency departments across Queensland Health.