Deadly RED

One of the project’s architects, Emergency Physician Dr Michelle Davison, said that during the implementation phase, the project was already recording some ‘epic saves’ with its interventions in patient care.

Dr Davison was the Medical Director of the Critical Care, Women’s and Children’s Service Line at Redcliffe Hospital when the Deadly RED pathway was developed last year.

She says the project began in response to feedback from the hospital’s Indigenous Hospital Liaison Officer (IHLO) team, which mirrored research showing too many of the hospital’s Aboriginal and Torres Strait Islander patients were leaving the emergency department without receiving the care they needed.

“The Deadly RED pathway incorporates a range of initiatives, all informed by a culturally appropriate co-design model. That model centred on increasing engagement, providing culturally-informed information about emergency department processes and yarning with our patients to understand their experiences,” Dr Davison said.

“The pathway team developed a welcome pack for our Aboriginal and Torres Strait Islander patients who identify at triage. The pack included a pictorial journey card designed by a local artist and information about hospital and community support services,” Dr Davison said.

“These patients are welcomed by an IHLO or emergency department team member, encouraging them to let us know if they felt unsafe or if they felt like they needed to leave.

“If they did need to leave before their care was complete, the pathway now provides a clinical follow-up within 24 to 48 hours.

“The follow-up can connect patients with community-based alternative services or encourage patients who need emergency care to return to the hospital.”

Dr Davison said that the follow-up service had made a real difference during the implementation period, with some dramatic and life-saving interventions.

“In other cases, it’s been a matter of connecting them with care providers in the community where they felt safer or more comfortable. That’s still a big win,” she said.

Dr Davison said another benefit of the pathway had been the increased understanding among clinicians around why Aboriginal and Torres Strait Islander patients sometimes left the emergency department before receiving care.

“Those reasons are connected with issues of health literacy, socio-economic and cultural complexities, and a long history of mistrust of government services,” she said.

“We’ve spent a lot of time working through these issues with our emergency department team, with cultural competency training and yarning sessions led by the hospital’s Cultural Capability Officer, Elwyn Henaway.

“That yarning process is essential for hospital staff and community members to understand each other’s perspectives properly, and to improve quality and culturally appropriate care.”

Dr Davison said that after the implementation phase, there were anecdotal reports that the feeling in the community was that Aboriginal and Torres Strait Islander patients were now getting better, more culturally competent care at Redcliffe Hospital.

“That’s another encouraging sign,” she said.

“We hear other things too – about the barriers we still need to overcome. It’s all useful as we continue to advocate for better access to care for our Aboriginal and Torres Strait Islander patients and community,” Dr Davison said.