Aboriginal cultural competence for health services in regional Victoria: lessons for implementation

Tynan, Michael; Smullen, Fran; Atkinson, Petah; Stephens, Kylie

doi:10.1111/1753-6405.12091

Cited by 5 publications

(13 citation statements)

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“…9 Rather, it was suggested that aligning the KB-AHCC Framework with accreditation standards would create the necessary motivation and accountability for services to implement the Framework effectively. 9 Findings from the present study do not support this approach. Some organisations were continuing their journey towards cultural competency slowly and reporting on their progress to DHHS would not have altered this.…”

Section: Discussionmentioning

confidence: 99%

“…1 This lack of improvement has been attributed to the underlying persistence of racism throughout Australian health and welfare systems, manifested in the social determinants of Aboriginal health and wellbeing. 8 In 2013, Tynan et al 9 described the development of the Victorian Department of Health endorsed Aboriginal Health Cultural Competence (AHCC) Framework, 10 part of the implementation of the Hume Close the Gap Health Plan (CTGP) 5 in Victoria.…”

mentioning

confidence: 99%

“…In 2013, Tynan et al 9 described the development of the Victorian Department of Health endorsed Aboriginal Health Cultural Competence (AHCC) Framework, 10 part of the implementation of the Hume Close the Gap Health Plan (CTGP) 5 in Victoria. Development of the CTGP was undertaken by the Hume Region Closing the Health Gap Steering Committee and identified five key priority areas for action, which included the need to increase the cultural competency of the public health and community service system across the Hume region 5 .…”

mentioning

confidence: 99%

“…Development of the CTGP was undertaken by the Hume Region Closing the Health Gap Steering Committee and identified five key priority areas for action, which included the need to increase the cultural competency of the public health and community service system across the Hume region 5 . To address this priority, the Aboriginal Health Cultural Competence Working Party (AHCC Working Party) was convened, consisting of members from key Aboriginal health and Traditional Owner organisations, the Victorian Department of Health and mainstream health organisations from across the region 9,10 . The AHCC Framework 10 and Audit tool were developed by the AHCC Working Party during four workshops in 2011 9 and focussed on identifying actions for leadership and quality teams to improve cultural competence within rural health and community services 10 .…”

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confidence: 99%

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A qualitative evaluation of the implementation of a cultural competence project in rural Victoria

Mitchell

Bourke

Shaburdin

2021

Australian and New Zealand Journal of Public Health

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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A qualitative evaluation of the implementation of a cultural competence project in rural Victoria

Mitchell

Bourke

Shaburdin

2021

Australian and New Zealand Journal of Public Health

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“…We suggest that this difficulty has deep origins in a broader political problem; that is, the unresolved question of recognition of the place and role of Aboriginal and Torres Strait Islander people in Australian society and in law. 37 The framework and tools of cultural competency, with their emphasis on organisational as well as individual capacities, 38,39 offer a practical way to address this problem.…”

Section: Discussionmentioning

confidence: 99%

Hospitals caring for rural Aboriginal patients: holding response and denial

Dwyer¹,

Willis²,

Kelly³

2014

Aust. Health Review

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Objective. To investigate how policy requiring cultural respect and attention to health equity is implemented in the care of rural and remote Aboriginal people in city hospitals.Methods. Interviews with 26 staff in public hospitals in Adelaide, South Australia, were analysed (using a framework based on cultural competence) to identify their perceptions of the enabling strategies and systemic barriers against the implementation of official policy in the care of rural Aboriginal patients.Results. The major underlying barriers were lack of knowledge and skills among staff generally, and the persistent use of 'business as usual' approaches in their hospitals, despite the clear need for proactive responses to the complex care journeys these patients undertake. Staff reported a sense that while they are required to provide responsive care, care systems often fail to authorise or guide necessary action to enable equitable care.Conclusions. Staff caring for rural Aboriginal patients are required to respond to complex particular needs in the absence of effective authorisation. We suggest that systemic misinterpretation of the principle of equal treatment is an important barrier against the development of culturally competent organisations. What is known about this topic?The care received by Aboriginal patients is less effective than it is for the population generally, and access to care is poorer. Those in rural and remote settings experience both severe access barriers and predictable complexity in their patient care journeys. This situation persists despite high-level policies that require tailored responses to the particular needs of Aboriginal people. What does this paper add? Staff who care for these patients develop skills and modify care delivery to respond to their particular needs, but they do so in the absence of systematic policies, procedures and programs that would 'build in' or authorise the required responsiveness. What are the implications for practitioners? Systematic attention, at hospital and clinical unit level, to operationalising high policy goals is needed. The framework of cultural competence offers relevant guidance for efforts (at system, organisation and care delivery levels) to improve care, but requires organisations to address misinterpretation of the principle of equal treatment.

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The “Waze” of Inequity Reduction Frameworks for Organizations: a Scoping Review

Spitzer-Shohat

Chin

2019

J GEN INTERN MED

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BACKGROUND: Different conceptual frameworks guide how an organization can change its policies and practices to make care and outcomes more equitable for patients, and how the organization itself can become more equitable. Nonetheless, healthcare organizations often struggle with implementing these frameworks. OBJECTIVE: To assess what guidance frameworks for health equity provide for organizations implementing interventions to make care and outcomes more equitable. STUDY DESIGN: Fourteen inequity frameworks from scoping literature review 2000-2017 that provided models for improving disparities in quality of care or outcomes were assessed. We analyzed how frameworks addressed key implementation factors: (1) outer and inner organizational contexts; (2) process of translating and implementing equity interventions throughout organizations; (3) organizational and patient outcomes; and (4) sustainability of change over time. PARTICIPANTS: We conducted member check interviews with framework authors to verify our assessments. KEY RESULTS: Frameworks stressed assessing the organization's outer context, such as population served, for tailoring change strategies. Inner context, such as existing organizational culture or readiness for change, was often not addressed. Most frameworks did not provide guidance on translation of equity across multiple organizational departments and levels. Recommended evaluation metrics focused mainly on patient outcomes, leaving organizational measures unassessed. Sustainability was not addressed by most frameworks. CONCLUSIONS: Existing equity intervention frameworks often lack specific guidance for implementing organizational change. Future frameworks should assess inner organizational context to guide translation of programs across different organizational departments and levels and provide specific guidelines on institutionalization and sustainability of interventions.

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Aboriginal cultural competence for health services in regional Victoria: lessons for implementation

Cited by 5 publications

References 0 publications

A qualitative evaluation of the implementation of a cultural competence project in rural Victoria

A qualitative evaluation of the implementation of a cultural competence project in rural Victoria

Hospitals caring for rural Aboriginal patients: holding response and denial

The “Waze” of Inequity Reduction Frameworks for Organizations: a Scoping Review

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