Embedding cultural safety in Australia's main health care standards

Laverty, Martin; McDermott, Dennis; Calma, Tom

doi:10.5694/mja17.00328

Cited by 126 publications

(110 citation statements)

References 10 publications

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“…They explicitly take their inspiration from the CSDH, recognising that much of the Indigenous–non‐Indigenous health gap must be attributed to differences beyond access to health care; and they lay great emphasis on education. I also note, from Laverty and colleagues, 6 that the preconditions for educational success can be strengthened by culturally safe health care, attuned to social determinants and provided in health settings free of racism. They ascribe a leadership role to government for specific action to embed cultural safety in standards for safe, quality‐assured clinical care.…”

mentioning

confidence: 94%

Dignity, social investment and the Indigenous health gap

Marmot

2017

Medical Journal of Australia

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mentioning

confidence: 94%

Dignity, social investment and the Indigenous health gap

Marmot

2017

Medical Journal of Australia

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“…The importance of cultural safety is now recognised by Australian health departments and many professional colleges by incorporating position statements and online educational modules, many focused on Aboriginal patients, into policy and training requirements. These actions may have positively influenced our findings, although there is no evidence that such programs improve health outcomes . The inconsistent reference to Aboriginal status by doctors may also reflect a lack of cultural awareness and appreciation of the diversity of Aboriginal communities.…”

Section: Discussionmentioning

confidence: 88%

“…These actions may have positively influenced our findings, although there is no evidence that such programs improve health outcomes. 14,15 The inconsistent reference to Aboriginal status by doctors may also reflect a lack of cultural awareness and appreciation of the diversity of Aboriginal communities. Most respondents to our survey (93%) believed that cultural awareness was pertinent to their training, but more than half (53%) felt that the level of cultural awareness training was inadequate.…”

Section: Discussionmentioning

confidence: 99%

Identifying the cultural heritage of patients during clinical handover and in hospital medical records

Morgan¹,

Harris

Gidgup³

et al. 2019

Medical Journal of Australia

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Objective To examine the frequency of and rationale for hospital doctors mentioning a patient's cultural heritage (ethnicity, national heritage, religion) during medical handovers and in medical records. Design Four‐phase observational study, including the covert observation of clinical handovers in an acute care unit (ACU) and analysis of electronic medical records (EMRs) of ACU patients after their discharge to ward‐based care. Setting, participants 1018 patients and the doctors who cared for them at a tertiary hospital in Western Australia, May 2016 – February 2018. Main outcome measure References to patients’ cultural heritage by ACU doctors during clinical handover (written or verbal) and by ward‐based doctors in hospital EMRs (written only), by geographic ethnic–national group. Results In 2727 ACU clinical handovers of 1018 patients, 142 cultural heritage identifications were made (ethnicity, 84; nationality, 41; religion, 17); the rate was highest for Aboriginal patients (370 [95% CI, 293–460] identifications per 1000 handovers). 14 505 EMR pages were reviewed; 380 cultural heritage identifications (ethnicity, 257; nationality, 119; religion, 4) were recorded. A rationale for identification was documented for 25 of 142 patients (18%) whose ethnic–national background was mentioned during handover or in their EMR. Multivariate analysis (adjusted for demographic, socio‐economic and medical factors) indicated that being an Aboriginal Australian was the most significant factor for identifying ethnic–national background (handovers: adjusted odds ratio [aOR], 21.7; 95% CI, 7.94–59.4; hospital EMRs: aOR, 13.6; 95% CI, 5.03–36.5). 44 of 75 respondents to a post‐study survey (59%) were aware that Aboriginal heritage was mentioned more frequently than other cultural backgrounds. Conclusions Explicitly mentioning the cultural heritage of patients is inconsistent and seldom explained. After adjusting for other factors, Aboriginal patients were significantly more likely to be identified than patients with other backgrounds.

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“…The competent physician should also be able to support team members from different cultures and backgrounds. Communication gaps between health professionals and indigenous people are well recognized in Australia and many other nations . The culturally competent doctor provides cultural safety for the patient as part of their medical care.…”

Section: Descriptors and Frameworkmentioning

confidence: 99%