‘We get so task orientated at times that we forget the people’: staff communication experiences when caring for Aboriginal cardiac patients

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.

Aboriginal patient and interpreter perspectives on the delivery of culturally safe hospital‐based care

“…Aligning with previous research, 21 previously published data. 23 Given that seven standard hospital forms include space for language documentation and interpreter requirements, we conclude that TEHS recognises the theoretical importance of this information.…”

“…Interpreters who “walk in two worlds” are uniquely placed to comment on the cultural safety of the institution and advise on improvements. Aligning with previous research, 21 interpreters described the need to diversify Aboriginal employment in the hospital so that Aboriginal staff truly represent the diverse patient population.…”

“How can I do more?” Cultural awareness training for hospital-based healthcare providers working with high Aboriginal caseload

“…McBain-Rigg and Veitch assert that for some Aboriginal patients, health issues are framed in relation to family and community connections and the importance of personal relationships extends to encounters with health professionals. Patient-provider relationships based on trust and respect are a necessary part of good healthcare; yet for the health professional, trained to focus on task-based issues, this approach is an anomaly [59,60]. This cultural difference needs to be understood by the health professional if they are to deliver culturally safe patient centred care.…”