The journey of Aboriginal children and their families throughout the NCHN
Ensuring the on-going provision of high quality, culturally appropriate services to Aboriginal children and their families as part of our core business is a high priority for the NCHN. This priority is supported by the Aboriginal Health Services Plans for both NC and HNE Health Services.
This project aims to facilitate the patient journey through primary, secondary and tertiary levels of care in order to prevent chronic and complex health issues.
The project targets Aboriginal children and their families/carers, traveling away from home to receive care from HNE and NC Area Health service (AHS). The scope is:
- from the point of a decision to care for locally or transfer into a higher level of care in the NCHN Health, through to
- the child is discharged, either directly into the community, or when the care is handed to another health or community care provider at the end of the episode of care.
The project will involve identifying a small number, possibly two receiving sites (higher levels of care) within each AHS (total of four). The sites chosen will reflect the points where the highest number of inflows of Aboriginal children to a secondary or tertiary facility occurs.
Site selection will occur after analysing current data during the first stage of the project. In addition, a number of sites with high numbers of Aboriginal children and families being referred for higher-level care will also be selected across the two AHS.
While the project will focus on the nominated sites, the successful solutions will be rolled out to cover the remaining parts of both Areas. This will come with the challenges arising from the differences in the complexity and the range and nature of issues arising from the diversity of the communities in the Area.
Aims and objectives
When the project commenced the objectives were reviewed and reworded as follows:
- Confirm what constitutes a culturally appropriate health service for Aboriginal children and their families.
- Explore communication between hospital staff and Aboriginal children and their families.
- Identify the level of involvement of Aboriginal children and their families have in health care and discharge planning.
- Identify what support and assistance is required for Aboriginal families when their child’s health care is transferred to a service outside their local community, in particular, travel, accommodation and social support arrangements.
- Build on existing initiatives so that the best possible and culturally appropriate supports are accessible to Aboriginal families when their child’s health care is transferred to a service outside their local community.
- Provide cultural knowledge to children’s health planning to ensure improved health experiences and outcomes for Aboriginal children.
In addition, the following Measurable Benefits were identified:
- Improved Aboriginal child and their families’ satisfaction with public hospital experiences. Explore the possibility of measuring this via the NSW Health Patient Survey, provided sample sizes are sufficient. Otherwise alternative measures will be explored.
- Increased percentage of Aboriginal families accessing the transport, accommodation and social support arrangements that are available when a child’s health care is transferred to a service outside their local community.
- All children’s health policy documents to include cultural aspects relevant to improved health outcomes for Aboriginal children.
Expected outcomes
Currently, after a decision is made to transfer from a smaller facility to a larger one, Aboriginal children often face isolation from family and friends, thereby compromising their cultural environment in a way that hampers the patient and family health experience and outcomes.This project aims to better understand the journey for the Aboriginal child and their family in this situation. The goal is to improve the patient and family experience by ensuring continued access to culturally appropriate health care for Aboriginal people, by redesigning the supporting infrastructure in a way that will lead to improvements in health outcomes.
Other expected outcomes include:
- A redesigned, more consistent child and their family/carer journey that recognises the difference in the geography, isolation, workforce and the range of service models across the NCHN.
- Better negotiation of the patient journey and support for children and their families who need specialist intervention in a health facility away from home and family/community.
- Better informed AHS policy and planning to better meet the needs of Aboriginal children and their families.
- Greater participation by the child and their family in the planning for all aspects of care prior to transfer to higher and lower levels of care
- Greater involvement by the mainstream discharge planners and the Aboriginal Liaison Officers and all other relevant care providers in the implementation of the care plan prior to and follow-up post discharge
- A re-orientation of mainstream health staff, leading to a greater understanding of how best to meet the needs of Aboriginal people
- An improved use of ‘prevention of relapse planning’ in the community setting, and
- Wider access to appropriate accommodation and social supports, and culturally appropriate care.
Key performance indicators
The success of the project will be measured by:
- Evidence of review of health services for Aboriginal children.
- Evidence of planning and policy development within the AHS in direct relationship with the results of the project.
- Evidence of follow-up on health issues identified through the patient journey.
Progress
Due to the extremely late allocation of funds by NSW Health the bulk of funding allocated for 2007/08 was withdrawn by NSW Health and reallocated for 2008/09. During the period April to June 2008, the Steering Committee had preliminary discussions and undertook detailed planning for the commencement of the project. Project officers have been identified and appointed, with two commencing in the last week of June with attendance at the first week of the NSW Health Redesign School.
For more information contact:
| Hunter New England Kim Browne Director, Population Health & Planning 02 4921 4908 |
North Coast Vahid Saberi Director, Population Health & Planning 02 6620 7520 |