Improving the patient journey for Aboriginal and Torres Strait Islander peoples with ACS: success stories, key enablers and common barriers

Transcription

1 Improving the patient journey for Aboriginal and Torres Strait Islander peoples with ACS: success stories, key enablers and common barriers Learning's from Phase 1 Lighthouse Hospital Project

2 I would like to acknowledge the Kaurna peoples who are the Traditional Custodians of this Land. I would also like to pay respect to the Elders both past and present.

3 Acknowledgments Department of Health & Ageing Project Team Vicki Wade Dr Rob Grenfell Andrew McAuliffe Eleanor Clune Case study sites

4 Princess Alexandra Hospital Arnold Ng, Staff cardiologist William Wang, Staff cardiologist Vivian Bryce, Clinical Nurse Consultant Tamworth Base Hospital Jane Kerr, CVD coordinator Val White, Welfare Worker Coffs Harbour Base Hospital Sheryl Bonn, Cardiac rehab CNC Jay Gilchrist, Cardiac Rehab Carolyn Hart, Aboriginal Health Education Officer Shane Gabriel, Nurse education CVD & primary care Pam Lane, Physiotherapist & CR Marilyn Body, Clinical Nurse Consultant Chronic Care for Aboriginal people iccnet, Adelaide Rosy Tirimacco, Network Operations & Research Manager Flinders Medical Centre Rob Baker, Director of Cardiac Surgery and Research and Perfusion Jayme Bennetts, Head of Cardiac Surgery St Vincent s Hospital Karen Daws, Research Fellow Linda Worrall-Carter, Director, Centre for Nursing Research and Cardiac Research John Willis, Coordinator, Aboriginal Health Projects Michelle Winters, Senior AHLO and Training Officer Royal Darwin Hospital Jeff Tinsley, Nursing Unit Manager, Coronary Care / Chronic Disease Coordination Unit Mark, Cardiac Rehab coordinator Flinders Medical Centre Daphne Perry, Aboriginal and Torres Strait Islander Remote Area Clinical Liaison Nurse for Cardiac Surgery and Cardiac Surgery preadmission coordinator Derek Francis, Aboriginal Liaison Officer Sue Treadwell, Cardiac services coordinator Aboriginal Patient Pathway Office Mandy, Project Officer, Closing the Gap, Improving Patient Journey Vicki Jacobs, Principal Policy Officer, Aboriginal Health Directorate

5 Overview What is a lighthouse hospital project? How the journey began Why a lighthouse hospital project? What we discovered from phase 1 Where to from here

6 What is a lighthouse hospital project? The concept of a lighthouse hospital involves identification of lead hospitals to undertake a change management process, which includes practice auditing and quality improvement of existing practices. Lighthouse sites then mentor other hospitals to enable them to benefit from their knowledge and expertise.

7 Why a lighthouse hospital project? Phase I: Data Collection: - Scoping -Consultation - Analysis - Design of Phases II & III Phase II: Implementation - Quality Audit toolkit development - Lighthouse hospital sites selected - Local lighthouse and mentoree hospital networks established - Implementation, evaluation and sustainability Phase III: Evaluation & sustainability Year DOHA funding = $ (inclusive GST)

8 How the journey began the catalyst When in hospital Indigenous Australians had: More than twice the in-hospital CHD death rate A 40% lower rate of being investigated by angiography A 40% lower rate of coronary angioplasty or stents procedures A 20% lower rate of coronary bypass surgery. compared to other Australians

9

10 Why a lighthouse hospital project? - More research and better, comprehensive data collection is needed - Addressing hospital disparities is a complex task that must involve the commitment of organisations and individuals in both government and non-government sectors - Lighthouse hospital demonstration project to identify lead hospitals, up skill services and share knowledge and expertise to improve outcomes - Some good things are happening in some places

11 The model and critical domains

12

13 Royal Prince Alfred, Liverpool and Campbelltown Natalie Richards, (Previously) Walgan Tilly Project Officer Managing Two Worlds Together Janet Kelly, Managing Two Worlds Together Project, Project Coordinator Royal Perth Hospital Narelle Wilson, Cardiac Rehabilitation Clinical Nurse Specialist

14 What we learned No one service was perfect Concepts Cultural protocols, Aboriginal staff, physical environment Workforce training, multidisciplinary care CQI identification, specific monitoring for variation of care Governance financial support, leadership, partnerships

15 What we learned Key enablers - Cultural competence - Leadership and champions - ALO/AHW/APPO programs - Effective relationships, partnerships and consultations - Administrative/logistical support - Good will - Information sharing

16 What we learned Key barriers - Inadequate resources/funding - Lack of support from senior management - Uncertain sustainability - Difficulties associated with identification and data availability - Cultural heterogeneity of Aboriginal and Torres Strait Islander populations and individuals - Variable utilisation of ALOs, AHWs and other support staff - Staffing instability - Wide variance in cultural training

17 What we learned Recommendations from phase 1 are: - Optimisation of roles of Aboriginal workforce - Better identification - Effective partnerships - Supporting clinical champions - Building capacity for patient-based care - Industry based quality matrix

18 What we learned Relationship to other activities - ESSENCE - National Clinical Goal for the ACS care - Aboriginal and Torres Strait Islander Health - Performance framework - National Hospital Performance framework

19 Where to from here Phase I: Data Collection: - Scoping -Consultation - Analysis - Design of Phases II & III Phase II: Implementation - Quality Audit toolkit development - Lighthouse hospital sites selected - Local lighthouse and mentoree hospital networks established - Implementation, evaluation and sustainability Phase III: Evaluation & sustainability Year