Abstract:

Although 2.4% of Australia's population are Aboriginal or Torres Strait Islander (ATSI), their geographic distribution across Australia is quite different. ATSI people comprise 1% of the population in major cities, yet 15% in remote areas and 49% in very remote areas[1]. Many ATSI people experience Chronic Kidney Disease (CKD), often as a complication of diabetes and heart disease. As the disease progresses, they need to access regular dialysis and specialist care. This leads to people leaving their homes and families in order to receive care in larger towns and cities. they then have to navigate numerous appointments across disjointed sections of healthcare. Attending dialysis three times a week, appointments for other health conditions, managing accommodation, financial challenges and transport issues can lead to missed appointments and a further decline in health. The need for equitable access, well-coordinated care and improved health outcomes has been identified in recent studies [2].

A set of ATSI patient journey mapping tools were developed [3] that identify the complexity within patient journeys, highlighting the critical steps and gaps between services and provided a focus and options for targeted action by health care providers. Therefore this education initiative invites ATSI kidney patients to identify gaps in their care and suggest improvements. As part of this education initiative the renal patient mapping tool is used and identified in detail exactly what happens when multiple health appointments are scheduled across different parts of the health service and show where “links in the chain” are missed that then lead to patients feeling unsupported.

This education initiative has involved senior health professionals, managers, researchers and educators to develop support services to improve indigenous patient journeys and care outcomes. Long term changes will be made to clinical practices and health care policies, with ongoing reference to patient values and priorities. Overall this education strategy looks at staff understanding cultural competence as an integral part of any health journey. Training is being provided for staff and within this training new case studies of the patient journeys will be used to improve the education of doctors, nurses and other health professionals in health care and university settings which can respond to identified needs and ensure staff cultural competency [1].

Ii is hoped that this new educational strategy can assist with better understanding and addressing the gaps in care, increasing the cultural competency and responsiveness of staff and services and lead to significant improvements in patient outcomes and patient satisfaction. This presentation will explain the development of the mapping tools and how they are being used to inform health journeys for renal patients and beyond.

References:
[1] Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.
[2] Dwyer, J., E. Willis, and J. Kelly, Hospitals caring for rural Aboriginal patients: holding response and denial. Australian Health Review, 2014. 38(5): p. 546-551.
[3] Kelly, J., Dwyer, J., Pekarsky, B., Mackean, T., Willis, E., de Crespigny, C., Perkins, S., ’Donnell, K., King, R., Mackean, L., Brown, A., Lawrence, M. and Dixon, K. 2015, Managing Two Worlds Together (Stage 3): Improving Aboriginal Patient Journeys – Study Report, The Lowitja Institute, Melbourne.

Keywords:

Aboriginal, Education, Patient Journey, Rural.