Improving cultural sensitivity to Indigenous people in Australian hospitals a continuous quality improvement approach

Abstract

BACKGROUND: The continuous quality improvement (CQI) model is widely applied in hospitals in the developed world and is an effective means of improving health service practices and outcomes. Consumer research indicates that most successful consumer centered reforms involve consumers in all phases of the 'plan, do, study, act' cycle and culturally this is consistent with the expectations of Indigenous Australians. Hospitals already use CQI processes, however we argue that this model can be applied to cultural standards. The aim of the Improving the Culture of Hospitals Project was to develop an evidence based quality improvement framework (the 'toolkit') for Australian hospitals. This toolkit includes a range of resources, tools and guidelines to support the design and implementation of CQI strategies for improving cultural sensitivity as it relates to Indigenous Australians. METHODS: Hospital case studies were undertaken to develop, then trial, the toolkit. Training for Aboriginal staff in the use of CQI technology was implemented. The draft toolkit, along with the findings from the case studies, was then presented to a national key stakeholder forum to explore implementation and future research issues. FINDINGS: The findings show that hospitals that have improved cultural sensitivity share a number of key characteristics including relationships with Aboriginal communities and commitment to supporting their Aboriginal workforce. CONCLUSIONS: Hospitals require senior management to prioritise and support this work and ensure that Aboriginal staff are trained to facilitate the process. The inclusion of Aboriginal specific elements in the Australian Council of Healthcare Standards is also seen as a key driver for change.