Oral Presentation Lowitja Institute International Indigenous Health and Wellbeing Conference 2016

Strengethening cultural identity: Breaking down paternalistic and post-colonial barriers in hospital (#34)

Vicki Wade 1 , Daniel James 1 , Carrie Sutherland 1 , Sussan Killon 2
  1. Heart Foundation Australia, Sydney, NSW, Australia
  2. AHHA, Canberra, ACT, Australia

Culture is often misconstrued as a barrier to care, however being confident and comfortable in one's culture can be empowering and a powerful enabler in the provision of quality care and positive health outcomes.

For many Aboriginal and Torres Strait Islander peoples the though of having to go to hospital evokes memories of racism, mistreatment and mistrust. Hospitals are a place where you go to die, where your babies are taken, it can be a alien land not country. Hospitals as a whole are disempowering, reinforcing hierarchical class structures, this post colonialism attitude has further disempowered Aboriginal and Torres Strait Islander patients. Often hospitals are driven by efficiencies and lack human interactions.

Having a heart attack is a very frightening experience and can leave the patient very vulnerable. For Aboriginal and Torres Strait Islander peoples this vulnerability can lead to further disempowerment and poor health outcomes. The Heart Foundation has been working for more than 10 years to break down the power imbalances while improving cultural competence in hospitals for Aboriginal and Torres Strait Islander peoples experiencing a heart attack. 

The Lighthouse Hospital Project is a quality improvement project that uses a toolkit and change management principles and has been working with eight hospitals across Australia, including their senior executive teams, cardiac departments, Aboriginal workforce and their Aboriginal communities. One of the strengths to date is the development of local solutions that facilitates cultural identity, awareness and competence at the same time as providing evidenced based care to Aboriginal and Torres Strait Islander survivors of heart attack. 

Early findings have indicated that empowering Aboriginal and Torres Strait Islander patients, the Aboriginal workforce and Aboriginal community has lead to an increase in mutual trust and respect breaking down hierarchical structures. Further to this cardiology staff including cardiologists have been open to providing care that is guided by the culture of the Aboriginal and Torres Strait Islander patient augmenting clinical guidelines. 

The Lighthouse Hospital Project has been instrumental in providing a positive patient journey at a time when patients are vulnerable and further disempowered it puts culture at the centre of care.