Effective communication is fundamental to ensuring quality and safety of health services but is particularly challenging when staff and patients do not share the same language and cultural background. At Royal Darwin Hospital (RDH) in the Northern Territory many Aboriginal patients and their families speak an Aboriginal language as their primary language and there are serious concerns about the effectiveness of communication between staff and consumers. The Communicate Study is Stage 1 of a two-stage process seeking to improve communication at RDH and was conducted through a collaboration between RDH, Aboriginal Interpreter Service (AIS), Department of Health, Menzies School of Health Research and Charles Darwin University. We used both qualitative and quantitative methods to identify enablers of, and barriers to, effective intercultural communication as well as strategies for improvement. Quantitative data has confirmed that uptake of the Aboriginal Interpreter Services is extremely low and on-site accessibility of interpreters in the hospital has decreased. We will discuss the qualitative findings from in-depth interviews with 35 participants including health care and Indigenous Liaison staff at RDH, AIS staff and interpreters as well as consumers.
Analysis of qualitative data revealed a range of barriers to achieving effective communication at health care system, practitioner and patient levels. For example, while clinicians recognise serious limitations in communication with Aboriginal patients and their families, they feel powerless to address the challenges in the very busy clinical environment. Easier access to interpreters, improved staff to patient ratios to allow enough time to communicate effectively and more comprehensive training of both health staff and interpreters in intercultural health communication, are examples of key strategies for improvement identified by participants. Such training is crucial to: increasing awareness of the risk and consequences of ineffective communication; improving staff skills in recognising when an interpreter is needed and to improve the skills of health staff and interpreters in working effectively together. The findings of this study are informing the next planned step in the process towards achieving effective intercultural communication–developing, implementing, evaluating and embedding strategies to support sustained improvement in communication between health staff and Aboriginal patients and their families.