The Communicate Study Partnership

The vision of the Communicate Study Partnership is to ensure more Aboriginal patients receive culturally safe healthcare in their first language. The Communicate Study Partnership will implement and evaluate creative ways to embed cultural safety training and increase use of Aboriginal Interpreters and Aboriginal Health Practitioners at Northern Territory Top End hospitals. Quantitative outcomes (interpreter uptake, outcomes including leave against medical advice, costs) will be measured using time-series analysis. Qualitative outcomes derived from interviews with patient, healthcare provider and interpreter participants, will be informed by decolonising theory and participatory approaches. Successful project implementation will improve experience of care and health outcomes for Aboriginal people, build Aboriginal workforce, and improve healthcare provider satisfaction.

The goal of "The Communicate Study: partnership across the Top End to improve Aboriginal patients' experience and outcomes of healthcare" is to achieve sustainable organisational change to provide excellence in cultural and clinical safety for Aboriginal people utilising NT Health facilities. Aim 1: Transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples \- Develop, implement and evaluate anti-racism training using 'Ask the specialist-Plus'. This comprises moderated discussion and reflection on 'Ask the Specialist' podcast episodes held during in-service and clinical teaching timeslots for healthcare providers Aim 2: Strengthen the tools and strategies required underpinning culturally safe practice 1. Improve demand for Aboriginal interpreters and Aboriginal health practitioners through improved cultural understanding and recognition of patient needs 2. Improve supply of interpreters and Aboriginal health practitioners willing to work in the hospital environment by creating a culturally safe workplace and supporting career pathways 3. Effectiveness strategies tailored to participating sites such as * positioning interpreters at points of need and embedding them in medical and surgical teams * Optimising workflow to facilitate efficiency and availability across hospital departments Aim 3: Evaluate outcomes using comprehensive qualitative and quantitative measures 1. Qualitative enquiry to assess cultural safety from patient perspectives, and understand experiences of Aboriginal and Non-Aboriginal healthcare providers and interpreters 2. Quantitative outcomes including * performance across key indicators: changes in documentation of language; Interpreter bookings made; Interpreter bookings completed; % Aboriginal patients in need getting access to an interpreter * Impact of intervention: proportion of admissions with and without interpreters ending in self-discharge; unplanned re-admissions and changes in hospital length of stay * economic analysis of the costs and cost benefits of interpreter use to decrease self-discharge and re-admission rates.

Inclusion Criteria: Different patient and provider participants (e.g. Aboriginal patients, Aboriginal interpreters, healthcare providers of any ethnicity) will be invited to participate in interviews, observations and surveys to assess effectiveness of study activities Exclusion Criteria: None