The Communicate Study Partnership

Condition(s) studied

Investigational drug(s) / intervention(s)

Interventions to transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples: 1. Implement 'Ask the Specialist Plus', a structured program to promote anti-racism within Northern Territory (NT) hospitals by giving healthcare providers training in cultural safety. 2. Implement strategies to foster 'Clinical champions of cultural safety' through a social media chat platform and face to face meetings to discuss anti-racism practice, cultural safety and practical ways to deliver culturally safe care including interpreter use. 3. Support simplified and improved strategies for booking an interpreter to increase uptake. 4. Implement retention strategies to ensure interpreters receive workplace support. 5. Provide training in health terminology for interpreters. 6. Integrate interpreter supply and demand through efficiency and effectiveness strategies tailored to participating sites. 7. Implement continuous quality improvement cycles with senior managers, using findings from qualitative and quantitative data collection and evaluation.

Study summary

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.

Eligibility

Primary outcome measure(s)

• Self discharge among Aboriginal inpatients at Royal Darwin Hospital, Palmerston Hospital, Katherine Hospital and Gove District Hospital — Up to 4 years. (Health system level data are collected and summarised quarterly during July 1 2022 - June 30 2026, and compared with the baseline phase July 1 2020 - June 30 2022)
  Self discharge (also referred to as 'Discharge against medical advice,', 'take own leave' or 'incomplete care') will be assessed among all admitted Aboriginal patients every quarter as a measure of the effeciveness of hospital-level study activities * Measured as proportion of all admissions of Aboriginal people that end in self-discharge * Data source: hospital Admitted Patient Care dataset (routinely collected by health services) The study has a two-year baseline phase July 1 2020 - June 30 2022, and four-year intervention (activity) period July 1 2022 - June 30 2026. There are no individually enrolled participants followed up at given time points; instead, activities are implemented continually at the level of the health systems, and outcomes are assessed using continuous hospital data and qualitative data, summarised quarterly.
• Patient experience (qualitative evaluation) — Up to 4 years. Interview data will be collected at regular intervals throughout the study (2022-2026) to track any change in patient experience during the course of the intervention period
  Patient experience pre- and post-implementation of the interventions will be assessed through in-depth 30-60 minute one-on-one, face-to-face interviews of inpatients and patients who have recently (within 14 days) been discharged, by a member of the research team. The research team member will speak the patient's first language, or will work with an Aboriginal interpreter to conduct the interview. Some individuals with repeated contact with healthservices (such as renal dialysis patients) will be invited to participate in serial interviews over time

Trial sites (4)

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