Aboriginal Community Controlled Health Services – Aboriginal and Torres Strait Islander Man Scenario

Aboriginal and Torres Strait Islander Man from Palm Island

You are a registered nurse working at a hospital in Brisbane. Matt is a 24 year old Aboriginal and Torres Strait Islander man from Palm Island, he is currently an inpatient, but is awaiting transfer to the discharge lounge. He will be traveling back to Townsville today where he will continue his care from his mother’s home in Kirwan, Townsville.

He experienced some challenges while admitted to your ward, however thanks to your confident and informed patient advocacy and culturally safe care, he was able to be empowered to complete his care.

Following is the discussion topic:

You have been asked to review the discharge plan for Matt. The discharge plan currently identifies the Townsville Hospital as the facility that has been in correspondence. However, you know from recent discussions with Matt that he plans to have his care handed-over to the Townsville Aboriginal and Islander Health Service (TAIHS), the local Aboriginal Community Controlled Health Service (ACCHS). When you approach the Community Hospital Interface Program (CHIP) nurse about this error, she asserts that ACCHSs are just like a General Practice (GP), and may not have the resources to support Matt’s rehabilitation.

The Australian Human Rights Commission’s Close the Gap 2018 report highlights the need for greater investment ACCHSs as a preferred service for closing the gap. Address the following tasks in your discussion essay:

  1. define what an ACCHS is, and discuss how ACCHSs respond to holistic health needs, as per the Aboriginal and Torres Strait Islander definition of health (as included in the NACCHO Constitution) (325 words)
    • what is ACCHS
    • what is holistic health and its needs
    • how ACCHSs respond to holistic health needs.
  2. compare and contrast ACCHSs and GPs regarding their ability to provide holistic and culturally safe care (325 words)
    • what is ACCHSs ability to provide holistic and culturally safe care
    • what is GPs ability to provide holistic and culturally safe care
    • what are their similarities and differences in providing holistic and culturally safe care
  3. describe the role of the Aboriginal and Torres Strait Islander Health Worker (ATSIHW). Discuss what nurses need to consider when working with ATSIHW in an interdisciplinary team (325 words)
    • describe the role of ATSIHW
    • Discuss what nurses need to consider when working with ATSIHW in an interdisciplinary team
  4. define self-determination and explain how it relates to ACCHOs, ATSIHWs and cultural safety (325 words)
    • define self-determination
    • explain how it relates to ACCHOs
    • explain how it relates to ATSIHWs
    • explain how it relates to cultural safety

Aboriginal Community Controlled health Services (ACCHS) – Sample Paper

Introduction

Indigenous Australians have been experiencing poor healthcare services that pay little or no attention to their cultural needs. This resulted to poor access to primary care, causing huge health disparity between indigenous people of Australia and the rest of the population (NACCHO, 2014). To improve the situation, the indigenous family focused on developing their own healthcare system that is managed and controlled by indigenous people, for indigenous people of Australia. The established ACCHS focused on provision of culturally based and holistic care to indigenous people of Australia (Ward, Fredericks & Best, 2017). This paper focuses on analysing ACCHS and its role in ensuring effective provision of healthcare for indigenous people of Australia.

ACCHS and its Response to Holistic Health Needs as per the Aboriginal and Torres Strait Islander Definition of Health

ACCHS refers to an incorporated Aboriginal organization based in and initiated by a local Aboriginal community. ACCHS was established across Australia to offer culturally accessible and appropriate primary care for Aboriginal and Torres Strait Islander people (Panaretto, Wenitong, Button & Ring, 2014). It offers culturally appropriate, comprehensive and holistic health care services to indigenous Australians community, who also controls it via Board of Management which is locally elected (Panaretto et al., 2014).  ACCHS offers an extensive range of community, preventive, cultural and population wellbeing and health services (NACCHO, 2014).

Read also Application of Culturally Safety to the Aboriginal and Torres Strait Islander Peoples’ Health and Well-being Context

Holistic health characteristically regards the whole person; spirit, mind and body. A holistic healing approach goes past symptoms elimination. Its condition defines the momentary condition of mental-psychical-social and physical relationships. Holistic health needs to consider the overall wellbeing of a person and aspects that influence people’s wellbeing which include economic needs (Mato-Juhasz, Kiss-Toth & Szegedi, 2016). According to Mato-Juhasz et all., (2016), the general health state of a person is determined by several factors which include personal behaviour factors, external environment factors and the host factors. Holist health needs to consider individual spiritual, economic social, emotional and physical needs, their response to illness, and the illness effect on individual ability to meet self-care requirements. Nurses offering holistic health care ensure that patients receive the prescribed medication, social and psychological support by talking to them and building friendship and trust with patients, give training about self-care, and ensure spiritual support (Mato-Juhasz et al., 2016).

 In ACCHS, holistic health involves considering the cultural aspects of indigenous people and how they influence their health, accessibility aspects, individual behaviours, lifestyle and individual perception of health (Ware, 2013). It also focuses on eliminating barriers that have been preventing effective access to primary care in the past, which include different social determinant of health among aboriginal people. The ACCHS responds to holistic health needs by integrating Aboriginal and Torres Islander people culture into the primary care services. They also consider their economic status and how it influences the accessibility to primary health care (Ware, 2013).

ACCHSs vs GPs Regarding the Ability to Provide Holistic and Culturally Safe Care

ACCHS was specifically designed to address the health needs of indigenous Australians. Its main purpose was to bridge the health gap by ensuring equity to access to healthcare services. ACCHS was incorporated by Aboriginal organizations and initiated in a local Aboriginal community, employing Aboriginal workers, and ensuring culturally competent health care services. ACCHS has been found to offer the more effectual and equitable primary health care services to indigenous people (Ong, Carter, Kelaher & Anderson, 2012). This means that ACCHS is one of the most cultural safe healthcare environments for indigenous people in Australia. ACCHS was also designed with holistic healthcare in mind. Its implementation thus plays a great role in ensuring the accomplishment of holistic care (Baba, Brola & Hill, 2014).

The Australian General Practice Services (GPS) have severally failed in providing effective healthcare services to Australian indigenous community. According to Kilian and Williason (2018), aboriginal adolescents and children in need of mental care services experienced difficulties navigating the Australian health care system, due to complex socio-cultural factors. This situation has also been experienced in other healthcare units in the GPS. Holistic health normally involves considering all factors that can influence people’s health. The GPS inability to consider indigenous people cultural aspect and how it influences their health and wellbeing makes it fail in provision of holistic care (Thomas, Mitchell, Rich & Best, 2018).

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ACCHS was basically created with indigenous people cultural and holistic care needs in mind. It thus demonstrates high ability to ensure culturally safe healthcare environment and total consideration of holistic health needs of patients. On the contrary, GPS has failed in creating a culturally safe health care environment for indigenous Australians. GPS was design to address healthcare needs of Australia people. Its designer had little or no knowledge or concern on special cultural needs of indigenous people that would influence their health. Although GPS is designed for holistic care its inability to consider cultural influences in indigenous people’s health makes it perform poorly in provision of holistic health care.

The Role of the Aboriginal and Torres Strait Islander Health Worker (ATSIHW)

ATSIHW refers to persons with initial qualification in the clinical practice and primary health care field. They play an essential role in the provision of primary and clinical health care for community groups, families and individuals, including specialty areas of mental health, alcohol and drug, eye and diabetes and ear health (Health.NSW, 2018). The ATSIHWs common goal is to help the Aboriginal and Torres Strait Islander people to assume a strong role in managing and controlling their own lifestyles and health.  Their main role in healthcare include offering cultural and health education to the community, acting as interpreters and communicators, treating injuries and diseases, and keeping medical records. They also offer life skills education, crisis intervention referral and counselling, and offer input in the evaluation, planning, monitoring, development and implementation of all health programs in the community   (Health.NSW, 2018). 

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According to Nancarrow et al. (2013), interdisciplinary team work refers to a complex process where in, different kinds of staff operate together to share skills, knowledge and expertise to influences patient care. The complexity is compounded by the team work multifactorial nature, comprising of the mix of skills, service organization, care setting, management structures and individual relationships (Nancarrow et al., 2013). While working together with ATSIHWs nurses need to ensure effective communication between the two team members. Effective communication ensures enhancement of care safety by avoid errors due to miscommunication, especially in a situation where (Ramsamy, 2018).

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ATSIHWs performs role that are quite similar to those of nurses, despite being less qualified. It is therefore important for the two groups define their roles and boundaries in an interdisciplinary operation, considering what ATSIHWs can or cannot do based on their level of qualification. Nurses should demonstrate respect for ATSIHWs and respect their contribution to the interdisciplinary operation (Ramsamy 2014). Effective care plan should also be enhanced to ensure total participation of all, without feeling undermined.  The two groups can also have shared roles and work as a team to enhance effective care for all especially in the nursing aspects that ATSIHWs are good at (Gausvik et al., 2015).

Self-Determination and how it Associates to ACCHOS, ATSIHWs and Cultural Safety

Self-determination refers to the equal entitlement to be in ones destinies control, while living with the governing institutions. Self-determination is important to enhancing indigenous wellbeing and health (O’Mara, 2012). Self-determination involves engaging the aboriginal and Torres Strait Islander population in each decision making layer, to be able to meet their health needs. Active involvement is required in the control, delivery and design of health services to those who will be using the services (O’Mara, 2012).

ACCHOs are health care organizations created by indigenous Australian people for their own health care services. The ACCHOs played a great role in the development of ACCHs that is total a self-determination healthcare system for indigenous people (Mazel, 2016). The system is created with intention of eliminating things that indigenous people did not like in the GPS, and integrating things they wished could have been prioritized in GPS. ACCHS is a system in which indigenous people took the main control in the health research, completion and assessment, obtaining the actual picture of the indigenous people health needs and considered them in developing indigenous people health care system (Armstrong & Hayman, 2012). ATSIHWs ensure self-determination by running the indigenous people health care services in a manner that considers their cultural needs. This ensures that the health care services are provided as people would want them to be. ATSIHWs belong to Aboriginal and Torres communities and thus, they clearly understand their health needs and how they can be addressed to gain better outcome. The involvement of indigenous people in the development of the ACCHS ensured that they integrated their cultural aspects in the provision of health care system (Ward, Fredericks & Best, 2017). The engagement of Aboriginal and Torres in the health care services provision through ATSIHWs ensured effective implementation of indigenous cultural aspects in care. This resulted to creation of a culturally safe health care environment through self-determination (Ward, Fredericks & Best, 2017).  

Conclusion Indigenous people of Australia have been experiencing cultural challenges in the main Australian health care system. This resulted to a huge health gap between them and the rest of the Australian population. The need for culturally safe healthcare system pushed the indigenous people into fighting for self-determination health care system, where indigenous people were fully involved in developing a health care system that suits their health care needs and that ensure a cultural safe health care environment. This resulted to the development of ACCHS which is commended for serving aboriginal and Torres people in a more satisfactory manner by considering their holistic health and cultural aspects.

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