Transforming EDs towards Cultural Safety (TECS)

Initiative Type
Redesign
Service Improvement
Status
Deliver
Added
27 June 2019
Last updated
01 July 2019

Summary

The Transforming EDs towards Cultural Safety (TECS) initiative supports the development of local multidisciplinary teams who share a passion for improving the cultural safety of patients and staff in the Emergency Department (ED).

As the first point of contact for many patients, EDs have an opportunity and a responsibility to ‘set the scene’ by providing a welcoming environment and culturally appropriate care.

TECS is derived from the Cairns Hospital Cultural Safety Working Group, formed with the primary objectives of:

  1. Developing and driving an inclusive ED focused program in cultural competency for all staff.
  2. Developing and maintaining locally relevant resources for staff.
  3. Developing relevant policies, procedures and protocols that relate to the National Safety and Quality Health Service (NSQHS) Standards for Aboriginal and Torres Strait Islander patients.
  4. Driving and documenting projects to improve the experience for Aboriginal and Torres Strait Islander patients and their families.
  5. Ensuring the cultural safety of Aboriginal and Torres Strait Islander staff in the ED.
Key dates
Jul 2019
Jun 2020
Partnerships
Queensland Emergency Department Strategic Advisory Panel (QEDSAP)

Aim

To optimise cultural capability in EDs that encourages better access and improved delivery of care to Aboriginal and Torres Strait Islander patients and their families.

Benefits

  • An ED environment that encourages Aboriginal and Torres Strait Islander patients to engage with emergency care.
  • Reduced number of Aboriginal and Torres Strait Islander patients who did not wait or left prior to completion of treatment in the ED.
  • Increased collaboration with other Queensland Health groups on issues specific to Aboriginal and Torres Strait Islander Health.
  • Increased Aboriginal and Torres Strait Islander staff members in the ED.  
  • Improved collaboration with community agencies.
  • Improved identification of Aboriginal and Torres Strait Islander patients presenting to the ED.

Background

The TECS Initiative Lead is Stefan Kuiper, Staff Specialist Emergency Physician at Cairns Hospital, Cairns and Hinterland HHS.

Developed in Cairns Hospital following an external Cultural Capability Audit, the Cairns ED Cultural Safety Working Group was founded to improve the ED across the domains of Cultural Respect and Recognition, Relationship and Partnership, Communication, and Capacity Building. The core tenets of this working group are the focus of TECS.

Solutions Implemented

The primary objectives of the Cairns group were achieved by:

  • Improving the physical environment in the ED, making it more welcoming (e.g. displaying artwork, positive images, flags and the Queensland Health “Statement of Commitment to Reconciliation”).
  • Collaborating with other Queensland Health groups on issues specific to Aboriginal and Torres Strait Islander Health.
  • Increasing the number of Aboriginal and Torres Strait Islander staff members across various streams, including Indigenous Liaison Officers and introducing Aboriginal Health Workers.
  • Collaboration with community agencies such as homeless shelters. And hosting an open day for agencies in the ED to discuss better coordination of care.
  • Improved staff training

Evaluation and Results

A full data analysis is awaiting completion. Pre- and post-implementation data, such as the proportion of patients that discharged against medical advice, emergency length of stay and representation rates to the ED has been halved since this initiative commenced.

Other evaluations are ongoing and include patient surveys and reviews at morbidity and mortality meetings, specifically evaluating how cultural safety was addressed.  

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Key contact

Stefan Kuiper
Staff Specialist Emergency Physician and Initiative Lead, Carins Hospital
PROV-ED Project – Healthcare Improvement Unit (HIU) – Clinical Excellence Queensland (CEQ)
(07) 3646 5005
PROVED.Project@health.qld.gov.au