Enquiries:+61 2 8502 4571
 

Element 2: Wellbeing is supported by an appropriately skilled and culturally competent healthcare team

Appropriately skilled healthcare teams are comprised of staff who are culturally competent as well as appropriately skilled and qualified to provide the types of clinical care that are required. Given the crucial role of Aboriginal and Torres Strait Islander staff in linking primary healthcare services with communities, and in the provision of culturally safe care, their particular role needs to be valued. Finally, effective leaders who can ensure that primary healthcare services are responsive to the needs of local communities are essential.

PRINCIPLES

Principle 2a: Ensuring that all staff are culturally competent

Ensuring that all primary healthcare staff are culturally competent may effectively protect the rights and safety of both clients and primary healthcare providers [29, 30].

Principle 2b: Equipping staff with suitable skills to support people with chronic disease

It is important that primary healthcare staff are appropriately skilled and qualified to meet the specific and often complex health needs of the communities they serve. Enhancing the professional development of staff can ensure the currency of clinical skills, as well as encourage retention of staff, thereby supporting continuity of care.

Principle 2c: Valuing and supporting Aboriginal and Torres Strait Islander staff

As a consequence of their cultural understandings and community connections, Aboriginal and Torres Strait Islander staff bring unique contributions to primary healthcare services [17, 31, 32]. It is important to ensure that Aboriginal and Torres Strait Islander staff are not discriminated against, excluded or isolated from other members of the healthcare team [13, 16, 33]. Aboriginal and Torres Strait Islander staff may require further support in managing any additional burden resulting from the dual responsibilities associated with being both healthcare providers and members of local communities [13, 17].

Principle 2d: Developing effective cultural leadership

Effective leaders, whether they sit on governing boards or occupy management positions, will be able to guide and direct the primary healthcare service to ensure that the diverse needs of communities are met and that services remain adequately transparent to maintain the trust of communities.

APPLICATIONS

Applications associated with Principle 2a: Ensuring that all staff are culturally competent

Cultural competency may be developed by:

  • Providing regular cultural safety training to all staff members [13, 16, 26]
  • Supplementing generic cultural safety training with locally specific face-to-face training [13, 33]
  • Involving Elders and other members of local Aboriginal and Torres Strait Islander communities in the development and provision of cultural safety training, and remunerating community members for their contributions to cultural safety training [13, 20, 55]
  • Tailoring cultural safety training to the roles and responsibilities of staff members [13, 27]
  • Ensuring that all staff are well-informed about local Aboriginal and Torres Strait Islander communities [13, 35]
  • Providing local cultural mentors for new staff [13, 49]
  • Ensuring non-Indigenous staff can access cultural support from designated Aboriginal and Torres Strait Islander staff members within primary healthcare services [19, 35]
  • Providing opportunities for staff to learn from each other [13, 20]
  • Ensuring that staff are aware of the important role of Aboriginal Health Practitioners [13, 16]
  • Providing opportunities for staff to engage directly with communities [55]
  • Utilising previous and current case studies where health service providers have applied cultural competency programs effectively [55]
  • Monitoring the progress of staff in cultural competency practice as well as the completion of cultural awareness training [55]
  • Ensure cultural competency is supported by appropriate procedures, policies and protocols
Applications associated with Principle 2b: Equipping staff with suitable skills to support people with chronic disease

Equipping staff with suitable skills to support chronic disease may be enhanced by:

  • Identifying skilled and respected staff who are clinically competent to ensure evidence-based care is provided [33, 56]
  • Developing recruitment policies that ensure that potential staff have sufficient skills, understanding and ability to contribute to the healthcare needs of communities [16, 19, 22]
  • Articulating clearly the roles and responsibilities of staff members [13, 14, 26, 33]
  • Providing opportunities for staff to debrief with their supervisors [13]
  • Rotating staff through remote areas and mainstream primary healthcare services to develop skills and experience [13]
  • Providing professional, personal and infrastructure support to staff working in rural and remote areas [33, 42, 56]
  • Providing ongoing professional development [20, 33, 44, 45, 56, 57]
  • Acknowledging and utilising the skills of staff that have been developed through experience [13, 20]
  • Supporting staff to undertake appropriate training and obtain qualifications [13, 22]
  • Identifying the needs of staff in order to promote and support their wellbeing, including formal support such as Employment Assistance Programs [14, 27, 55, 58]
Applications associated with Principle 2c: Valuing and supporting Aboriginal and Torres Strait Islander staff

Valuing and supporting Aboriginal and Torres Strait Islander healthcare staff may be achieved by:

  • Actively encouraging recruitment and retention of Aboriginal and Torres Strait Islander Health Workers and staff members, and ensuring equity in salaries and remuneration packages [55]
  • Including Aboriginal and Torres Strait Islander staff in setting primary healthcare priorities and in decision making within the primary healthcare service [16, 33]
  • Responding to cultural, spiritual, family and community obligations of Aboriginal and Torres Strait Islander staff [13, 38]
  • Ensuring that Aboriginal and Torres Strait Islander staff are provided with support to assist in managing any additional responsibilities associated with being both members of local communities and of primary healthcare teams [17, 31]
  • Encouraging and supporting Aboriginal and Torres Strait islander staff to meet their career goals [13, 16, 55]
  • Recognising Aboriginal and Torres Strait Islander healthcare staff as an integral part of a multi-disciplinary team
Applications associated with Principle 2d: Developing effective cultural leadership

Effective leadership may be developed by:

  • Supporting local community members to actively guide and govern local primary healthcare services [17, 33]
  • Facilitating opportunities for Aboriginal and Torres Strait Islander people to take up leadership positions [13, 27]
  • Employing leaders who are able to establish and implement clear strategies based on agreed-upon goals [6, 28, 44, 49, 59, 60]
  • Establishing reporting systems which ensure transparency [16, 44]
  • Establishing a succession plan to ensure sound future leadership [6, 44]