Cultural safety - Colonoscopy Clinical Care Standard
The Commission is committed to supporting healthcare services to provide culturally safe and equitable healthcare to all Australians. See our recommendations on culturally safe care from the Colonoscopy Clinical Care Standard.
Cultural safety and equity
Person-centred care recognises and respects differences in individual needs, beliefs, and culture. The Commission:
- Is committed to supporting healthcare services to provide culturally safe and equitable healthcare to all Australians
- Acknowledges that discrimination and inequity are significant barriers to achieving high‑quality health outcomes for some patients from culturally and linguistically diverse communities
Culturally safe service provision and environments are those where the places, people, policies and practices foster mutual respect, shared decision making, and an understanding of cultural, linguistic and spiritual perspectives and differences. Cultural safety is supported by organisations and individuals that recognise cultural power imbalances and actively address them by:
- Ensuring access to and use of interpreter services or cultural translators when this will assist the patient and aligns with their wishes
- Providing visual or written information in a language that the patient, their family and carers will understand
- Providing cultural competency training for all staff Encouraging clinicians to review their own beliefs and attitudes when treating and communicating with patients
- Identifying variation in healthcare provision or outcomes for specific patient populations, including those based on ethnicity, and responding accordingly.
Cultural safety and equity for Aboriginal and Torres Strait Islander peoples
Health outcomes for Aboriginal and Torres Strait Islander peoples can be improved by addressing systemic racism and other root causes that reduce access to care. Historical and current contributing factors include a lack of culturally safe care, culturally appropriate health education and sociocultural determinants such as differences in employment opportunities.
The considerations for improving cultural safety and equity in this Clinical Care Standard focus primarily on overcoming cultural power imbalances and improving outcomes for Aboriginal and Torres Strait Islander people through better access to health care
Cultural safety and equity recommendations in this document have been developed in consultation with Aboriginal and Torres Strait Islander individuals, clinicians and representative health service organisations. However, it is recognised that cultural safety is determined by the Aboriginal and Torres Strait Islander individuals, families and communities experiencing the care.
Recommendations
When implementing this Clinical Care Standard, cultural safety can be improved through embedding an organisational approach such as described in the recommendations below. Specific considerations for cultural safety for people undergoing colonoscopy are provided throughout this Standard.
When providing care for Aboriginal and Torres Strait Islander people, particular consideration should be given to the following recommendations.
Building culturally safe systems
- Ensure systems and processes support people to self-report their Aboriginal and Torres Strait Islander status and to record self-identification
- Ensure all staff engage regularly in cultural safety training
- Implement the six actions for Aboriginal and Torres Strait Islander Health from the NSQHS Standards.
Flexible and connected service delivery
- Provide flexible service delivery to optimise attendance and help develop trust with individual Aboriginal and Torres Strait Islander people and communities
- Establish robust communication channels and referral pathways with primary healthcare providers (including Aboriginal Community Controlled Health Organisations [ACCHOs])
- Where possible, provide outreach services close to home, on Country or in collaboration with ACCHOs or other community healthcare providers.
Communication and person-centred care
- Take a collaborative approach to ensure that interventions are suitably tailored to the individual’s personal needs and preferences for care
- Encourage the inclusion of support people, family and kin or the person’s trusted healthcare provider (such as their ACCHO) in all aspects of care, including decision making and planning treatment and management
- Engage culturally appropriate interpreter services and cultural translators when this will assist the patient
- Involve Aboriginal and Torres Strait Islander Health Workers or Aboriginal and Torres Strait Islander Health Practitioners as part of a patient’s multidisciplinary team and involve Aboriginal and Torres Strait Islander Liaison Officers in hospital settings
- Use culturally and linguistically appropriate materials to aid in communication and discussion, accounting for varying levels of health literacy.
Building culturally safe systems
- Ensure systems and processes support people to self-report their Aboriginal and Torres Strait Islander status and to record self-identification
- Ensure all staff engage regularly in cultural safety training
- Implement the six actions for Aboriginal and Torres Strait Islander Health from the NSQHS Standards.
Flexible and connected service delivery
- Provide flexible service delivery to optimise attendance and help develop trust with individual Aboriginal and Torres Strait Islander people and communities
- Establish robust communication channels and referral pathways with primary healthcare providers (including Aboriginal Community Controlled Health Organisations [ACCHOs])
- Where possible, provide outreach services close to home, on Country or in collaboration with ACCHOs or other community healthcare providers.
Communication and person-centred care
- Take a collaborative approach to ensure that interventions are suitably tailored to the individual’s personal needs and preferences for care
- Encourage the inclusion of support people, family and kin or the person’s trusted healthcare provider (such as their ACCHO) in all aspects of care, including decision making and planning treatment and management
- Engage culturally appropriate interpreter services and cultural translators when this will assist the patient
- Involve Aboriginal and Torres Strait Islander Health Workers or Aboriginal and Torres Strait Islander Health Practitioners as part of a patient’s multidisciplinary team and involve Aboriginal and Torres Strait Islander Liaison Officers in hospital settings
- Use culturally and linguistically appropriate materials to aid in communication and discussion, accounting for varying levels of health literacy.
What the standard says
Related resources
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NSQHS Standards User guide for Aboriginal and Torres Strait Islander health
A guide to help improve the quality of care and health outcomes for Aboriginal and Torres Strait Islander people based on the National Safety and Quality Health Service Standards. -
National Agreement on Closing the Gap
An agreement built around four priority reforms for transforming the way governments work with, and for, Aboriginal and Torres Strait Islander peoples to improve outcomes. -
Cultural respect framework 2016–2026 for Aboriginal and Torres Strait Islander health
A framework that commits the Australian Government and all states and territories to embed cultural respect principles into their health systems. -
Clinical Yarning
A patient-centred framework to improve communication in Aboriginal health care. -
Communicating positively: a guide to appropriate Aboriginal terminology
A guide developed by NSW Health to use when working with Aboriginal people and communities, and when developing policy and programs. -
Plain English Health Dictionary
A resource developed by the Northern Territory Government as a resource for Aboriginal Interpreter Services.