Health services

The Health Services Integration Project

Working with local managers of health services in NSW

The Health Services Integration Project is working closely with local managers of health services and agencies to support their staff to routinely provide Aboriginal clients with brief smoking cessation interventions. All managers of staff participating in the 2010-2011 SmokeCheck workshop program are now receiving information about how they can support their staff member to put their SmokeCheck training into practice.

Do you have staff who have completed SmokeCheck training?

Click here to view the check list for managers to assist you with putting SmokeCheck brief intervention into routine practice in your service.

Health Services Integration Pilot Project

Throughout 2010 the Project Manager of the Health Services Integration Project spent time visiting and talking to many colleagues around NSW about how we can better support our trained health workers to use the SmokeCheck brief intervention in routine practice with Aboriginal clients. A draft practical guide called ‘Let’s get started’ was developed as a result of these discussions and will has now been pilot-tested in 3 sites around NSW. A working group has been established with representatives including service managers, team leaders and senior clinicians from Local Health Districts. They have been working closely with the SmokeCheck Program to develop this guide.

The pilot program will commence in September 2010 and was completed in March 2011. It will test the draft ‘Let’s get started’ practice guide and work with the managers and staff from the 3 sites to design service-specific implementation plans for creating supportive workplace environments to enable the use of the SmokeCheck brief intervention in routine health care.

The 3 sites are:

• Mootang Tarimi Renal Screening Outreach Program (Western Sydney)
• Birra-Li Aboriginal Birthing Service (Hunter New England)
• Aunty Jean’s Good Health Program (Far South Coast)

We will update this page soon to report on the progress of the pilot project and to provide further information to assist managers.

Would you like to know more about the Health Services Integration Project?

Our SmokeCheck Health Services Integration Project will be ongoing throughout the Phase 2 period 2009-2011. Our activities also include working collaboratively with and supporting managers to:

• introduce improved recording systems to gather information about the smoking status of all Aboriginal health clients;
• improve access to advice, referral and information for health professionals and their Aboriginal health clients about quitting and methods for quitting; and
• design and implement procedures that will encourage and assist local services (mainstream and community controlled) to make the SmokeCheck brief intervention part of regular health care practice.

For further information on the Health Services Integration Project you can contact SmokeCheck on 02 9036 7113 or by email: .

A range of resources are also available from the NSW Ministry of Health Resource Distribution Unit for display in waiting rooms. For SmokeCheck A2 posters click here, or for other NSW Health promotional materials click here.

Cultural Competence

Cultural factors influence how effectively organisations can provide quality services to their client/patients and support employees. Cultural competence is the idea that individuals, agencies and systems have the capacity, skills and knowledge to respond to the needs of a culturally diverse population¹.

Cultural competence begins with the recognition that we are all born, raised and living in social, educational and organisational cultures. These cultures shape our assumptions, beliefs, values and behaviours. When we interact with others, the similarities and differences between our cultural expectations often make the interaction both more interesting and more challenging. In a health setting these challenges must be met if we are to provide equitable, appropriate and accessible services to all our clients².

Respecting the difference

The NSW Ministry of Health, Aboriginal Workforce Development Unit and Workforce Development & Innovation have developed an Aboriginal Cultural Training program called ‘Respecting the difference’. The first part of this program is a generic 2 hour online course which is intended to act as a foundation unit. This will be built upon in subsequent face-to-face workshops to be held in Local Health Districts across the state.

The goals of the program are to;

• Motivate staff to question their current attitudes, behaviours and actions in delivering health services to Aboriginal people
• Recognise how healthcare outcomes for Aboriginal people can be improved through greater awareness of Aboriginal culture
• Challenge preconceived perceptions or beliefs about working with and providing health services to Aboriginal communities and, in particular, dismantle the stereotyping of Aboriginal people, and
• Understand how Aboriginal people may view healthcare and the barriers that can prevent individuals or groups from accessing services.

The programme is set to commence soon.

^{1 - Department of Families, Housing, Community Services and Indigenous Affairs, Australian Government: Quality Strategy Toolkit.
2 - South East Sydney Illawarra Area Health Service http://www.sesiahs.health.nsw.gov.au/Multicultural_Health_Service/culturalcomp.asp.}

Aboriginal culture and spirituality – a model for health promotion

This model was developed by Vicki Wade¹ to put into context the effects of colonisation on traditional values and the health and wellbeing of Aboriginal people. The underlying message is the importance of understanding Aboriginal culture and spirituality in order to “close the gap”.

Susan Grant, a respected Aboriginal artist, was commissioned by the former Sydney South West Area Health Service to translate the model into a painting. Susan, a descendant of the Wiradjiri people of southwest NSW, has captured the spiritual and cultural meaning inherent in the framework that underpins the Aboriginal Health experience.

• The inner circle represents the camp fire, the giver of warmth that nourishes the family and community connecting the family and community to the earth. The family sitting around the fire are connected to each other by this secure base; this foundation that is important to our mothers and babies and families.
• The middle circle represents traditional lore, men’s business and women’s business, the nurturing of babies by mothers and grandmothers and the passing of cultural knowledge through stories, music, dance and painting. This traditional lore with its spiritual guidance holds communities together and provides connection to land and people. It keeps Aboriginal people strong in body and mind.
• Within the outer circle is an Aboriginal man who is disconnected; lost from his traditional way of life and spiritual connectedness. He is on the fringe looking inwards and can re-enter with help from his people and services in the community.
• This sense of disconnect, powerlessness and not belonging is a result of colonisation and breakdown of traditional life.
• The lines coming in from each corner represents chaos, those things that have made Aboriginal people unhealthy; racism, discrimination, tobacco, drugs, diseases, alcohol and domestic violence.
• The blood is seen running from the camp fire; the blood of the lives of Aboriginal people who are much sicker and die much earlier than non Aboriginal people.

This artwork with its vibrant earthy ochre colours gives us hope like the Aboriginal man looking lost but able and wanting to become reconnected to land and to community; the pink ochre is significant for Aboriginal people and their journey back to health.

^{1 - Vicki Wade was the Area Director Aboriginal Health, Sydney South West Area Health Service; she is now the Leader of the National Aboriginal Health Unit in Heart Foundation Australia (July 2011).}