Reimagining Emergency Care for First Nations Communities in the Loddon Mallee
Dr Mishel McMahon, Proud Yorta Yorta Woman and Senior Research Fellow at Latrobe University
System Reform for First Nations Communities within Emergency Departments (EDs) and Urgent Care Centres (UCCs) is underway across the Loddon Mallee Region (LMR). A First Nations Best Practice Framework (BPF) will be delivered mid-2024. All 17 LMHN healthcare services and Aboriginal Community Controlled Health Organisations (ACCHOs) are showing their commitment, and stronger partnerships are beginning to grow. A First Nations-led research project, prioritising the voices and lived-experience of First Nations researchers and healthcare professionals in hospitals and community is underway in collaboration with Latrobe Rural Health School, funded by the Department of Health. The need to vastly improve the accessibility, cultural safety and outcomes for First Nations Peoples when they visit emergency care is well-documented. Despite well-intentioned decades of research, it’s the critical implementation of research findings that fails for First Nations communities. It is crucial this solution-based project delivers a Best Practise Framework for emergency service providers who understandably have different challenges and different context, as the first ‘Discovery Stage’ of the project has shown.
Early findings include a need to repair the ‘trust gap’ for First Nations Peoples, growing the First Nations workforce in emergency care and improving Cultural Safety in the design, the processes and clinical practice of emergency departments and urgent care centres to name a few. But for real, positive change and actual system reform, respecting the voices, relational worldviews and research process of First Nations People is paramount. “My message is very simple”, Dr Mishel McMahon, Proud Yorta Yorta Woman and Senior Research Fellow at Latrobe University explains. “Do we want accurate, effective research findings that enables actual system change and high engagement during implementation?” Common misconceptions and assumptions about First Nations research is a barrier to change. Positioning First Nations methodologies, capacity building in First Nations communities, allowing space for deep listening, reciprocity, rapport, relationships and tangible benefits for First Nations communities, for example, can cause people (including non-First Nations researchers) to assume that the research process is ‘too hard’ or too long.
able to) talk from their cultural self, which means the research findings hold high social capital with the intended target population. Which for this study is Aboriginal and non-Aboriginal professionals connected to emergency care. Without relationship- based research, which is a longer, high engagement process, there is danger of people shutting down because they have given-up on research or are simply burnt out by the system that many of us are ashamed to admit, remains inherently racist. Building relationships “This project is unique in that it is relationship-based. The data collected is authentic and sometimes holds discomfort,” said Mishel. “Sure, it takes longer to develop and build rapport with all stakeholders – positioning everyone as a pivotal part of the ‘research body’. In line with First Nations relational concept of equality there is no hierarchy - from the CEOs to the ACCHOs to the ED staff to the patients in the community. Every voice and experience is heard and taken into account,” said Mishel. We are asking non-Aboriginal people to understand that the competitive, individualised Western research processes have not worked, we are not getting the data we need, health outcomes for First Nations communities are not improving.
For real, positive change and actual system reform,
respecting the voices, relational worldviews and research process of First Nations People is paramount
“But it’s actually the opposite, it allows for authenticity,” said Mishel. People can (or should be
Continued overleaf
LMHN Regional Review | Issue 6 | Summer 2024
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