Every voice is heard and taken into account
Aboriginal flag colours with spiral: birth, death and re-birth. Excellence in First Nations health is continuing, even through our experience of colonisation, it is our cultural inheritance. Dr Mishel McMahon
“So all of this extra work in relationship-based research means that when we get to implementation stage, key stakeholders already engaged, they are invested and the probability of meeting the needs of the localised communities is increased.” A monthly Governance Group meeting of around 90 invitees from Loddon Mallee health services and ACCHOs has been taking place, and will continue for the duration of the project. Also to address a high level of engagement, Jean McMahon, First Nations Strategic & Partnerships Lead, LMHN recognised that shorter ‘touch-base’ 30 minute meetings would be beneficial. Creating another space for truth telling and learning the unique context of each emergency care organisation. This has proved to be positive in engaging some healthcare workforce who previously had not, or perhaps felt unsafe to share their concerns. “The touch-based sessions are so important for people to ground and connect, to build that relationship, it’s helping them to focus, and we are engaging people we may not have before,” said Jean. “Also, we’ve had the occasion when a group member has had to leave and attend an emergency. It’s the nature of the work and understandable. Some staff may be unable to engage, so we are trying to communicate in different ways with as many people as we can throughout this project,” said Jean. Taking pause for action
the 12 month timeline, is there are times due to the reciprocal nature of First Nations-led research when the research group have to ‘down tools’ and reschedule, to address challenges or requests from health organisations. “So for reciprocity to happen, it means that sometimes we stop our planned schedule for the week and attend to a real-time priority, such as completing a rapid review from the literature for a particular hospital or reaching out to a stakeholder a member has identified as pivotal to the project,” said Mishel. Culturally-safe design One of emerging components that’s coming out of the current findings is a need for cultural safety in evidence-based design of EDs and UCCs. “In our research we are finding that EDs need to have a space for community, maybe it’s an outdoor area, maybe it’s a bigger room, because a lot of time when First Nations people come in they will come with their family, it’s a kinship system, it’s collective identities, it’s the extra caring roles people hold, so it’s a bigger group. And if the ED is actually designed in a way to hold that, there’s more chances of First Nations people staying in and getting the care they require,” said Mishel. Solution-based Mishel says to create opportunity for system reform, it means her focus needs to stay on strength- based solution, what’s currently working well, and what innovations are occurring nationally and
internationally for First Nations people accessing emergency care. Then through the expertise and leadership of the project’s Governance Group develop a Best Practice Framework tailored specifically for LMHN members, ACCHOs and their communities, which is submitted to Department of Health for implementation. Stronger partnerships “During engagement with Governance Group members ACCHOs are telling us they need data that will allow them to match their services to their communities health needs as reported in the emergency care data,” said Mishel. “Highlighting the necessity for strong partnerships with ACCHOs in the region.” Many of the region’s CEOs and executive staff have engaged with Jean around cultural safety, accountability and white fragility and have started their learning journey of personal bias, sitting with discomfort and reflecting on their own identity. The ‘Narrative Stories’ of the next stage of the project will ensure we get a real-life contextualised solutions from health services and ACCHOs, that will hopefully enable system reform within our emergency care services, and First Nations communities can regain their excellence in health previously held by their Ancestors. Lastly Mishel explains, “the literature is also stating that initiatives which enable First Nations people better access to emergency care, also improves access, experience and outcomes for many other people groups.”
Up Next:
‘Design’ roundtable discussions with Governance Group members to design a final draft of the Best Practice Framework (BFP). This will be submitted for implementation to Department of Health and other key stakeholders
mid-2024.
Another point of difference of this project, despite
LMHN Regional Review | Issue 6 | Summer 2024
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