What is the Lighthouse hospital project?
- The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA).
- The aim: to improve care and health outcomes for Aboriginal and Torres Strait Islander peoples experiencing coronary heart disease, the leading cause of death among this population.
Australia is a privileged nation by world standards. Despite this, not everyone is equal when it comes to heart health and Aboriginal and Torres Strait Islander people are the most disadvantaged. The reasons are complex and not only medical in nature. Aboriginal and Torres Strait Islander people have a troubled history with institutions of all kinds, including hospitals.
The Lighthouse Hospital project aims to change this experience by providing both a medically and culturally safe hospital environment. A culturally safe approach to healthcare respects, enhances and empowers the cultural identity and wellbeing of an individual.
This project matters because the facts are sobering. Cardiovascular disease occurs earlier, progresses faster and is associated with greater co-morbidities in Aboriginal and Torres Strait Islander peoples. They are admitted to hospital and suffer premature death more frequently compared with non-Indigenous Australians[1].
Major coronary events, such as heart attacks, occur at a rate three times that of the non- Indigenous population. Fatalities because of these events are 1.5 times more likely to occur, making it a leading contributor to the life expectancy gap [2].
Current employment opportunities
1.The National Project Manager – Lighthouse Hospital Project
Will manage the development, delivery and evaluation of the Lighthouse Hospital Project (Phase 3) across 18 hospital sites nationally. The role will lead project partnerships and oversee a national team of four to drive sustainable change in acute settings to improve cardiac care and outcomes for Aboriginal and Torres Strait Islander peoples. Regular interstate travel will be required.
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2.The Lighthouse Hospital Project ( 3 ) Coordinators
Will manage the day to day support for the development, implementation and evaluation of the Lighthouse Hospital Project (Phase 3) in approximately six hospital sites each. The Coordinators will support the development of local and state-based project partnerships and work as part of a national project team of five to drive sustainable change in acute settings to improve cardiac care and outcomes for Aboriginal and Torres Strait Islander peoples. Regular interstate travel will be required.
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Contact:
Fiona Patterson, National Programs Manager,
fiona.patterson@heartfoundation.org.au, 03 9321 1591
Phase 1 (2012–2013)
Aim – To improve the care of Aboriginal and Torres Strait Islander peoples experiencing acute coronary syndrome (ACS).
We developed this project was developed in response to a 2006 report from the Australian Institute of Health and Welfare (AIHW).
The project first focused on providing culturally safe and positive consumer experiences, which were reviewed by 10 organisations known for providing exemplary care in the treatment of Aboriginal and Torres Strait Islander patients with acute coronary syndromes (ACS).
The project identified key elements that make a difference to ACS care:
- expanding roles for Aboriginal Liaison Officers, Health Workers, Patient Pathway Officers and equivalent roles
- better identification of Aboriginal and Torres Strait Islander patients
- building strong partnerships and communication channels with local Aboriginal and Torres Strait Islander communities and other relevant organisations
- fostering and supporting clinical champions
- building capacity for patient-focused care
- use of technology
- use of an industry-based quality matrix.
Phase 2 (2013–2016)
Aim – To drive systemic change in acute care hospital settings to improve care for and the experience of Aboriginal and Torres Strait Islander peoples experiencing ACS.
In Phase two, the scope was to improve activities in eight public hospitals across Australia to improve clinical and cultural care for Aboriginal and Torres Strait Islander patients with ACS.
The toolkit
We developed a quality improvement toolkit, ‘Improving health outcomes for Aboriginal and Torres Strait Islander peoples with acute coronary syndrome’, to provide a framework to address health disparities.
The toolkit aimed to:
- ensure care providers met minimum standards of care, cultural safety
- identify practices and actions that can and/or should be improved
- foster engagement
- improve healthcare services for Aboriginal and Torres Strait Islander peoples with ACS.
The toolkit outlined four areas that were critical in providing holistic care for Aboriginal and Torres Strait Islander peoples and their families as they journeyed through the hospital system and return to their communities.
The four domains were:
- governance
- cultural competence
- workforce
- care pathways.
The pilot
Eight pilot hospitals participated in testing the toolkit:
- Bairnsdale Regional Health Service, Victoria
- Coffs Harbour Health Campus, New South Wales
- Flinders Medical Centre, South Australia
- Liverpool Hospital, New South Wales
- Princess Alexandra Hospital, Queensland
- Royal Perth Hospital, Western Australia
- St Vincent’s Hospital, Victoria
- Tamworth Rural Referral Hospital, New South Wales.
Each hospital developed an action plan that outlined the areas they would address and the quality improvement activities they would undertake during the pilot. The project outcomes were dependent on community engagement, capacity to embed change, project support and the governance structures at each site.
Key Phase 2 achievements
- Improved relationships with Aboriginal and Torres Strait Islander patients
- Strengthening relationships with the Aboriginal and Torres Strait Islander community and medical services
- Creating culturally safe environments for Aboriginal and Torres Strait Islander patients
- Increased self-identification among Aboriginal and Torres Strait Islander patients
- Streamlining processes related to culturally appropriate clinical care of Aboriginal and Torres Strait Islander patients
- Enhanced staff capacity to respond to the needs of Aboriginal and Torres Strait Islander patients
Phase 3
We are awaiting funding for Phase three of the Lighthouse Project.
This will aim to increase the reach and the critical mass of Aboriginal and Torres Strait Islander peoples experiencing an acute coronary syndrome who receive evidence based care in a culturally safe manner.
Within this phase there will be a focus on integration of health services and care coordination by enhancing the relationships between local community groups, hospitals, local Aboriginal Community Controlled Organisations and Primary Health Networks.
The implementation of this phase would enable hospitals to address the actions in the revised Australian Commission on Safety and Quality in Healthcare National Safety and Quality Health Service.
The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association and is funded by the Australian Government Department of Health.
References
- Australian Health Ministers Advisory Council (AHMAC). Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. Canberra: AHMAC, 2012.
- Mathur S, Moon L, Leigh S. Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. Cardovascular disease series no. 25. Canberra: Australian Institute of Health and Welfare, 2006.