Resources

What is required to change this reality? How do we deliver healthcare to ‘close the gap’? How can we ensure that the values of Aboriginal and Torres Strait Islander peoples (First Nations) are not only embraced, but understood?

It is imperative we listen to the views of First Nations peoples, and make cultural safety a priority. Cultural safety is about what a patient ‘feels and experiences’ when they interact with your health service or other care organisation. This means putting the perspectives of First Nations people at the centre of person-centred design. 

Not only do First Nations peoples require a connection with ‘self’ – as we all do, for our health and well-being – they require a connection to their ecosystem. The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Well-being sets out ‘overlapping’ domains of this ecosystem. 

There are 7 different types of ‘connection’ which are essential to First Nations peoples, and therefore to culturally safe care. These are connection to: body (physical health), mind and emotions (mental health), family and kinship (which are ‘central to the functioning of Indigenous Australian societies’), community (connections with each other), culture (cultural identity and the exercise of cultural rights and responsibilities), country (‘an area on which Indigenous people have a traditional or spiritual association’) and spirituality and ancestors (‘relationship with traditional beliefs and metaphysical worldviews’).

Most of all, relationships and partnerships in care delivery are integral to culturally safe care – as such, they need to be considered as ‘outcomes’ in themselves and it is imperative they are enduring and sustained. They are not just a means to an end.  

Culturally safe care must be embodied in the concept of clinical governance itself, which is ultimately about relationships or connections with people, and the roles and responsibilities throughout your organisation that support those relationships and connections with people (which ultimately impact their health and well-being) – to collectively enhance the care experience. This proposition acknowledges that ‘outcomes’ in clinical governance encompass that care experience.

Finally, just as there is no ‘one-size fits all approach’ in clinical governance which must adapt to different situations, there is no fixed model of care to support best practice in cultural safety – this is up to the individual, in line with person-centredness. That is, if we are going to be person-centred, let’s be authentic about it. Therefore, to achieve cultural safety, it is crucial that health and care organisations are culturally responsive – meaning they must focus on the person experience, and observe the ‘signals’ coming from their patients and consumers, acknowledging this will differ according to the individual and their background (which includes their ‘country’).

If we can achieve true cultural safety through cultural responsiveness, then we can ‘close the gap’ through an authentic commitment to repairing bridges and reconciliation.

All accessed on 17/10/22:

A Ropitini. ‘Realising Cultural Safety in Practice’. AICG Patient Safety & Quality Care Symposium 2022. 15 September 2022. 

‘The Framework’. Australian Institute of Health and Welfare, 24 March 2022 (page last updated). Accessed at: https://www.indigenousmhspc.gov.au/topics/sewb#theframework 

M Tan. ‘What does clinical governance mean in aged care, in 2022?’ ACCPA National Conference 2022 (‘It’s Up to Us’). 12-14 October 2022 (presented on 14 October 2022)

M Tan. ‘Aged Care Regulation through the looking glass of clinical governance: a framework for aged care providers’ (2022) 30(5&6) HLB 116.

‘What is clinical governance at the end of life?’ AICG, 18 September 2022. Accessed on at: https://www.aicg.edu.au/resources/what-is-clinical-governance-at-the-end-of-life/