The Lighthouse Project
(Southern Health News, August 2016)
Beacon of light cast on improving Indigenous health outcomes
Flinders Medical Centre (FMC) is one of eight hospitals selected from around Australia to pilot a project aimed at improving care and outcomes for Aboriginal and Torres Strait Islander peoples experiencing coronary heart disease.
A joint venture by the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA) and funded by the Department of Health, the Lighthouse Project casts a spotlight on the leading cause of death for Aboriginal and Torres Strait Islander peoples, with an estimated 60 per cent likely to die from coronary heart disease.
The Australian Institute of Health and Welfare (AIHW) indicate that more than half of Indigenous adults have three or four risk factors for cardiovascular disease, including smoking, high blood cholesterol, being overweight, poor dietary intake, being physically inactive, and having diabetes.
Living in remote areas, having limited access to health care and experiencing low socio-economic status are some of the social factors that may impact Aboriginal and Torres Strait Islander health outcomes.
FMC’s Cardiac and Thoracic Surgical Unit is responsible for performing more than 30 per cent of heart surgeries for Aboriginal and Torres Strait Islander peoples in Australia.
Indigenous patients make up around 20 per cent of the cardiac surgery performed at FMC annually.
There is strong evidence suggesting that Aboriginal and Torres Strait Islander peoples experience rates of coronary events, such as heart attack, three times higher than that of other non-Indigenous Australians.
Recently the AIHW released landmark findings declaring that in comparison to other patients, Aboriginal and Torres Strait Islander patients admitted to hospital with acute coronary syndrome will experience:
- More than twice the in-hospital coronary heart disease death rate,
- 40 per cent lower rate of angiography (x-rays of blood vessels),
- 40 per cent lower rate of coronary angioplasty or stent procedures,
- 20 per cent lower rate of coronary artery bypass surgery,
- 26 times higher rate of rheumatic fever, often resulting in valve surgery.
The Lighthouse Project is developing a model that drives efficiency and change within the health system, with the second phase of the project aiming to improve the cardiac hospital pathway for Aboriginal and Torres Strait Islander peoples, by utilising a tool-kit and guidelines to assist with this process.
Led by Cardiac Surgeons Associate Professor Jayme Bennetts and Associate Professor Robert Baker and Project Managers Daphne Perry and Bronwyn Pesudovs from the FMC’s Cardiac and Thoracic Surgical Unit, the Lighthouse Project is working in collaboration with other staff from across the Southern Adelaide Local Health Network (SALHN) on the following initiatives:
- Aboriginal and Torres Strait Islander Patient Care Guidelines (Sad News, Sorry Business) available to all staff working within SALHN. Topics within the guidelines include providing culturally safe care, communication tips, aspects of clinical care including pain management and end of life care.
- Aboriginal Liaison Officers from FMC’s Karpa Ngarrattendi have undertaken training to increase their knowledge in cardiac and Intensive and Critical Care procedures as well as in-case note documentation;
- Changes to the Cardiac Surgical Waiting List pathway will seek to reduce the time remote Aboriginal and Torres Strait Islander people wait for cardiac surgery;
- Improving FMC’s Cardiac and Thoracic post discharge documentation from a paper based format to an electronic version;
- An Aboriginal and Torres Strait Islander Your Hospital Journey booklet;
- A patient welcome package.
A/Professor Jayme Bennetts says a long term relationship with Northern Territory Health spanning over 20 years has seen FMC’s Cardiac and Thoracic Surgical Unit earn the title as a centre of excellence for Aboriginal and Torres Strait Islander peoples.
“Our unit is committed to playing a critical role in improving access to evidence-based care for Aboriginal and Torres Strait Islander patients requiring cardiac surgery,” A/Prof Bennetts says.
“This commitment has led the Heart Foundation and the AHHA to invite the unit to be part of the Lighthouse Project,” he said.
“The Australian Government has committed to achieving equality in the health status and life expectancy for Aboriginal and Torres Strait Islander peoples by 2031. I believe this project sets us in the right path to achieving that goal.”
The team leading the project at FMC say creating initiatives in care pathways, workforce, governance and cultural competence are critical in the delivery of holistic care for Aboriginal and Torres Strait Islander people and their families, as they journey through the hospital system and return to their communities.
For more information about the Lighthouse Project at Flinders Medical Centre, contact Daphne Perry at email@example.com
Lighthouse resources makes hospital journey easier, says Selena
Louise Brown has a smile that can light up a room.
She sits up on her hospital bed, chatting to her carer and sister Selena Brown while at the same time listening to music and playing on her phone.
Louise is 25 years old and recently had heart surgery at Flinders Medical Centre.
Selena says she could not prepare Louise or herself for the experience of being in hospital.
“Louise was sick a week before her operation, which set us back an extra couple of weeks. All our friends and families live in the Northern Territory, so it makes it really hard to get the support you need while in hospital,” she says.
“I think having this booklet (Your Hospital Journey booklet) for Aboriginal and Torres Strait Islander people that travel from the Northern Territory is a really excellent source of information that everyone of all ages can understand.”
“I'm so happy that Louise was involved in providing feedback to this project. The information in the booklet will make the time in hospital for Aboriginal and Torres Strait Islander people easier.”