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Managing Two Worlds Together Managing Two Worlds Together Stage 3: Improving Aboriginal Patient Journeys— Cardiac Case Studies Janet Kelly Mark Ramage Daphne Perry Jeff Tinsley Hugh Auckram Wendy Corkhill Sarah Wyatt Natalie McCabe Cover Artwork: Kuntjanu – Mingkiri Tjuta Tjukurpa (Marsupial Mouse Dreaming) by Rama Sampson painting (no.74), courtesy Better World Arts Managing Two Worlds Together Stage 3: Improving Aboriginal Patient Journeys— Cardiac Case Studies Janet Kelly Mark Ramage Daphne Perry Jeff Tinsley Hugh Auckram Wendy Corkhill Sarah Wyatt Natalie McCabe © Flinders University, 2015 ISBN 978-1-921889-31-8 First published in April 2015 This work has been produced by Flinders University and is published as part of the activities of The Lowitja Institute, Australia’s national institute for Aboriginal and Torres Strait Islander health research, incorporating the Lowitja Institute Aboriginal and Torres Strait Islander Health CRC (Lowitja Institute CRC), a collaborative partnership funded by the Cooperative Research Centre Program of the Australian Government Department of Industry. This work is the copyright of Flinders University. It may be reproduced in whole or in part for study or training purposes, or by Aboriginal and Torres Strait Islander community organisations subject to an acknowledgment of the source and no commercial use or sale. Reproduction for other purposes or by other organisations requires the written permission of the copyright holder(s). Downloadable pdfs of the Managing Two Worlds Together. Stage 3: Improving Aboriginal Patient Journeys— Cardiac Case Studies and the other four Case Studies, along with printed copies and a pdf of the Study Report and a writeable pdf of the Workbook, can be obtained from: Department of Health Care Management The Lowitja Institute Flinders University PO Box 650, Carlton South Bedford Park, SA 5042 AUSTRALIA Vic. 3053 AUSTRALIA T: +61 8 8201 7755 T: +61 3 8341 5555 F: +61 8 8201 7766 F: +61 3 8341 5599 E: [email protected] E: [email protected] W: www.flinders.edu.au W: www.lowitja.org.au Authors: Janet Kelly, Mark Ramage, Daphne Perry, Jeff Tinsley, Hugh Auckram, Wendy Corkhill, Sarah Wyatt, Natalie McCabe Managing Editor: Jane Yule @ Brevity Comms Copy Editor: Cathy Edmonds Design and Print: Inprint Design For citation: Kelly, J., Ramage, M., Perry, D., Tinsley, J., Auckram, H., Corkhill, W., Wyatt, S. & McCabe, N. 2015, Managing Two Worlds Together. Stage 3: Improving Aboriginal Patient Journeys—Cardiac Case Studies, The Lowitja Institute, Melbourne. iii Table of Contents The Managing Two Worlds Together Project v Acknowledgments vi Abbreviations and Terms vi About the Cardiac Case Studies 1 The Patient Journey Mapping Process 3 Case Study A: Hospital Education and Reflective Practice 4 Case Study B: Adapting the Tools to Highlight Significant Gaps and Delays in Care 11 Case Study C: Northern Territory Cardiac Coordination 20 Diagram, Figures and Tables Diagram 1: The three stages, focus and outcomes of the Managing Two Worlds Together project v Diagram 2: The process of using the Aboriginal PJM tools – an overview 3 Case Study A – Figure 1: Visual mapping 5 Case Study A – Table 1: Dimensions of health 6 Case Study A – Table 2: Underlying factors 7 Case Study A – Table 3: Multiple perspectives 8 Case Study A – Figure 2: Staff education worksheet 9 Case Study B – Figure 1: Visual mapping – a typical interstate cardiac journey 12 Case Study B – Table 1: Dimensions of health 13 Case Study B – Table 2: Underlying factors 14 Case Study B – Table 3 (Part a): Multiple perspectives – first diagnosis to surgery 15 Case Study B – Table 3 (Part b): Multiple perspectives – discharge to follow-up 17 Case Study C – Table 1: Dimensions of health 22 Case Study C – Table 2: Underlying factors 23 Case Study C – Table 3: Multiple perspectives 24 Case Study C – Figure 1: Mapping patient journeys, specifically and generally, and working with the results 25 iv v The Managing Two Worlds Together Project The Improving Aboriginal Patient Journeys (IAPJ) consist of a set of tables that enable an entire patient study is the third stage of the Managing Two Worlds journey to be mapped across multiple health and Together (MTWT) project. The MTWT project geographic sites, from the perspective of the patient, investigated what works well and what needs their family and health staff in each location. improvement in the health system for Aboriginal people who travel for hospital and specialist care Stage 3 (2013–15) involved an expanded research from rural and remote areas of South Australia and team and staff participants working together in the Northern Territory to city hospitals. a range of health care and education settings in South Australia and the Northern Territory. The Stage 1 (2008–11) focused on understanding aim was to modify, adapt and test the Aboriginal the problems that occur within and across patient PJM tools developed in Stages 1 and 2. As the journeys, and the barriers and enablers to access, project progressed the basic set of tools was further quality and continuity of care. Challenges and developed with flexible adaptations for each site. strategies from the perspectives of individual This involved three steps – Preparing to map the Aboriginal patients, their families, and health and patient journey, Using the tools and Taking action on support staff and managers were examined using the findings – organised into 13 tasks with prompt interviews, focus groups and patient journey questions. Careful consideration was given as to mapping. Complex patient journeys were analysed how the information that emerged from the use and a patient journey analysis tool was developed of the tools could best highlight communication, collaboratively with staff, patients and carers. coordination and collaboration gaps within and between different health care providers (staff, Stage 2 (2012) focused on possible solutions and services and organisations) so as to inform the strategies. As the research team shared findings with design of effective strategies for improvement. These health care providers, case managers and educators were compared and combined with existing policies, in a range of different health and education settings, practice and protocols. the potential and scope of the Aboriginal patient journey mapping (PJM) tools for quality improvement, Diagram 1 (below) sets out these three stages, along training and education emerged. The resulting tools with the focus and outcomes of each stage. Stage 1: 2008–11 Stage 2: 2012 Stage 3: 2013–15 Focus: Understanding the Focus: Exploring solutions and Focus: Improving Aboriginal problems strategies patient journeys Identifying the barriers, enablers, Considering application of findings Modifying, adapting and testing gaps and strategies to care and mapping tools mapping tools for quality improvement and education MTWT reports MTWT reports Knowledge exchange and translation City Hospital Care for Country Stage 2: Patient Journey Mapping Aboriginal People—Project Report Tools MTWT reports City Hospital Care for Country Stage 3: Improving Aboriginal Aboriginal People—Community Patient Journeys—Study Report Summary Stage 3: Improving Aboriginal Study 1—Report on Admissions Patient Journeys—Workbook and Costs (Version 1) Study 2—Staff Perspectives on Stage 3: Improving Aboriginal Care for Country Aboriginal Patients Patient Journeys—Case Studies Study 3—The Experiences of • Renal Patients and their Carers • Cardiac Study 4—Complex Country • Maternity Aboriginal Patient Journeys • Rural and Remote Sites • City Sites Diagram 1: The three stages, focus and outcomes of the Managing Two Worlds Together project vi Acknowledgments The authors would like to acknowledge the following Miller, Jo Newham, Annapurna Nori, Kim O’Donnell, people who were involved in, or assisted with the Brita Pekarsky, Sharon Perkins, Pam Pratt, Damian development of the tools and these case studies: Rigney, Christine Russell, Bronwyn Ryan, Kerry Taylor, Kym Thomas, Cheryl Wilden, Eileen Willis, Jacene Alex Brown, Sarah Brown, Lisa Catt, Christine Wiseman and Chris Zeitz. Connors, Charlotte de Crespigny, Karen Dixon, Judith Dwyer, Toni East, Amy Graham, Kylie Herman, We would also like to acknowledge the editorial Liz Izquierdo, Wendy Keech, Rosie King, Michael assistance of Jane Yule and Cathy Edmonds, the Kirkbride, Monica Lawrence, Wendy McInnes, design work of Rachel Tortorella at Inprint Design, Gay Martin, Lee Martinez, Sonia Mazzone, Laney and the Lowitja Institute CRC for providing ongoing Mackean, Tamara Mackean, Paula Medway, Debra support for this study and publishing its outcomes. Abbreviations and Terms AHW Aboriginal Health Worker GP General Practitioner ALO Aboriginal Liaison Officer IAPJ Improving Aboriginal Patient Journeys APPO Aboriginal Patient Pathway Officer MTWT Managing Two Worlds Together CNC Clinical Nurse Consultant PATS Patient Assistance Transport/ Travel Scheme – South Australia/ CTSU Cardiothoracic Surgical Unit Northern Territory ECG Electrocardiogram (recording of heart’s PJM Patient Journey Mapping electrical activity) RFDS Royal Flying Doctor Service Echo Echocardiogram (a sonogram that creates images of the heart) RHD Rheumatic Heart Disease Terminology The use of the terms ‘Aboriginal’, ‘Aboriginal and Case study – The use of the term ‘case study’ Torres Strait Islander’, ‘Indigenous’ and ‘Elder’ reflect refers to specific problem-solving activities the preference of the people with whom we worked. undertaken by participating health staff to
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