The term, ‘Cultural Lens’, can conjure up entertaining mental images, particularly when we realise that everyone has their own, deeply implanted, culture; so deep we aren’t even aware we have it most of the time.
I recently read the article “The cultural assumptions behind Western Medicine” (The Conversation, 2013) by Deborah Upton, it got me thinking again about the importance of recognising our own world views, perceptions, beliefs and values when we work cross culturally.
Culture is integral to all of us and given the cultural diversity of WA’s population, it is likely that we are going to work with people from different cultures to our own. Whether they be work colleagues, patients or clients. It is also likely that we will be challenged from time to time by cultural differences between ourselves and those who cross our path. Such challenges can be day to day things like food stuffs, to other, more significant matters like patient’s spiritual beliefs or thoughts around medical treatment.
When those challenges occur, it is important to realise that we all view the world, its people and cosmologies through our own cultural lens. Our beliefs and values etc. shape our world view and it is critical to remember at such times that there are many other ways of thinking, doing and being than our own. This does not make anyone wrong or right. It just means while working we need to remember to check our cultural lens from time to time and to view things in a cultural context.
Bananas and Snails
My own cultural lens tells me eating banana sandwiches is perfectly normal. I have eaten them since I was small, as has my family. On my first visit to Nigeria in 1994 I found my niece felt sick at mere sight of me eating a banana sandwich (as an aside, they have the best ever bananas in Nigeria!), even the very thought of a banana sandwich made her queasy…in Nigeria it is NOT ‘normal’ to eat banana sandwiches. It is ‘normal’ however to eat large snails; these are huge and I have held some that weigh at least 500g. They are cooked in stews and eaten with great relish. I have tried them and can’t say they are my favourite food, I suspect this is because I didn’t grow up eating giant African snails.
I have used this example to demonstrate how ‘normal’ varies from one culture to another; we cannot assume we share the same ‘normal’. Working cross culturally means this is an important factor to keep in mind and that we need to keep checking our cultural lens to see what is informing us.
Louise Ford | Consumer and Community Engagement Manager | Health Consumers’ Council
Do you want to find out more?
If you would like to know more about working and engaging cross culturally you can register for HCC’s workshops and Diversity Dialogue’s Forums. These can provide the foundation stones for you to build on, they are also great opportunities for networking and have received excellent feedback from past attendees. Nursing staff can also claim PD points for attending. Click here for information on Health Consumers’ Council upcoming events including workshop sessions for both health service professionals and health consumers.
You may have heard about Press Ganey, the patient experience survey being implemented in Perth hospitals including Royal Perth, Bentley, Fiona Stanley, Sir Charles Gairdner and Osborne Park Hospitals. The survey is sent out to patients two weeks after they have been discharged home and seeks feedback on a range of different measures. The question was asked about how this ensures a diverse response, e.g. from Aboriginal and non English speaking patients.
At our most recent Consumer Advisory Council Roundtable, we had their CEO, Amanda Byers provide a presentation on how their survey works. For those who were unable to attend, a video of the presentation is available below. It is just under 45 minutes long. The powerpoint is available here, however it is well worth watching the video as it makes sense of the slides’ information.
The third slide has a useful reflection on the suffering that a patient will undergo when in hospital. It notes that there is suffering unavoidably associated with both diagnosis and treatment. The avoidable suffering caused through defects and care in service is where the Press Ganey survey focuses. Press Ganey also highlighted that it was a validated tool which means it has had psychometric testing to ensure a reliable result.
Once the survey results are returned to Press Ganey they are analysed and the reports provided to the hospital. This process can see about a three to six month delay between the healthcare episode and when the feedback is provided to the healthcare service. Some hospitals such as Royal Perth are also implementing questionnaires that Community Advisory Council members undertake with patients to ensure a quicker response when issues are identified. The presentation did highlight however that service improvement can be supported through Press Ganey surveys using the example of a large hospital in Asia which transformed their health service in nine months. Despite this health service’s initial concerns about how well this would work, their performance improved significantly.
Lucy Palermo | Marketing & Communications Coordinator | Health Consumers’ Council (WA) Inc
This week I sat down with Sandy McKiernan, Cancer Information and Support Services Director at the new Cancer Council WA offices in Subiaco, to discuss the upcoming August Community Conversation in partnership with Health Consumers’ Council (WA) and Carers WA, ‘After cancer treatment ends – Where to from here?’.
Why are you holding the community conversation?
Cancer Council WA has a strong commitment to engaging with the community. My division and I provide a direct service to people affected by cancer; be that cancer patients, carers or their family and their children. We feel really strongly about having opportunities for meaningful conversations. That is why having Carers WA and Health Consumers’ Council WA involved in this meeting is really important.
It is not unusual that, when someone is diagnosed with cancer, their partner is also suffering from a chronic condition. This makes it all the more difficult to have support in the home during treatment. This is when our services can be invaluable by providing them and their family with support.
What services do Cancer Council WA offer?
Cancer Council 13 11 20 service is there to support consumers, carers and family members who are affected by cancer. Our metro team and our regional teams of registered nurses with oncology experience can provide information and support on cancer and cancer-related issues. If we don’t provide the service they need, then our team can connect consumers to other providers that do.
Cancer Council WA want to engage with consumers for which we provide a direct service. We enjoy the opportunity to speak to, assist and support consumers who are affected by cancer.
What are the key outcomes you would like to achieve by holding this meeting?
We want to identify the gaps; What difficulties have they experienced after treatment? How can we continue to support them? What challenges have they faced? Are our current services meeting their needs? Were or are they being well supported?
We value any opportunity to work with those with lived experience. To be able to gain feedback to improve our services, is priceless.
Who can attend this meeting?
The meeting is open for those who are still receiving treatment for cancer, their carers and family; and those who have ceased treatment, their carers and family. It is also important to remember that carers and family members have a lived experience with cancer too.
With the state elections coming up, the voice of the people has become all the more important. As strong advocates for good public policy in cancer, we want to find out what is the voice of the people. We know there are system issues, but gaining a better understanding of the lived experience and what consumers believe could help changee things, is important.
Is there anything more you would like to add?
It would be fantastic if we could attract future consumer representatives that would be willing to talk about their experience in a more formal setting. There is strength in talking about cancer and, with an increase of consumer representatives, we can grow our interactions with other agencies, increase our network and continue to champion improvements to cancer treatment in the WA health system.
We hope people are willing to share and use this opportunity so that we can discover what is important to them.
Have you been affected by Cancer?
Cancer Council WA, in partnership with Health Consumers’ Council (WA) and Carers WA, invites those who have been affected by cancer, their family and carers to share their real life challenges regarding life after cancer at a Free Community Conversation on 24th August, on living well after cancer treatment. Click here for further details.
“Low life” thieves are targeting vulnerable patients at Royal Perth Hospital, stealing personal belongings, money and even medical equipment.
A freedom of information investigation has uncovered 124 counts of stealing from patients, their family and friends and medical staff at RPH between January 2014 and August 2015.
Incident reports from the hospital’s security logbook revealed dozens of thefts of mobile phones, cash and computers from patients’ rooms.
Some of the stealing occurred from bedside tables when patients were asleep, or out of their rooms having surgery or tests.
“Unfortunately there are some pretty low life people in our society who will take advantage of anyone in a difficult situation,” Health Minister John Day said.
“It’s completely unacceptable and appalling,” he said.
On one occasion an amputee’s wheelchair was stolen.
In another case a man was asleep at a table at the hospital’s café when a thief was caught on CCTV stealing a backpack he’d left on the floor behind him.
“When you are unwell or when a family member is unwell you are just under so much pressure and it’s just so hard to think that people are also having to cope with losing their valuables as well,” said Pip Brennan from the Health Consumers’ Council.
Nurses and doctors were also victims, with several reports of staff lockers broken into and bags, clothes and cash taken.
Security cameras outside the hospital’s emergency department filmed a man stealing a mobile phone left on a stretcher by a paramedic while he worked at the back of an ambulance.
“It’s just got to be the lowest of the low I think,” said Ms Brennan.
The security log also recorded 24 incidents of stealing from the hospital, including at least three cases when thieves took mattresses and blankets.
Vending machines were also regularly targeted, with at least one recorded case of a man caught using a drill, hidden in a backpack, to break open the machine.
RPH’s Acting Executive Director Dr Aresh Anwar said thefts at the hospital occur” as they do in any large public place frequented by thousands of people every day”, and he’s urged patients not to bring valuables to the hospital.
“Whilst we appreciate some individuals are facing tremendous hardship we cannot condone theft of any kind,” Mr Anwar said.
“We take security incidents seriously and have processes in place to ensure incidents are thoroughly investigated and appropriate legal action taken.”
On Thursday 28th and Friday 29th April the Health Consumers’ Council hosted our inaugural Patient Experience Week (PXW) with a series of events at The Boulevard Centre in Floreat. We are excited to be finalising our new HCC Podcast of those events we were able to record, and in the meantime, here are some event highlights for you from day one of PXW.
The Welcome and Introduction
Olman Walley gave a Welcome to Country on both days, providing his own unique and gracious welcome in language and with music. His didgeridoo playing was evocative and on the second day, and veered off into rap. Sense of humour that one!
Pip Brennan presented on behalf of the HCC and thanked the sponsors Illuminance and Empower ICT who provided essential support for the event. Pip then spoke about how HCC supported consumers individually through advocacy and supported health reform through consumer representative training and sector support. The importance of supporting the health sector in working with Aboriginal as well as Culturally and Linguistically Diverse communities was highlighted. Pip also referenced the December 2015 Clinical Senate Debate on the Patient Experience. She particularly highlighted the four Recommendations from that debate which were endorsed and therefore WA Health has a mandate to ensure they are implemented. The Recommendations are:
WA Health should introduce a system-wide, consistently branded ‘Patient First’ program that drives the patient experience agenda and under which all key patient experience improvement programs are measured, with results publically available.
In consultation with consumer and carer peak bodies: •A statewide definition of a great patient experience is developed that incorporates a value-based, patient-centered approach. WA Health, as system manager, is to ensure this is adopted by the whole of Health. •Patient experience tools are developed or selected for use that reflect the indicators that matter to patients.
The Senate recommends that a consumer is appointed as a member of State Health Executive Forum (or its equivalent post legislative amendments to create Health Service boards).
The Senate recommends Chief Executive Officers visibly and actively lead consumer partnership programs and have related Key Performance Indicators (KPIs) in their performance agreement with their boards.
The Director General of WA Health formally opened the launch and stated WA Health’s commitment to patient care, patient safety and providing the best patient experience. He highlighted that it is essential to have an organisational culture where staff feel valued and respected, and patients are treated with dignity and respect. In order to achieve that, consumers must be involved in strategic processes that guide the planning, design and evaluation of health services. He referenced the December 2015 Clinical Senate Debate on Patient Experience and highlighted WA Health’s commitment to developing a Compassionate Care initiative. Compassionate Care is about the way in which people relate to each other. This means the way staff treat each other as well as they way they treat patients. His powerpoint can be accessed by clicking here.
The Director General closed with these statements:
The patient journey is unique to each person. Every interaction with patients and their families impacts on their experience.
We must transparently measure the patient experience.
Lessons learnt – through both positive and negative feedback – can be used to improve health services.
A system-wide definition of a great patient experience should be developed.
Consumers must be involved in the planning, design and evaluation of health services.
It is essential to have an organisational culture where staff feel valued and respected, and patients are treated with dignity and respect.
This starts with our behaviour and our values.
We were then joined on Skype by Dr Karen Luxford, Director of the NSW’s Clinical Excellence Commission. The gremlins were with us at this point, so the Skype presentation didn’t record. After Patient Experience Week was over, Karen kindly agreed to be interviewed about the Clinical Excellence Commission, their Patient Experience Week events and why the patient experience movement is important. You can listen to that audio by clicking the link below:
The final presentation of the launch was by the irrepressible Jason Wolf, CEO of The Beryl Institute. The Beryl Institute is an international community of health professionals, consumer, carer and community members dedicated to improving patient experience in health care. His presentation was highly motivating, and can be watched by clicking the arrow below. Alternatively you can view his slide presentation here.
The Actors – Two Sides to the Patient Experience
Straight after the launch, Agents Improvocateurs took to the stage to enact a patient journey scenario, inspired by stories HCC hears from consumers who seek our advocacy assistance. In the scenario, a patient had been stung by a bee near her breast and attended the Emergency Department and was then put on a children’s ward where she endured hours of hunger, (children’s portion dinners) pain (failed insertion of a cannula to administer antiobiotics, then a reaction to those antibiotics) and being ignored. She was also confused and frightened by talk of a possible mastectomy in a discussion between two health professionals in a conversation in her hearing which excluded her. The audience offered suggestions for how things could be done differently and the scenario was played through again. It also explored the situation from the provider perspective – each interaction always has at least two people and in this one we explored the fears and humiliation of the nurse who had failed to insert the cannula. Alma Digweed from Bentley Community Advisory Council agreed to join the actors on the stage and was the star of the show.
Alma Diggins, Star!
Take Two
Walking with her drip, begging for help!
Lunchbox Session – Organisational Approaches to Patient Experience
This diverse session included a presentation from Anita Deakin and Carmel Crock, in relation to the Emergency Medicines Events Register (EMER). This interesting and innovative tool is a change management mechanism in that in encourages both clinicians and consumers to report near misses and develop a culture which supports a learning approach to near misses to support a safer patient culture. The Powerpoint presentation is available here, and you can find out more about EMER here.
Next up was James Sherriff, General Manager of St John’s Ambulance and former paramedic. James’ presentation focused on the internal change that St Johns have actively sought within the organisation to ensure front line staff always have the patient at the centre of the care. You can view his Powerpoint here.
The session closed with HCC’s Dr Martin Whitely and Murdoch researcher Dr Norman Stomski describing a key research project they have been collaborating on. HCC provides individual advocacy for mental health consumers who are voluntary. HCC sought to better understand what the advocacy intervention meant for consumers whose patient journey was far from smooth. 60 de-identified individual advocacy cases were written up for research analysis. Martin and Norman’s joint presentation can be viewed here.
Workshop Session – Partnering for Patient Experience
The day concluded with a workshop facilitated by HCC’s Steph Newell. Presenting was Professor Anne Williams on her years of research and development of Patient Experience Tools – known as PEECE and PEECH. Helen Fernando from South Australia presented on the unique and effective Messenger Model that she has developed, and a version of the concept runs at Flinders Medical Centre. The Messenger Model involves the consumer representative providing a conduit for information about health care needs and experiences to reach front-line staff during the episode of care. The feedback about what has gone well or otherwise alerts staff to issues that may be addressed whilst the patient and family are still in the care of the health professional team so that the patient experience can be transformed. Steph Newell explained the key factors of partnership – trust and common purpose. During the workshop session, audience members were encourage to view sections of this video on patient experience and consider the scenarios within the context of the tools discussed – PEECE, PEECH and the Messenger Model.
The Theme, The Crowd
We aligned with the international theme for 2016 Patient Experience – “Connecting for Patient Experience – We are ALL the Patient Experience”
Panelists of ‘A Multicultural Perspective on Pregnancy, Childbirth and Postnatal Care’ in Partnership with Department of Nursing & Midwifery Education and Research at KEMH, May 2015
The Diversity Dialogues seminar series has been developed by HCC for consumers and health service providers to explore ways to develop hospital services and patient care strategies that respond to cultural diversity.
Diversity Dialogues comprise a panel discussion where the panelists are from a range of cultural backgrounds, who share their knowledge and experiences around culturally aware practice, building culturally inclusive services and discussing the importance of cultural awareness in best practice. They can be run in partnership with a health service which will host the event. The outcome of the forums is to formulate recommendations regarding best practice.
Diversity Dialogue events are run on particular themes, such as pregnancy, mental health or sexual health. Information about Past Diversity Dialogues is available here.
To express your interest in the next forum, or to talk to us about hosting a dialogue at your workplace, get in touch.
HCC provides a range of support services for health providers who are seeking to increase consumer engagement in health service policy, planning and review.
We are always available to have a chat about your project or plans, however some of our services may attract a fee. Please contact us on info@hconc.org.au if you’d like to discuss this further.
Our consulting services support consumer-focused organisations with the design and development of innovative, contemporary approaches to consumer and community partnerships and involvement. With a people-first approach and a consumer/lived experience lens at the heart of everything we do, our work helps health organisations and staff feel more confident to work with consumers in a meaningful way.
Promoting a Consumer Representative Opportunity
If you are looking for consumers for your committee or project, we may be able to assist you by promoting the opportunity through our networks.
We can also run this training on a bespoke basis for your consumer advisory group – find out more here.
Cultural Diversity
We offer a range of free and fee for service workshops to assist health workers gain knowledge and skills to communicate and engage more effectively with people from culturally and linguistically diverse (CaLD), ethnoculturally and linguistically diverse (ELD), and new and emerging communities. Click hereto find out more.
For further information
Please contact the Health Consumers Council Engagement team on 9221 3422 or email info@hconc.org.au
Would you like to use your experience as a patient or carer to create a better health system? We know that pro-active and skilled Consumer Representatives can do just that, and this introductory course will help you get started.
Consumer Representatives play an integral role in the Australian health care system. They provide vital information and ideas from a service user’s perspective, to health services and government committees.
This highly interactive workshop will give you the opportunity to hear, learn and think about important information for consumer representatives including:
The roles and purpose of a consumer representative
The benefits of consumer representation
Barriers to participation for consumer representatives
Overcoming barriers to participation
Maintaining effectiveness as a consumer representative
Book now and see why people are loving our new, highly interactive learning experiences at HCC
Workshop duration
4 hours
Workshop Location
Health Consumers’ Council, Unit 4, 434 Lord Street, Mount Lawley
This award is to acknowledge outstanding service to Aboriginal/Torres Strait Islander health consumers. The candidates can be an Aboriginal/Torres Strait Islander person or organisation.
Aboriginal Health Team
This holistic services offers a range of health services and screening in one clinic. There are 9 locations for this innovative service. There are also 4 playgroups across the metropolitan offered after consulting with consumers. The purpose of the playgroup is to get the children ready for school, plus empower the mothers, assist the mums to read to their children, plus mimic the activities utilised each week.
Boodjari Yorgas Family Care Program
The Boodjari Yorgas family care group, including its Aboriginal Grandmothers, are involved on a daily basis with Aboriginal women and their families as ‘consumers’ of maternity care, making sure their needs are met, that they are able to attend appointments, and have a consistent person available to them to answer questions and help them negotiate the, often complex, maternity care system.
Christine Parry | Boodjari Yorgas Family Care Program
Christine Parry has been part of the Moort Boodjari Yorga’s antenatal program since its beginning. Christine’s knowledge is exceptional, and she has contributed to improving non- Aboriginal health professionals cultural understanding of women’s needs and that her Aboriginal and non-Aboriginal colleagues are able to effectively work within the health system to care for Aboriginal women during the important events of pregnancy, birth and early parenting.
Kerri Colgate | St John of God Midland
While patients are in hospital Kerri supports staff to deliver a culturally safe model of care. In addition, Kerri creates relationships between the hospital and community service providers to ensure people get what they need after discharge back into the community. She maintains contact once people have been discharged and supports people to understand their health and how to stay well.
Living Improvements For Everyone (L.I.F.E)
The Chronic Disease Self-Management Living Improvements for Everyone (L.I.F.E) Program objective is to improve the capacity and participation of Aboriginal people in Metropolitan region of Perth in the self- management of chronic disease. This is achieved through the delivery of the LIFE course and culturally secure training and education programs to increase knowledge of chronic disease management for health care professionals and community members.
Leah Bonson | Child and Adolescent Health Service
Leah has worked tirelessly to support the Child and Adolescent Health Service to be more culturally supportive of Aboriginal patients, with a focus on supporting the Child and Adolescent Mental Health Service.
Peter Humphries and Natasha Garlett | Aboriginal Health Liaison Officers, East Metro Health Service
The liaison officers in the LIFE program both Peter and Natasha provide support to improve Aboriginal health by working with the Aboriginal community and other relevant agencies. They do this effectively by treating consumers with dignity and respect. They share information and knowledge with skill and care. As LIFE Program facilitators they have a wonderful rapport with participants based upon respect and sharing of information in a culturally appropriate way. The partnership between facilitator and consumer is a two-way learning that is professionally embraced.
WA Cervical Cancer Prevention Program
The creation of this resource in partnership with Aboriginal women from across WA has ensured that relevant, timely, culturally appropriate and user friendly information is utilised in the educational strategies targeted to this consumer group. It results in a better understanding of health risks and greater acceptance of cervical cancer prevention strategies for this group of women.
Thank you for your patience as we navigate increased demands for our advocacy service.
Our advocacy waitlist is currently closed; we are working hard to clear it and hope to reopen the waitlist soon.
In the meantime, please still contact us if you are having, or have had, issues within the health system. Our dedicated team is able to provide information, system navigation, and some support in relation to the issue you are experiencing. Contact an advocate on (08) 9221 3422 or advocacy@hconc.org.au
