The Communicate study – Stage 2
Many Aboriginal patients at Royal Darwin Hospital speak a language other than English at home, and would benefit from an interpreter when they encounter the health care system. Multiple studies show that the quality of communication healthcare in the northern Territory is very poor – patients don’t understand their diagnosis or what treatment they need, and doctors don’t appreciate the knowledge gap between themselves and patients. Poor communication is not just about not using the right language, but also about using a culturally respectful approach, appreciating differing worldviews, and taking time to build a trusting relationship and provide culturally meaningful explanations.
Use of Aboriginal interpreters is still the exception rather than the rule, due to a variety of systems barriers, including difficulty in booking interpreters and lack of time.
We undertook surveys, audits and interviews at Royal Darwin hospital, identifying barriers that could be readily fixed, and advocated for an Aboriginal Interpreter Coordinator to be employed. Fortunately, this role was supported by Top End Health Services, and we are now evaluating the effect on Interpreter uptake, and on patients’ experiences of care. We are implementing a suite of interventions and collecting further qualitative and quantitative data to understand whether efforts to overcome barriers can result in genuine, sustainable behaviour change.
The Communicate Study seeks to shift the culture of Royal Darwin Hospital, to help recognition that poor communication – like poor quality in any aspect of medical care – is unacceptable. In this translation phase of the study, advocacy needs to become more visible and entrenched, to ensure that changes are sustainable.