To the Editor: It has been estimated that “levelling the playing field” in terms of cardiovascular health alone could narrow the life-expectancy gap between Indigenous and non-Indigenous Australians by 6.5 years.1
three times the rate of major coronary events
higher death rates from coronary heart disease both in and out of hospital
lower rates of coronary angiography, angioplasty and bypass surgery2
a greater likelihood of adverse outcomes in the 2 years after discharge.3
In 2010, the Heart Foundation and Australian Healthcare and Hospitals Association (AHHA) published a report examining these disparities and providing specific recommendations to achieve better care for Aboriginal and Torres Strait Islander people throughout the patient journey.4 It acknowledged that, although quality care is being provided in some places, more research and comprehensive data collection are needed.
The Heart Foundation and AHHA are now seeking support for a national “lighthouse hospital” initiative to showcase exemplary efforts in this area and allow sharing and collaboration between participating hospitals (see http://www.heartfoundation.org.au/information-for-professionals/aboriginal-health for more details).
Cultural competence refers to both an organisation’s and an individual’s capacity to respect and accommodate another’s set of beliefs, providing a safe and secure environment in which to deliver care.
A focus on clinical quality improvement allows for each step in the care pathway to be monitored and adapted.
The workforce requires training in dealing with other cultures and quality improvement, and it needs to be of adequate number (including Aboriginal health staff).
Overarching governance and accountability, including genuine engagement of management, is crucial.
No relevant disclosures.