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The Managing two worlds together project aimed to add to existing knowledge of what works well and what needs improvement in the system of care for Indigenous patients from rural and remote areas of SA (and parts of the NT). It explored their complex patient journeys and what happens when they went to Adelaide for hospital care.
The relationship between patients and health care providers is the foundation of care and requires communication across cultures, geography and life experiences. As a staff member in one rural Aboriginal Community Controlled Health Service put it: 'It's like managing two worlds together, it doesn't always work'.
Stage 1 of the project focused on the problems. Four studies were conducted and are reported in six documents:
Stage 2 focused on solutions and consisted of a small set of action research projects. During 2012 the research team worked with partner organisations in this study to develop and/or document the implementation of strategies to improve the health care journeys for country Indigenous patients, based on existing good practice and on the findings of Stage 1. The final report from stage 2 was the Managing two worlds together: stage 2 - patient journey mapping tools.
Stage 3 focused on working with staff in a range of different settings to modify, adapt and test the patient journey mapping tools developed in Stage 2. These were then used specifically for quality improvement in health care and education. The research team and staff participants worked together in a range of health care and education settings in SA and the NT. The aim was to modify, adapt and test the Aboriginal patient journey mapping tools developed in Stages 1 and 2. As the project progressed the basic set of tools was further developed with flexible adaptations for each site. This involved three steps – preparing to map the patient journey, using the tools and taking action on the findings – and organising into 13 tasks with prompt questions. Careful consideration was given as to how the information that emerged from the use of the tools could best highlight communication, coordination and collaboration gaps within and between different health care providers (staff, services and organisations) so as to inform the design of effective strategies for improvement. These were compared and combined with existing policies, practice and protocols. Documents generated from this stage included:
Abstract adapted from Flinders University
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This paper describes the patient journey mapping tool and frameworks used in the Managing two worlds together (MTWT) project. Through interviews and focus groups with patients, their carer/family, and health care providers, the paper explores the barriers and enablers, gaps and strategies in relation to the journeys of country Aboriginal patients from rural and remote locations to city hospitals and their return. The primary aim of the MTWT project is to enhance existing knowledge of the strengths, and areas of improvement, in the care of Aboriginal patients from rural and remote areas of South Australia by exploring what happens when they come to Adelaide for hospital care. The project is comprised of two stages, with Stage 1 focusing on the problems, and Stage 2 focusing on solutions. The patient journey mapping tools are the first output of Stage 2.
Abstract adapted from Managing two worlds together: stage 2 - patient journey mapping tools
This study report summarises the activities, findings and challenges of the Improving Aboriginal patient journeys (IAPJ) study, which was stage three of the Managing two worlds together project. The aim of the IAPJ study was to develop, refine and evaluate a set of Aboriginal patient journey mapping tools for use in quality improvement and education. A collaborative approach to knowledge exchange was used, with the research team working with staff and managers from a range of health settings in South Australia and the Northern Territory. Together they explored how the tools could be adapted and used to make real improvements in communication, coordination and collaboration within and across a diverse range of patient journeys. The study focused on improving the health care journey for Aboriginal people as they travelled from home to hospital to home across numerous geographical and health care sites.
The Aboriginal patient journey mapping tools described in this report were used:
Abstract adapted from authors