Action 1.29

The health service organisation maximises safety and quality of care:

a. Through the design of the environment

b. By maintaining buildings, plant, equipment, utilities, devices and other infrastructure that are fit for purpose

Intent

The physical environment supports safe and high-quality care and reflects the patient's clinical needs.

Reflective questions

How does the health service organisation ensure that the design of the environment supports the quality of patient care?

How does the health service organisation ensure that buildings and equipment are safe and maintained in good working order?

Key tasks

Regularly conduct environmental audits to see whether the environment is safe and promotes best practice

Implement a schedule of review to ensure that all buildings, plant and equipment are fit for purpose, safe and in good working order at all times.

Strategies for improvement

Hospitals

Develop maintenance strategies

Develop a comprehensive maintenance plan that includes:

  • clear and easy-to-use documentation of maintenance and repairs
  • records of all plant and equipment, including (as a minimum) the date of purchase, preventive maintenance schedule, location and serial number
  • details of routine and preventive maintenance performed for each item of equipment and plant, including electromedical equipment
  • records of dates when equipment is regularly tested to ensure its readiness, including information relating to generators and battery backup.

Where equipment is regularly tested to ensure its readiness, record these dates, including information relating to generators and battery backup.

Australian standards are available for devices and equipment, and these should be reflected in the organisation’s policies and procedures so that purchases, repairs and replacements are carried out following a specified standard. Similarly, the Building Code of Australia articulates the technical provisions for the design and construction of buildings and other structures throughout Australia, and should also be reflected in the organisation’s policies and procedures. Manufacturers also set guidelines for the use and tolerance of equipment and devices. Faulty devices may need to be reported (for example, to the Therapeutic Goods Administration) or may be subject to a recall.

Use evidence-based design principles to promote safe practice

The physical environment can have a major impact on safety and quality performance. Good design can contribute to safe and high-quality care by promoting safe practices and removing potential hazards. It can reduce healthcare-associated infections and medical errors1, improve patient and workforce satisfaction, and increase organisational performance.2

Consider the following design principles when redesigning or upgrading amenities:

  • Automating processes, if appropriate (for example, dispensing medicines, handwashing facilities)
  • Designing spaces to prevent adverse events (for example, removing tight corners, selecting appropriate furnishings and surfaces that can be easily decontaminated, providing enough lighting)1
  • Designing spaces to prevent adverse events relating to self-harm (for example, removing ligature points and installing safety glass, if relevant)
  • Designing rooms for scalability, adaptability and flexibility, which can help to minimise patient transfers and provide space for family members
  • Standardising the layout and placement of supplies and equipment in rooms to improve efficiency and reduce errors2
  • Providing information that is visible and easily accessible to patients and the workforce
  • Positioning nursing stations centrally on the ward to minimise workforce fatigue and maximise workforce overview
  • Using soft furnishings to reduce the impact of background noise on patients
  • Providing clearly marked signs, maps and instructions to help patients and visitors navigate the health service.

Examples of evidence

Select only examples currently in use:

  • Policy documents that describe the health service organisation’s
    • requirements for maintaining buildings, plant, equipment, utilities and devices
    • reporting lines and accountability for actions, including during emergency situations
  • Strategic plan for facilities and capital works
  • Maintenance schedule for buildings, equipment, utilities and devices
  • Audit results of compliance with maintenance schedules and inspections of equipment
  • Register of equipment that is assigned to meet individual patients’ needs
  • Audit results of the use of a pre-purchase checklist and risk assessment to identify suitability of all new equipment
  • Observation of design and use of the environment to reduce risks relating to self-harm (for example, removal of ligature points, collapsible curtain rails)
  • Observation that the different types of accommodation (for example, private and shared rooms, designated palliative care rooms, patient/ consumer/carer lounge) are allocated based on clinical need
  • Observation that the physical environment includes consideration of safety and quality (for example, interview rooms in high-risk areas that have double doors, use of CCTV surveillance, duress alarms, access to security services, a secure environment after hours)
  • Business continuity plan
  • Analysis of incident reports and action taken to deal with issues identified
  • Risk register and quality improvement plan that includes information from an analysis of incidents.
Day Procedure Services

Develop maintenance strategies

Develop a comprehensive maintenance plan that includes:

  • Clear and easy-to-use documentation of maintenance and repairs
  • Records of all plant and equipment, including (as a minimum) the date of purchase, preventive maintenance schedule, location and serial number
  • Details of routine and preventive maintenance performed for each item of equipment and plant, including electromedical equipment
  • Records of dates when equipment is regularly tested to ensure its readiness, including information relating to generators and battery backup.

When equipment is regularly tested to ensure its readiness, record these dates, including information relating to generators and battery backup.

Australian standards are available for devices and equipment, and these should be reflected in the organisation’s policies and procedures so that purchases, repairs and replacements are carried out following a specified standard. Similarly, the Building Code of Australia articulates the technical provisions for the design and construction of buildings and other structures throughout Australia, and should also be reflected in the organisation’s policies and procedures. Manufacturers also set guidelines for the use and tolerance of equipment and devices. Faulty devices may need to be reported (for example, to the Therapeutic Goods Administration) or may be subject to a recall.

Use evidence-based design principles to promote safe practice

The physical environment can have a major impact on safety and quality performance. Good design can contribute to safe and high-quality care by promoting safe practices and removing potential hazards. It can reduce healthcare-associated infections and medical errors1, improve patient and workforce satisfaction, and increase organisational performance.2

Consider the following design principles when redesigning or upgrading amenities:

  • Automating processes, if appropriate (for example, dispensing medicines, handwashing facilities)
  • Designing spaces to prevent adverse events (for example, removing tight corners, selecting appropriate furnishings and surfaces that can be easily decontaminated, providing enough lighting)1
  • Providing information that is visible and easily accessible to patients and the workforce
  • Using soft furnishings to reduce the impact of background noise on patients
  • Providing clearly marked signs, maps and instructions to help patients and visitors navigate the health service.

Examples of evidence

Select only examples currently in use:

  • Policy documents that describe the health service organisation’s
    • requirements for maintaining buildings, plant, equipment, utilities and devices
    • reporting lines and accountability for actions, including during emergency situations
  • Strategic plan for facilities and capital works
  • Maintenance schedule for buildings, equipment, utilities and devices
  • Audit results of compliance with maintenance schedules and inspections of equipment
  • Register of equipment that is assigned to meet individual patients’ needs
  • Audit results of the use of a pre-purchase checklist and risk assessment to identify suitability of all new equipment
  • Observation of design and use of the environment to reduce risks relating to self-harm (for example, removal of ligature points, collapsible curtain rails)
  • Observation that the different types of accommodation (for example, private and shared rooms, designated palliative care rooms, patient/consumer/carer lounge) are allocated based on clinical need
  • Observation that the physical environment includes consideration of safety and quality (for example, interview rooms in high-risk areas that have double doors, use of CCTV surveillance, duress alarms, access to security services, a secure environment after hours)
  • Business continuity plan
  • Analysis of incident reports and action taken to deal with issues identified
  • Risk register and quality improvement plan that includes information from analysis of incidents.
MPS & Small Hospitals

MPSs and small hospitals need to consider the following design principles when redesigning or upgrading amenities:

  • Automating processes, if appropriate (for example, dispensing medicines, handwashing facilities)
  • Designing spaces to prevent adverse events (for example, removing tight corners, selecting appropriate furnishings and surfaces that can be easily decontaminated, providing enough lighting)1
  • Designing spaces to prevent adverse events relating to self-harm (for example, removing ligature points and installing safety glass, if relevant)
  • Designing rooms for scalability, adaptability and flexibility, which can help to minimise patient transfers and provide space for family members
  • Providing information that is visible and easily accessible to patients and the workforce
  • Using soft furnishings to reduce the impact of background noise on patients
  • Providing clearly marked signs, maps and instructions to help patients and visitors navigate the health service.

MPSs and small hospitals also need to:

  • Regularly conduct environmental audits to see whether the environment is safe and promotes best practice
  • Implement a schedule of review to ensure that all buildings, plant and equipment are fit for purpose, safe and in good working order at all times
  • Develop a comprehensive maintenance plan that includes
    • clear and easy-to-use documentation of maintenance and repairs
    • records of all plant and equipment, including (as a minimum) the date of purchase, preventive maintenance schedule, location and serial number
    • details of routine and preventive maintenance performed for each item of equipment and plant, including electromedical equipment
    • records of dates when equipment is regularly tested to ensure its readiness, including information relating to generators and battery backup.

Australian standards are available for devices and equipment, and these should be reflected in the organisation’s policies and procedures so that purchases, repairs and replacements are carried out following a specified standard. Similarly, the Building Code of Australia articulates the technical provisions for the design and construction of buildings and other structures throughout Australia, and should also be reflected in the organisation’s policies and procedures.

Examples of evidence

Select only examples currently in use:

  • Policy documents that describe the health service organisation’s
    • requirements for maintaining buildings, plant, equipment, utilities and devices
    • reporting lines and accountability for actions, including during emergency situations
  • Strategic plan for facilities and capital works
  • Maintenance schedule for buildings, equipment, utilities and devices
  • Audit results of compliance with maintenance schedules and inspections of equipment
  • Register of equipment that is assigned to meet individual patients’ needs
  • Audit results of the use of a pre-purchase checklist and risk assessment to identify suitability of all new equipment
  • Observation of design and use of the environment to reduce risks relating to self-harm (for example, removal of ligature points, collapsible curtain rails)
  • Observation that the different types of accommodation (for example, private and shared rooms, designated palliative care rooms, patient/ consumer/carer lounge) are allocated based on clinical need
  • Observation that the physical environment includes consideration of safety and quality (for example, interview rooms in high-risk areas that have double doors, use of CCTV surveillance, duress alarms, access to security services, a secure environment after hours)
  • Business continuity plan
  • Analysis of incident reports and action taken to deal with issues identified
  • Risk register and quality improvement plan that includes information from an analysis of incidents.

Action 1.30

The health service organisation:

a. Identifies service areas that have a high risk of unpredictable behaviours and develops strategies to minimise the risks of harm for patients, carers, families, consumers and the workforce

b. Provides access to a calm and quiet environment when it is clinically required

Intent

Aspects of the environment that can increase risks of harm are identified and managed.

Reflective questions

How does the health service organisation identify and manage aspects of the environment and other factors that can worsen risks of harm?

What processes are in place to assess the appropriateness of the physical environment of the health service organisation for people at high risk of harm, such as people with cognitive impairment?

Key tasks

  • Review the design of the clinical environment to identify safety risks for patients, carers, family and the workforce
  • Conduct a risk assessment to identify service areas where there is a high risk of unpredictable behaviours, and develop strategies to manage identified risks
  • Identify areas where patients could be treated that offer a calm and quiet environment.

Strategies for improvement

Hospitals

Health service environments are stressful – they are brightly lit, noisy and constrained. In emergency department waiting rooms, people with different presenting problems are crowded together, uncertain about what is about to happen, and often frustrated by actual or perceived delays in accessing treatment. This can add to stress for people who are already experiencing stress.

This action is not intended to apply to every patient. People respond to stress in different ways, and have different needs in terms of environmental response. A calm and quiet environment is clinically appropriate for a person experiencing agitation and aggressive feelings. Access to sensory modulation resources may help a person who is experiencing psychosis or depersonalisation. Conversely, a person with thoughts of self-harm may consider being moved to a space on their own as isolating, and may require one-to-one nursing until they have been assessed and treatment has been initiated.

The Victorian Department of Health and Human Services has developed an audit tool that organisations can use to perform environmental audits and to develop action plans for improving the physical environment for older people using their services.3

Examples of evidence

Select only examples currently in use:

  • Policy documents for safe work practices and emergency situations
  • Audit results of healthcare records for compliance with policies, procedures or protocols regarding unpredictable behaviours
  • Training documents about safe work practices and emergency situations
  • Observation that the physical design of the environment includes consideration of safety and quality (for example, interview rooms in high-risk areas that have double doors, use of CCTV surveillance, duress alarms, access to security services, a secure environment after hours)
  • Security contracts and surveillance systems.
Day Procedure Services

Day procedure services should use pre-admission screening processes to identify patients with a high risk of unpredictable behaviour. The screening processes listed under Actions 5.10 and 5.11 could also be used to demonstrate the management of risk for Action 1.30a.

Action 1.30b may not be applicable for many day procedure services because of the size of the service and the nature of the clinical environment.

Services should refer to the advice for hospitals for detailed implementation strategies and examples of evidence for this action, as required.

MPS & Small Hospitals

MPSs and small hospitals should:

  • Use the environment flexibly to meet the changing needs of patients, their carers and families
  • Conduct a risk assessment to identify service areas in which there is a high risk of unpredictable behaviours, and develop a risk management plan to manage identified risks.

This action is not intended to apply to every patient. People respond to stress in different ways, and have different needs in terms of environmental response. A calm and quiet environment is clinically appropriate for a person experiencing agitation and aggressive feelings. Access to sensory modulation resources may help a person who is experiencing psychosis or depersonalisation. Conversely, a person with thoughts of self-harm may consider being moved to a space on their own as isolating, and may require one-to-one nursing until they have been assessed and treatment has been initiated.

Examples of evidence

Select only examples currently in use:

  • Policy documents for safe work practices and emergency situations
  • Audit results of healthcare records for compliance with policies, procedures or protocols regarding unpredictable behaviours
  • Training documents about safe work practices and emergency situations
  • Observation that the physical design of the environment includes consideration of safety and quality (for example, interview rooms in high-risk areas that have double doors, use of CCTV surveillance, duress alarms, access to security services, a secure environment after hours)
  • Security contracts and surveillance systems.

Action 1.31

The health service organisation facilitates access to services and facilities by using signage and directions that are clear and fit for purpose

Intent

Patients, carers and visitors can locate relevant facilities and services.
 

Reflective question

How do patients and visitors find the facilities to gain access to care?

Key task

Review the signage and directions provided throughout the facility.
 

Strategies for improvement

Hospitals

Consider how to direct patients to get to the health service, find their way around the campus, and find the right unit or service within a building. When designing the wayfinding system, consider4:

  • The physical environment, including layout, lighting, landmarks, and changes to interior finishes and colours
  • How to provide information to patients to prepare for their journey
  • The types of signs, graphics and terminology
  • How to ensure that members of the workforce can provide appropriate directions for patients who need assistance.

Instructions should:

  • Be simple, intuitive, user friendly and accessible
  • Integrate with the requirements of a safe and secure facility
  • Meet the legal requirements for accessibility
  • Be easy to maintain
  • Align with the principles of universal design.

Wayfinding strategies may include hard copies of signs, maps and written directions, or more interactive approaches such as employees or volunteers who help people with directions, interactive information kiosks or smartphone apps.

Examples of evidence

Select only examples currently in use:

  • Policy documents for signage, disability access and inclusion
  • Observation of the use of universal signage to enable wayfinding for people from culturally and linguistically diverse backgrounds
  • Audit results that show whether signs are clearly visible to people with disability
  • Location maps that are displayed at entrances and in areas of high visual impact
  • Facility map that is available in multiple languages
  • Observation of the use of volunteers in reception areas to assist consumers with directions.
Day Procedure Services

Consider how to direct patients to the health service, including with information about parking, public transport and other essential services. Also consider the types of signs used, graphics and terminology.4

Instructions should4:

  • Be simple, intuitive, user friendly and accessible
  • Integrate with the requirements of a safe and secure facility
  • Meet the legal requirements for accessibility
  • Be easy to maintain
  • Align with the principles of universal design.

Wayfinding strategies may include hard copies of signs, maps and written directions, or more interactive approaches such as employees or volunteers who help people with directions, interactive information kiosks and smartphone apps.

Examples of evidence

Select only examples currently in use:

  • Policy documents for signage, disability access and inclusion
  • Observation of the use of universal signage to enable wayfinding for people from culturally and linguistically diverse backgrounds
  • Audit results that show whether signs are clearly visible to people with disability
  • Location maps that are displayed at entrances and in areas of high visual impact
  • Facility map that is available in multiple languages
  • Observation of the use of volunteers in reception areas to assist consumers with directions.
MPS & Small Hospitals

Consider how to direct patients to the health service, including with information about parking, public transport and other essential services. Also consider the types of signs used, graphics and terminology.

Instructions should4:

  • Be simple, intuitive, user friendly and accessible
  • Integrate with the requirements of a safe and secure facility
  • Meet the legal requirements for accessibility
  • Be easy to maintain
  • Align with the principles of universal design.

Wayfinding strategies may include hard copies of signs, maps and written directions, or more interactive approaches such as employees or volunteers who help people with directions, interactive information kiosks and smartphone apps.

Examples of evidence

Select only examples currently in use:

  • Policy documents for signage, disability access and inclusion
  • Observation of the use of universal signage to enable wayfinding for people from culturally and linguistically diverse backgrounds
  • Audit results that show whether signs are clearly visible to people with disability
  • Location maps that are displayed at entrances and in areas of high visual impact
  • Facility map that is available in multiple languages
  • Observation of the use of volunteers in reception areas to assist consumers with directions.

Action 1.32

The health service organisation admitting patients overnight has processes that allow flexible visiting arrangements to meet patients’ needs, when it is safe to do so

Intent

Flexible visitation contributes to improved safety and quality of care for patients.
 

Reflective question

What processes are in place to support flexible visiting arrangements?

Key tasks

  • Review policies, procedures or protocols about visiting arrangements
  • Ensure that infrastructure and supports are available to provide flexible visiting arrangements
  • Monitor the effectiveness of flexible visiting arrangements.

Strategies for improvement

Hospitals

The unrestricted presence and participation of a support person can improve the safety of care, and patient and family satisfaction. By facilitating unrestricted access for a chosen support person(s), patients can be provided with emotional and social support.

For patients, flexible visiting can reduce anxiety, confusion and agitation. It can make them feel safe and increase their satisfaction with the care provided. Flexible visiting arrangements can also increase satisfaction for family members and reduce their anxiety. It can promote communication and allow family members to learn about the patient’s condition, because they are involved in their care.

Although there are perceived concerns with unrestricted visiting hours – such as family members getting in the way when care is provided, potential for increased infections and family members overextending the hours they visit – these barriers are not supported by evidence.

Support flexible visiting arrangements by developing or revising the organisation’s policies and procedures on visiting arrangements to allow unrestricted visiting hours, if practicable. Include information about limiting visitation for those who infringe on the rights of others, or whose presence is medically or therapeutically contraindicated.5

The governing body and management should provide leadership and support for changes in visiting arrangements. Document these changes to ensure that there is clear direction for implementation. Communicate changes to the workforce through established communication channels, at orientation and through ongoing education, and during the professional development process.

Consider how patients and carers are advised about their right to identify a partner in care and inform them about how they can be involved. Document the patient’s preferences about the chosen support person and their level of involvement in the patient’s healthcare record.

Some other examples of strategies can be found in the Canadian Better Together campaign and the Institute for Patient- and Family-Centered Care Better Together campaign.

Examples of evidence

Select only examples currently in use:

  • Policy documents about visiting rights of patients, including any clinically necessary or reasonable restrictions or limitations that the health service organisation may have
  • Consumer and carer information packages or resources that inform consumers of visiting policies or guidelines
  • Availability of different types of accommodation to meet patients’ needs (for example, visitor waiting rooms, family rooms, quiet rooms).
Day Procedure Services

This action is not applicable for day procedure services that do not admit patients overnight.

Day procedure services that admit patients overnight (for example, those with 23-hour licences) should refer to the advice for hospitals for detailed implementation strategies and examples of evidence for this action.

MPS & Small Hospitals

The unrestricted presence and participation of a support person can improve the safety of care, and patient and family satisfaction. By facilitating unrestricted access for a chosen support person(s), patients can be provided with emotional and social support.

MPSs and small hospitals should consider:

  • Reviewing policies, procedures or protocols about visiting arrangements
  • Ensuring that infrastructure and supports are available to provide flexible visiting arrangements
  • Monitoring the effectiveness of flexible visiting arrangements.

For patients, flexible visiting can reduce anxiety, confusion and agitation. It can make them feel safe and increase their satisfaction with the care provided. Flexible visiting arrangements can also increase satisfaction for family members and reduce their anxiety. It can promote communication and allow family members to learn about the patient’s condition, because they are involved in their care.

Although there are perceived concerns with unrestricted visiting hours – such as family members getting in the way when care is provided, potential for increased infections and family members overextending the hours they visit – these barriers are not supported by evidence.

Consider how patients and carers are advised about their right to identify a partner in care and inform them about how they can be involved. Document the patient’s preferences about the chosen support person and their level of involvement in the patient’s healthcare record.

Examples of evidence

Select only examples currently in use:

  • Policy documents about visiting rights of patients, including any clinically necessary or reasonable restrictions or limitations that the health service organisation may have
  • Consumer and carer information packages or resources that inform consumers of visiting policies or guidelines
  • Availability of different types of accommodation to meet patients’ needs (for example, visitor waiting rooms, family rooms, quiet rooms).

Action 1.33

The health service organisation demonstrates a welcoming environment that recognises the importance of the cultural beliefs and practices of Aboriginal and Torres Strait Islander people

Intent

Aboriginal and Torres Strait Islander people feel welcome and respected when receiving care.

Reflective questions

How does the health service organisation make Aboriginal and Torres Strait Islander patients feel welcome and safe when receiving care?

How does the physical environment meet the needs of Aboriginal and Torres Strait Islander patients, carers and families?

Key tasks

  • Establish relationships with local Aboriginal and Torres Strait Islander communities, and seek feedback on current practices in the organisation and areas for improvement
  • Review the factors that create a welcoming environment for Aboriginal and Torres Strait Islander people.

Strategies for improvement

Hospitals

Providing a welcoming, culturally sensitive and safe environment for Aboriginal and Torres Strait Islander people may improve their patient and carer experience during an episode of care. This may lead to improved health outcomes and may reduce the rate of early discharge.

Create a welcoming, culturally sensitive and safe environment for Aboriginal and Torres Strait Islander people by6:

  • Collaborating with local Aboriginal and Torres Strait Islander people and communities to review the design, use and layout of public spaces, and to maximise privacy and minimise distress in clinical spaces
  • Engaging the community in the development of messages to explain organisational processes
  • Identifying spaces for Aboriginal and Torres Strait Islander people to hold family conferences, and to consult with members of the clinical workforce, carers and family; this could include outdoor spaces, if appropriate
  • Seeking feedback on the signs, symbols and displays that could be used, such as
    • Aboriginal or Torres Strait Islander flags
    • artwork from local and partner communities
    • statements of reconciliation and acknowledgement of traditional owners
    • participation in cultural events
  • Supporting Aboriginal and Torres Strait Islander consumers to have access to culturally appropriate services.

Further strategies are available in the User Guide for Aboriginal and Torres Strait Islander Health.

Examples of evidence

Select only examples currently in use:

  • Policy documents about cultural diversity that deal with the needs of Aboriginal and Torres Strait Islander patients, and their carers and families
  • Committee and meeting records that show that the local community provided input about the cultural beliefs and practices of Aboriginal and Torres Strait Islander people
  • Availability of an Aboriginal support officer to support Aboriginal and Torres Strait Islander patients on entry or admission to the health service organisation
  • Information brochures that outline the role of the Aboriginal support officer, and the services available to support Aboriginal and Torres Strait Islander patients
  • Examples of services that are tailored to meet the needs of Aboriginal and Torres Strait Islander patients
  • Aboriginal and Torres Strait Islander flags, local artworks or land maps that are displayed in main foyers, or used in soft furnishings and information brochures
  • Statements of reconciliation and acknowledgement of traditional custodians
  • Use of Aboriginal and Torres Strait Islander names for wards and meeting rooms
  • Results of consumer satisfaction surveys that provide feedback on actions to meet the needs of Aboriginal and Torres Strait Islander patients
  • Identified space for Aboriginal and Torres Strait Islander people to hold family conferences or to consult with members of the clinical workforce
  • Evidence of involvement in, or recognition of, ceremonies such as NAIDOC celebrations, smoking ceremonies and National Sorry Day.
Day Procedure Services

This action applies to day procedure services that commonly provide care for Aboriginal and Torres Strait Islander people. These services should refer to the advise for hospitals and the User Guide for Aboriginal and Torres Strait Islander Health for detailed implementation strategies and examples of evidence for this action.

Day procedure services that rarely provide care for Aboriginal and Torres Strait Islander people, or when the risk of harm for these patients is the same as for the general patient population, should manage the specific risk of harm, and provide safe and high-quality care for these patients through the safety and quality improvement systems that relate to their whole patient population.

Day procedure services need to implement strategies to improve the cultural awareness and cultural competency of the workforce under Action 1.21, and identify Aboriginal and Torres Strait Islander patients under Action 5.8.

MPS & Small Hospitals

Providing a welcoming, culturally sensitive and safe environment for Aboriginal and Torres Strait Islander people may improve the patient and carer experience during an episode of care. This may lead to improved health outcomes and may reduce the rate of early discharge.

MPSs and small hospitals should consider how they:

  • Establish relationships with local Aboriginal and Torres Strait Islander communities, and seek feedback on current practices in the organisation and areas for improvement
  • Review the factors that create a welcoming environment for Aboriginal and Torres Strait Islander people.

Create a welcoming, culturally sensitive and safe environment for Aboriginal and Torres Strait Islander people by6:

  • Collaborating with local Aboriginal and Torres Strait Islander people and communities to review the design, use and layout of public spaces, and to maximise privacy and minimise distress in clinical spaces
  • Engaging the community in the development of messages to explain organisational processes
  • Identifying spaces for Aboriginal and Torres Strait Islander people to hold family conferences, and to consult with members of the clinical workforce, carers and family; this could include outdoor spaces, if appropriate
  • Seeking feedback on the signs, symbols and displays that could be used, such as
    • Aboriginal or Torres Strait Islander flags
    • artwork from local and partner communities
    • statements of reconciliation and acknowledgement of traditional owners
    • participation in cultural events
  • Supporting Aboriginal and Torres Strait Islander consumers to have access to culturally appropriate services.

Further strategies are available in the User Guide for Aboriginal and Torres Strait Islander Health.

Examples of evidence

Select only examples currently in use:

  • Policy documents about cultural diversity that deal with the needs of Aboriginal and Torres Strait Islander patients, and their carers and families
  • Committee and meeting records that show that the local community provided input about the cultural beliefs and practices of Aboriginal and Torres Strait Islander people
  • Availability of an Aboriginal support officer to support Aboriginal and Torres Strait Islander patients on entry or admission to the health service organisation
  • Information brochures that outline the role of the Aboriginal support officer, and the services available to support Aboriginal and Torres Strait Islander patients
  • Examples of services that are tailored to meet the needs of Aboriginal and Torres Strait Islander patients
  • Aboriginal and Torres Strait Islander flags, local artworks or land maps that are displayed in main foyers, or used in soft furnishings and information brochures
  • Statements of reconciliation and acknowledgement of traditional custodians
  • Use of Aboriginal and Torres Strait Islander names for wards and meeting rooms
  • Results of consumer satisfaction surveys that provide feedback on actions to meet the needs of Aboriginal and Torres Strait Islander patients
  • Identified space for Aboriginal and Torres Strait Islander people to hold family conferences or to consult with members of the clinical workforce
  • Evidence of involvement in, or recognition of, ceremonies such as NAIDOC celebrations, smoking ceremonies and National Sorry Day.
Last updated 1st June, 2018 at 12:04am
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References

Huisman ERCM, Morales E, van Hoof J, Kort HSM. Healing environment: a review of the impact of physical environmental factors on users. Build Environ 2012;58:70–80.

Reiling J, Hughes R, Murphy M. The impact of facility design on patient safety. In: Hughes RG, editor. Patient safety and quality: an evidence-based handbook for nurses. Rockville (MD): Agency for Healthcare Research and Quality; 2008.

Victorian Government Department of Human Services. Improving the environment for older people in health services: an audit tool. Melbourne: Department of Human Services; 2006.

Queensland Health. Queensland Health wayfinding design guidelines. Brisbane: Queensland Health; 2010.