Using Yarning to Improve Cardiac Care at a Metropolitan Hospital

Abstract

Improving cultural safety for Aboriginal and Torres Strait Islander patients and staff has been identified as a means of addressing the cardiovascular diseases disparities that exist between this group and the broader Australian community. Yarning is an Aboriginal and Torres Strait Islander people's cultural practice that connects, validates and enhances cultural identities. Since 2013, on the cardiac wards at our metropolitan hospital in Melbourne, we have had a committee working alongside the Aboriginal Hospital Liaison Officers to review the journeys of Aboriginal and Torres Strait Islander patients. Care processes are reviewed from both cultural and clinical perspectives. Yarning is central to all our work; it has enhanced non-Aboriginal staffs’ understanding of culture and its relationship to health outcomes. It is used as a clinical tool for establishing therapeutic relationships with Aboriginal and Torres Strait Islander patients; nurses yarn around care interventions, with the intention of improving the patients’ sense of safety. Yarning establishes cultural safety for Aboriginal / Torres Strait Islander staff in meetings with non-Aboriginal staff and fosters working relationships. We are starting to use yarning for clinical handover to Aboriginal Medical Services. Yarning informs our decision making, implementation and evaluation of processes. We audit and yarn about our adherence to evidence based care for Aboriginal and Torres Strait Islander patients. We have improved identification of Aboriginal and Torres Strait Islander patients, developed guidelines for care, implemented strategies for discharge and improved access to medications. Yarning is sustainable and resource effective. This presentation will describe how we do this.