Prof. Ray Mahoney1,2, Ms. Rica Lacy3
1Flinders University, Adelaide, Australia, 2CSIRO, AeHRC, Brisbane, Australia, 3Darling Downs Hospital and Health Service, Toowoomba, Australia
Introduction:
The InReach Kids (IRKs) project was a collaboration between an Aboriginal and Torres Strait Islander community controlled primary health organisation (Goondir Health Services) and hospital service (Darling Downs) in southwest Queensland. IRKs aimed to address 14 objectives across service delivery and health outcomes over a 12-month period. With existing health data sharing agreements, the integration model sought to implement universal seamless care and services for Indigenous children aged 0-14 years; and address health service needs for antenatal, perinatal, and postnatal women.
Aim:
CSIRO was contracted to conduct a mixed-methods evaluation to assess the appropriateness and effectiveness of IRKs. The first phase of this evaluation, the qualitative arm, aimed to explore staff perspectives of IRKs impact, alongside facilitators and barriers to its success including cultural safety assessments.
Methods:
This involved conducting semi-structured interviews with project staff, either face-to-face or via video-conferencing. Interview data was transcribed and thematically analysed.
Results:
IRKs improved the coordination of care between the primary and tertiary health services; strengthened internal relationships and external partnerships; and led to a sustained increase in staff resourcing. Project success factors largely revolved around investments in staffing capacity such as dedicated coordinator positions complemented by existing staff relationships with the local community. Barriers to success were largely at the systems level including a lack of data interoperability both internally within the hospital system, and between the two services. Other identified barriers included short-term funding cycles; and difficulties recruiting allied health in the relatively short timeframe. Finally, hospital staff cultural competency was seen to be improved through partnership with the Indigenous health service.
Conclusion:
IRKs was seen to be successful in improving the coordination of care for Indigenous women and children between the community-controlled primary health service, and the hospital service. Key recommendations from this work were presented to each service and will be used to sustain and build upon current program success. Outcomes from evaluations can be used to strengthen advocacy for factors usually beyond the control of project staff such as time allowed for building community relationships and proposing investments into staffing, data interoperability, longer-term funding, and cultural safety training.
Biography:
Ray Mahoney is a descendant of the Bidjara people of Central West Qld and is Professor of Aboriginal and Torres Strait Islander Health and Discipline Lead for Population Health at Flinders University and a Visiting Scientist with the Australian eHealth Research Centre (AeHRC) at CSIRO. Ray has adjunct academic appointments with School of Public Health in the Faculty of Medicine at UQ and with the Faculty of Health at QUT. Ray’s research background includes cardiovascular disease, e-health, culturally safe care and racism in the health sector