The ‘Dalarinji’ Emergency Department (ED) Flexi Clinic is a co-designed model between Aboriginal and non-Aboriginal Health staff that provide a culturally safe, accessible and timely service for Aboriginal patients accessing ED. The model was created to respond to the high rate of incomplete treatment in EDs for Aboriginal patients compared to non-Aboriginal patients.
The model was co-designed by ED and Aboriginal Health unit staff to address the barriers Aboriginal patients face when accessing ED services. The co-design processes empowered Aboriginal staff to use their expertise and was underpinned by seven core values that promote cultural sensitivity and humility. The model was supported by a working group that included Aboriginal Health Unit staff, an ED staff specialist, nursing staff, members of the hospital executive and the Director of ED. The support from the hospital executive and Board was a critical enabler for the success of this model.
The model established a dedicated system for Aboriginal patients presenting to ED that aims to provide maximum flexibility that addresses the barriers Aboriginal patients face in hospitals. The Flexi Clinic team includes a rostered ED senior clinician and an AHW who work in partnership and is managed daily by an ED staff specialist and overnight by an ED registrar. When an Aboriginal patient presents at ED the team is alerted via a text message and seen as soon as possible, balanced with the needs of other patients. If the patient chooses to leave before treatment is complete, a card is provided with a summary of the current plan; and on return, the card is presented at triage and the patient’s management will continue where it left off. All patients are followed up by telephone within 48 hours of departure from leaving the ED. After three months of the model the rate of incomplete treatment reduced from 19.5% to 5.2% for Aboriginal patients, with no reduction in care for other patients.
Program, ward and service management Principle 2
