Cultural Safety in Healthcare

This article discusses the importance of cultural safety in healthcare, specifically focusing on the Royal Darwin Hospital and its efforts to provide culturally appropriate care to Aboriginal and Torres Strait Islander people. It highlights the role of health literacy and effective communication in delivering culturally safe healthcare and outlines strategies to improve communication and health literacy. The article also addresses the relationship between health literacy and effective communication, as well as external influences and barriers to implementing culturally safe practices. Overall, it emphasizes the need for organizations to have a policy statement that promotes cultural safety in healthcare.

Running head: CULTURAL SAFETY IN HEALTHCARE 1
Cultural Safety in Healthcare
Students Name
Institutional Affiliation

CULTURAL SAFETY IN HEALTHCARE 2
Introduction
The Royal Darwin Hospital is located in the Northern Territory and serves most of the
Aboriginal and Torres Islander people. About 90% of the patients in the hospital are the
Indigenous Australians, and hence, this explains the need to provide culturally appropriate
healthcare that addresses their unique needs. Health literacy and effective communication play a
crucial role in delivering culturally safe healthcare. A position statement that incorporates the
importance of health literacy and effective communication is key to providing a culturally safe
environment.
Part 1
The Royal Darwin hospital is keen on ensuring effective health communication and
health literacy to help deliver culturally safe care. The Royal Darwin hospital acknowledges the
fact that improving communication and health literacy has a significant impact on improving
access to health services by the Aboriginal people and hence, improving their health outcomes.
The hospital also acknowledges the fact that poor communication and health literacy are barriers
to promoting culturally safe health care among the Aboriginal people (Cultural safety crucial in
Aboriginal and Torres Strait Islander healthcare, 2018).
The hospital resolves to improve communication with the Aboriginal and Torres Islander
people by overcoming the language barrier by employing more Aboriginal staff. The
organization also aims at enhancing communication by avoiding the use of complex words and
using models, images, diagrams, and DVDs to help explain important terms, concepts, and
instructions. The organization believes that improving health care professionals' communication
is key to ensuring that they deliver culturally appropriate health care services. The Organization,
therefore, intends to improve their communication by training them on how the Aboriginal

CULTURAL SAFETY IN HEALTHCARE 3
people perceive Rapport, language, time, personal space, touch, silence, eye contact, and non-
verbal communication. For instance, the organization is keen on ensuring that the health care
workers understand the nonverbal communication methods used by the Aboriginal people have a
different meaning from the western context (Wynia & Osborn, 2010).
The organization is also keen on ensuring that the health workers understand the fact that
the Aboriginal people value silence during conversations and hence they should observe body
language and silence to know when it is appropriate for them to speak. The organization is also
keen on ensuring that healthcare professionals understand that Aboriginal people consider
avoiding eye contact as a sign of respect. This is different from the western culture, which views
avoiding eye contact as being rude or dishonest (Cultural safety crucial in Aboriginal and Torres
Strait Islander healthcare, 2018).
The Royal Darwin hospital understands the fact that the Indigenous people with poor
health literacy fail to make informed health choices. They cannot also utilize health information
and the hence lacking the ability to maintain good health. The Royal Darwin hospital is keen on
improving health literacy among the Indigenous Australians to promote healthy behaviors,
reduce the morbidity and mortality rates, to improve the health status and improve the
communication with health care providers. The organization aims at improving health literacy
among the Aboriginal people by reducing the barriers through utilizing the language services and
ensuring that health information is accessible (Ana Dell et al., 2014). Secondly, the organization
aims at improving health literacy by ensuring that it provides health information materials in
English and use symbols, diagrams, and pictures. Lastly, the organization seeks to increase
health literacy among the Aboriginal people through working with the communities to ensure

CULTURAL SAFETY IN HEALTHCARE 4
that the translated health information material is culturally appropriate (Coast, Jones, Lattof &
Portela, 2016).
Part 2
Such a position statement is crucial in providing a culturally safe healthcare environment
as it helps the organization understand its roles and responsibility and how it should carry out its
day to day activities. The position statement also outlines the organization's plan and activities on
promoting health literacy and health communication among the aboriginal people and hence
making it easy for them to create a culturally safe environment (Department of Health, 2016).
Effective communication between patients and healthcare providers is essential in providing
culturally competent care. Lack of effective communication between healthcare providers and
Indigenous Australians has been a significant barrier to access to healthcare services (Amery &
Robert, 2017).
According to Wynia & Osborn (2010), effective communication only occurs when the
healthcare professional and the patient have a similar linguistic understanding or when they share
cultural and lingual backgrounds. The benefits of effective communication include the fact that it
helps establish beneficial and good relationships between the health workers and the Indigenous
people. As a result, this makes them build trust in the care they are given and hence, creating a
culturally safe environment. Secondly, effective communication reduces the chance of the
occurrence of errors and misunderstandings from preventive treatment such as screening,
diagnosis, treatment, and other healthcare services. As a result, this helps improve the health
outcomes among the Aboriginal people.

CULTURAL SAFETY IN HEALTHCARE 5
Thirdly, effective communication helps improve the self-empowerment of the Aboriginal
people by helping them understand information regarding treatment, diagnosis, prevention, and
management of their health. Fourthly, effective communication helps improve the professional
and personal skills of the healthcare providers and hence creating a culturally safe environment.
Lastly, effective communication helps improve the respect between the health practitioner and
the patient and thus helping promote a culturally safe environment (Lambert & Keogh, 2014).
There is a strong relationship between health literacy and effective communication.
Health literacy refers to the ability of an individual to obtain, process and comprehend health
information that can help him or her make important health decisions and follow the instructions
on the treatment of a disease (Lambert et al., 2014). Effective communication, on the other hand,
refers to adequate communication between the patients and the health practitioners that can
improve patient satisfaction as well as improved health outcomes. Both health literacy and
effective communication improve the health outcomes among the patients. Health literacy
improves the health of the people by helping them understand how to live healthy lives to
prevent disease. It also helps them learn more about preventive, and diagnostic services as well
as managing their health. Effective communication helps ensure that the patients can explain
their symptoms or health issues to the health practitioner with ease (Cancer Australia, 2014).
According to Artuso, Cargo, Brown & Daniel (2016), effective communication depends
on the health literacy of a patient. A patient with a high level of health literacy is more likely to
communicate effectively. This is attributed to the fact that health literacy improves a patient's
knowledge regarding illnesses, how they are transmitted and managed. Health literacy also
depends on effective communication. For a person to be health literate, he or she should be
educated on matters concerning health using a language he or she understands better. Poor

CULTURAL SAFETY IN HEALTHCARE 6
communication is associated with decreased health literacy among the people as it makes them
unable to use the health information given to them properly. Both health literacy and effective
communication are affected by the presence of language barriers. The language barriers make it
difficult for the health practitioners to understand the symptoms of patients and hence leading to
misdiagnosis. The language barriers also make it hard for the health practitioner to communicate
with the patient and hence making it difficult to prescribe medication to the Aboriginal people.
Concerning health literacy, the language barriers makes it hard for the Indigenous people to
understand the health information issued to them through the posters and other health education
materials (Christine, Sophie, Martin, Vivian & Karoline, 2018).
The external influences that may contribute to culturally safe practices include pressure
from the ministry of health and the relevant authorities that are concerned with the health of the
people. An example is a push by the Congress of Aboriginal and Torres Islander Nurses and
Midwives to ensure cultural safety in health care delivery. The media can also contribute to
culturally safe practice in the healthcare environment by encouraging more health workers to
learn how to offer this type of care. This might improve the health outcomes of the Aboriginal
people in the Organization by ensuring that they improve their health seeking behavior.
Improving their health-seeking behavior will help in the early detection and treatment of disease.
Secondly, it will improve the outcomes of the Aboriginal people by ensuring that their unique
health needs are addressed. The historical injustices such as the discrimination of the Aboriginal
people can hinder the offering of culturally safe practice in the healthcare environment. As a
result, this may lead to a reduction in the consumption of healthcare services among the
aboriginal people and hence leading to increased morbidity and mortality rates (Cultural safety
crucial in Aboriginal and Torres Strait Islander healthcare, 2018).

CULTURAL SAFETY IN HEALTHCARE 7
The barriers that may prevent the implementation of this position statement in the
Organization is lack of income and proper planning. Lack of income can make it difficult to train
and employ more health care professionals that can offer culturally appropriate healthcare. Lack
of proper planning can make it difficult for the organization to put into place the essential
strategies that can help ensure that the Aboriginal people receive quality care. Therefore, the
Organization should ensure that it engages in proper planning and that it involves the relevant
stakeholders in the process to overcome this barrier. The organization should also source for
funds from donors and the well-wishers who support this initiative to ensure that it becomes
successful (Bart, Maryam, Leslie, Damme, Wim & Jacobs, 2015).
Conclusion
In conclusion, health literacy and effective communication play an important role in
delivering culturally safe healthcare to the Aboriginal people. Therefore, it is crucial for
organizations to have a policy statement that addresses the importance of the two practices to
help create a culturally safe healthcare environment. Barriers such as lack of income and poor
planning may occur in the implementation of the position statement. Therefore, it is crucial for
organizations to engage in proper planning to overcome these barriers.

CULTURAL SAFETY IN HEALTHCARE 8
References
Amery, & Robert. (2017, July 03). Recognising the communication gap in Indigenous health
care. Retrieved from https://www.mja.com.au/journal/2017/207/1/recognising-
communication-gap-indigenous-health-care
Ana Dell, José Braunstein, Cecilia Touris, Graciela Dinardi, Ignacio Llovet, & Sergio Sosa-
Estani. (2014, January 29). Cultural barriers to effective communication between
Indigenous communities and health care providers in Northern Argentina: An
anthropological contribution to Chagas disease prevention and control. Retrieved from
https://equityhealthj.biomedcentral.com/articles/10.1186/1475-9276-13-6
Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2016, March 06). Factors influencing health
care utilisation among Aboriginal cardiac patients in central Australia: A qualitative
study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3606832/
Bart, Maryam, Leslie, P., Damme, V., Wim, & Jacobs. (2015, May 12). Addressing access
barriers to health services: An analytical framework for selecting appropriate
interventions in low-income Asian countries. Retrieved from
https://academic.oup.com/heapol/article/27/4/288/604184
Cancer Australia. (2014, December 01). Step 3: Cultural safety, skill development and
communication. Retrieved from http://edcan.org.au/edcan-learning-resources/supporting-
resources/aboriginal-and-torres-strait-islander-peoples/cultural-safety/cultural-safety-and-
communication

CULTURAL SAFETY IN HEALTHCARE 9
Christine Loignon, Sophie Dupéré, Martin Fortin, Vivian R. Ramsden, & Karoline Truchon.
(2018, June 28). Health literacy – engaging the community in the co-creation of
meaningful health navigation services: A study protocol. Retrieved from
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3315-3
Coast, E., Jones, E., Lattof, S. R., & Portela, A. (2016, December). Effectiveness of interventions
to provide culturally appropriate maternity care in increasing uptake of skilled maternity
care: A systematic review. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091340/
Cultural safety crucial in Aboriginal and Torres Strait Islander healthcare. (2018, March 26).
Retrieved from https://ahha.asn.au/news/cultural-safety-crucial-aboriginal-and-torres-
strait-islander-healthcare
Department of Health, N. T. (2016, December 15). Royal Darwin Hospital. Retrieved from
https://health.nt.gov.au/professionals/medical-officers/teaching-hospitals/royal-darwin-
hospital
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J. (2014,
November 29). Health literacy: Health professionals' understandings and their
perceptions of barriers that Indigenous patients encounter. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267746/
Lambert, V., & Keogh, D. (2014, May). Health literacy and its importance for effective
communication. Part 2. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24805035

CULTURAL SAFETY IN HEALTHCARE 10
Wynia, M. K., & Osborn, C. Y. (2010). Health literacy and communication quality in health care
organizations. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086818/