The Communicate Study Partnership
Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexAll
AgeNot listed
SponsorMenzies School of Health Research
About this trial
The vision of the Communicate Study Partnership is to ensure more Aboriginal patients receive culturally safe healthcare in their first language.
The Communicate Study Partnership will implement and evaluate creative ways to embed cultural safety training and increase use of Aboriginal Interpreters and Aboriginal Health Practitioners at Northern Territory Top End hospitals.
Quantitative outcomes (interpreter uptake, outcomes including leave against medical advice, costs) will be measured using time-series analysis. Qualitative outcomes derived from interviews with patient, healthcare provider and interpreter participants, will be informed by decolonising theory and participatory approaches.
Successful project implementation will improve experience of care and health outcomes for Aboriginal people, build Aboriginal workforce, and improve healthcare provider satisfaction.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
None
Disqualifiers
None
Trial design
Design model
Single group
Treatments tested in this trial
Interventions to transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples
Behavioral1. Implement 'Ask the Specialist Plus', a structured program to promote anti-racism within Northern Territory (NT) hospitals by giving healthcare providers training in cultural safety. 2. Implement strategies to foster 'Clinical champions of cultural safety' through a social media chat platform and face to face meetings to discuss anti-racism practice, cultural safety and practical ways to deliver culturally safe care including interpreter use. 3. Support simplified and improved strategies for booking an interpreter to increase uptake. 4. Implement retention strategies to ensure interpreters receive workplace support. 5. Provide training in health terminology for interpreters. 6. Integrate interpreter supply and demand through efficiency and effectiveness strategies tailored to participating sites. 7. Implement continuous quality improvement cycles with senior managers, using findings from qualitative and quantitative data collection and evaluation.
Treatment groups
340 Participants
are divided into 1 treatment groupGroup A: Cultural safety training and behaviour change interventionExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Self discharge among Aboriginal inpatients at Royal Darwin Hospital, Palmerston Hospital, Katherine Hospital and Gove District Hospital
Self discharge (also referred to as 'Discharge against medical advice,', 'take own leave' or 'incomplete care') will be assessed among all admitted Aboriginal patients every quarter as a measure of the effeciveness of hospital-level study activities * Measured as proportion of all admissions of Aboriginal people that end in self-discharge * Data source: hospital Admitted Patient Care dataset (routinely collected by health services) The study has a two-year baseline phase July 1 2020 - June 30 2022, and four-year intervention (activity) period July 1 2022 - June 30 2026. There are no individually enrolled participants followed up at given time points; instead, activities are implemented continually at the level of the health systems, and outcomes are assessed using continuous hospital data and qualitative data, summarised quarterly.
Time frame
Up to 4 years. (Health system level data are collected and summarised quarterly during July 1 2022 - June 30 2026, and compared with the baseline phase July 1 2020 - June 30 2022)2
Patient experience (qualitative evaluation)
Patient experience pre- and post-implementation of the interventions will be assessed through in-depth 30-60 minute one-on-one, face-to-face interviews of inpatients and patients who have recently (within 14 days) been discharged, by a member of the research team. The research team member will speak the patient's first language, or will work with an Aboriginal interpreter to conduct the interview. Some individuals with repeated contact with healthservices (such as renal dialysis patients) will be invited to participate in serial interviews over time
Time frame
Up to 4 years. Interview data will be collected at regular intervals throughout the study (2022-2026) to track any change in patient experience during the course of the intervention periodSecondary outcomes
1
Documentation of language in hospital medical records
Adequacy of documentation (proportion of Aboriginal patients for whom language is documented) will be used to inform quarterly quality improvement data review meetings. Data source: hospital electronic system (currently CARESYS, transitioning during the study period to ACACIA)
Time frame
Up to 4 years. (Documentation of language will be tracked throughout the 4-year intervention period.)2
Access to an interpreter during admission
Interpreter access (proportion of Aboriginal patients with a language other than English as their first language) will be used to inform quarterly quality improvement data review meetings.
Time frame
Up to 4 years. (Documentation of interpreter access will be tracked throughout the 4-year intervention period.)3
Healthcare provider experience
Healthcare provider experience of working with Aboriginal interpreters (qualitative evaluation) assessed by 30 minute semi-structured one-on-one, face-to-face interviews of healthcare providers with a member of the research team.
Time frame
Up to 4 years. Interview data will be collected at regular intervals throughout the study (2022-2026) to track any change in healthcare provider experience during the course of the intervention period4
Cost
Healthcare costs will be calculated based on variables including the top 6 ICD codes per admission and hospital length of stay. Economic evaluation will be conducted from the payer perspective and include the linked Admitted Patient Care and Aboriginal Interpreter Service datasets and NTHTE Unit expenditure reports, as well as ICD codes and Australian Refined DRGs.
Time frame
Up to 4 years. Continuous data (daily data, summarised monthly) will be assessed during - the two-year baseline phase July 1 2020 - June 30 2022 - the four-year intervention (activity) period July 1 2022 - June 30 2026Sponsors and contacts
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Menzies School of Health Research
Lead sponsor
Northern Territory of Australia as represented by the Department of Health
Collaborator
Djalkiri Foundation Aboriginal Corporation
Collaborator
Charles Darwin University
Collaborator
National Accreditation Authority for Translators and Interpreters
Collaborator
Northern Territory Government as represented by the Department of The Chief Minister and Cabinet
Collaborator
Source ClinicalTrials.gov