About the Lighthouse Hospital Project
The Lighthouse Hospital Project aims to improve health and care outcomes for Aboriginal and Torres Strait Islander peoples with coronary heart disease (CHD). The project’s focus is the implementation of quality activities that improve care and outcomes for CHD patients..
CHD is the leading cause of death for Aboriginal and Torres Strait Islander peoples in Australia, taking 344 lives in 2017.
When compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander people are:
- Twice as likely to have CHD
- 2.6 times as likely to be hospitalised for CHD
- Three times more likely to have a heart attack than a non-Indigenous Australian
- Admission rates for Aboriginal and Torres Strait Islanders for heart-related conditions were 3.2 times higher than non-Indigenous women and 2.3 times higher than non-Indigenous men
- Dying from CHD at almost twice the rate of other Australians.
In addition, hospital admission rates for heart-related conditions are higher: for Aboriginal and Torres Strait Islander women the admission rate is 3.2 times higher than non-Indigenous women, for Aboriginal and Torres Strait Islander men the admission rate is 2.3 times higher than non-Indigenous men.
Data also shows that Aboriginal and Torres Strait Islander peoples have less access to medical services that can effectively diagnose and treat CHD.
Since 2012 the Australian Government has funded the Lighthouse Hospital Project, in response to these heart health disparities and to help close the heart health gap.
Improving the patient journey
Aboriginal and Torres Strait Islander peoples often travel vast distances, sometimes interstate, to access medical treatment. This means they must leave their family, friends and support. People can feel isolated and overwhelmed, especially if they are unfamiliar with the hospital environment, the local area, services or the local languages.
Aboriginal and Torres Strait Islander patients face a range of barriers to accessing evidence-based, quality healthcare, including frequent breakdowns in the flow of information and coordination of care between hospitals and the primary care sector. Steps that can be taken to improve this include adherence to post discharge care, which in turn improves patient health and reduces a patients’ likelihood to re-present at emergency departments.
Other actions to improve the patient journey include providing access to telehealth, and enhancing relationships and co-ordination of care.
Aboriginal and Torres Strait Islander peoples continue to have negative experiences with institutions of all kinds, including hospitals. These negative hospital experiences can impact on the level of comfort Aboriginal and Torres Strait Islander peoples feel when in hospital, and therefore on their stay in hospital and return for future treatment.
Many issues contribute to these negative experiences, including racism, discrimination, and a ‘one size fits all’ approach that doesn’t acknowledge and respect Aboriginal and Torres Strait Islander peoples, cultures and differing views on health.
Change for the better
The Lighthouse Hospital Project demonstrates that better health outcomes can be achieved through delivering improved patient experiences and culturally responsive and flexible care for Aboriginal and Torres Strait Islander peoples. The project has helped to deliver a number of improvements in participating hospitals, including:
- Commitment to Aboriginal Health and leadership including accountability for cultural safety of staff and patients within Lighthouse Hospitals.
- Executive and organisational commitment to continuing to improve Aboriginal health outcomes.
- Systems and processes to improve the patient experience and care pathways.
- Discharge against medical advice (DAMA) protocols to reduce the incidence and impact of patients leaving hospital against the advice of their doctor.
- Relationships between hospital cardiac teams and Aboriginal Medical Services driving
- improved discharge processes, communication and follow-up care.
- Roles and inclusion of Aboriginal Health Workers in cardiac care teams and cardiac rehabilitation services.
- Improved access to Close the Gap Pharmaceutical Benefit Scheme prescriptions post discharge.
- Improved identification rates of Aboriginal and Torres Strait Islander patients through using improved identification practices. These practices have improved as a result of training workshops and online eLearning programs, such as the Heart Foundation Asking the Question of Origin e-learning module.
- Greater attendance of Aboriginal and Torres Strait Islander patients at cardiac rehabilitation services, which now provide more flexible models of care.
- Patient access to translation services, as well as heart health resources translated into local languages.
- The existence of culturally safe spaces for families, clinicians and clinical yarning.
The Lighthouse Toolkit
This health professional toolkit provides a framework to address health disparities facing Aboriginal and Torres Strait Islander peoples.