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About the Lighthouse Hospital Project

Heart disease is the number one cause of death in Australia, but the burden of disease disproportionately affects Aboriginal and Torres Strait Islander peoples.

Key takeaways

  • The Lighthouse Hospital Project aims to reduce the impact and incidence of discharge against medical advice for Aboriginal and Torres Strait Island peoples through better in-hospital and post-hospital cardiac care  
  • By improving the patient journey of Aboriginal and Torres Strait Islander peoples face a with heart disease, we can enhance their ability to live well and longer. 
  • Many factors contribute to the negative experiences Aboriginal and Torres Strait Islander peoples feel when in hospital, including racism, discrimination, and cultural insensitivity.  
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 heart health with Aboriginal and Torres Strait Islander peoples  

Heart disease is the number one cause of death in Australia, but the burden of disease disproportionately affects Aboriginal and Torres Strait Islander peoples. Coronary heart disease (CHD) is the leading cause of death for Aboriginal and Torres Strait Islanders in Australia.  

The Lighthouse Hospital Project is a joint initiative between the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA) to improve health and care outcomes for Aboriginal and Torres Strait Islander peoples with CHD.  

Since the program’s launch in 2012, it’s enabled better in-hospital and post-hospital cardiac care, through improved hospital systems and fostering cultural competence in acute care staff.  

The Lighthouse Project has a sustained focus on supporting more hospitals to reduce rates of discharge against medical advice (DAMA) for their Aboriginal and Torres Strait Islander patients with CHD.  

Improving the patient journey 

Aboriginal and Torres Strait Islander patients face a range of barriers to accessing quality healthcare, including:
  • Communication breakdowns in the coordination of care between hospitals and the primary care sector 
  • Less access to medical treatment. They may need to travel vast distances (even interstate), which can mean they are without their family, friends and support network 
  • They may feel isolated and overwhelmed, especially if they are unfamiliar with the hospital environment, the local area, services or the local languages. 

Fortunately, the program outlines actions that can improve post discharge care. This can improve patient health and reduce 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 coordination of care. 

Cultural experience 

Aboriginal and Torres Strait Islander peoples tend to have negative experiences with institutions of all kinds, including hospitals. These negative hospital experiences can impact the level of comfort Aboriginal and Torres Strait Islander peoples feel when during their stay in hospital, and likeliness to return for future treatment. 

Many issues contribute to these negative experiences, including:  
  • Racism and 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 for Aboriginal and Torres Strait Islander peoples through improved patient experiences and culturally responsive and flexible care.  
Phase three evaluation highlighted that more than three-quarters of Aboriginal and Torres Strait Islander peoples with ACS surveyed in Lighthouse Hospitals rated their hospital experience as ‘very good’ or ‘good’.  

During phase three, hospitals made progress in strengthening: 
  • Engagement and relationships with community organisations, such as Aboriginal Community Controlled Organisations (ACCHOs) and Aboriginal Medical Services (AMSs) 
  • The prominence of Aboriginal and Torres Strait Islander culture and values in hospital environments  
  • The integration of Aboriginal and Torres Strait Islander workers with ACS care teams 
  • Staff capacity to provide culturally appropriate patient-centred care 
  • Clinical processes related to admission, identification, discharge and post-discharge care for Aboriginal and Torres Strait Islander patient admitted with an Acute Coronary Syndrome 

Alignment with Government initiatives    

The Lighthouse Hospital Project aligns with the Better Cardiac Care for Aboriginal and Torres Strait Islander peoples’ program. The Australian Health Ministers Advisory Council identified the program as a national priority, with a focus on improving access to guideline-based therapy for acute coronary syndrome, within a culturally safe and appropriate environment. 

The project supports a range of Australian Government policies, programs and strategies which seek to reduce disadvantage among Aboriginal and Torres Strait Islander peoples, including inequalities in health outcomes and life expectancy. 

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