Birang Daruganora: what do Aboriginal and Torres Strait Islander communities need in a new hospital? A qualitative study

BMJ Open. 2024 May 17;14(5):e078658. doi: 10.1136/bmjopen-2023-078658.

Abstract

Objectives: To elicit the Aboriginal community's cultural and healthcare needs and views about six prominent and emerging models of care, to inform the development of a new hospital.

Design: Cross-sectional qualitative study co-designed and co-implemented by Aboriginal team members.

Setting: Western Sydney, New South Wales, Australia.

Participants: Aboriginal and Torres Strait Islander healthcare providers (n=2) and community members (n=18) aged between 21 and 60+ years participated in yarning circles (20 participants; 14 female, 6 male).

Results: Handwritten notes from yarning circles were inductively analysed to synthesise the cultural and healthcare needs of providers and community members in relation to a new hospital and six models of care. Three primary themes emerged in relation to future hospitals. These were 'culturally responsive spaces', 'culturally responsive systems' and 'culturally responsive models of care'. Strengths (eg, comfort, reduced waiting time, holistic care), barriers (eg, logistics, accessibility, literacy) and enablers (eg, patient navigator role, communication pathways, streamlined processes) were identified for each of the six models of care.

Conclusions: Aboriginal and Torres Strait Islander community members and providers are invested in the co-creation of an innovative, well-integrated hospital that meets the needs of the community. Common themes of respect and recognition, relationships and partnering, and capacity building emerged as important consumer and provider considerations when developing and evaluating care services. Participants supported a range of models citing concerns about accessibility and choice when discussing evidence-based models of care.

Keywords: health equity; health services accessibility; patient satisfaction; patient-centered care; public hospitals.

MeSH terms

  • Adult
  • Australian Aboriginal and Torres Strait Islander Peoples*
  • Cross-Sectional Studies
  • Cultural Competency
  • Female
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Health Services, Indigenous* / organization & administration
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • New South Wales
  • Qualitative Research*
  • Young Adult