ACEM: Closing Gap

Emergency departments (and health systems generally) have been poor at providing culturally safe and appropriate environments for Aboriginal and Torres Strait Islander peoples.

ACEM recognises that in order to help o close the gap in health outcomes emergency departments and the health system must improve our accessibility and responsiveness to Aboriginal and Torres Strait Islander communities.

A 2018 ACEM report examining the experience of Aboriginal and Torres Strait Islander (Indigenous) and non-Indigenous patients presenting to Australian emergency departments shows Indigenous patients are overrepresented, both in their number of presentations to EDs relative to their proportion of population (in remote, very remote and metropolitan areas).

For many patients, the emergency department is the front door to the health system. The experience of any patient presenting to an ED is one that may then shape their steps into specialist or other care, and their opportunities to achieve optimal health and life outcomes, so it is particularly important that the care we provide is culturally safe.

Since 2008 disparities health and life outcomes for Aboriginal and Torres Strait Islander peoples have been measured and tracked as part of the Australian Government’s Closing the Gap strategy, which has sought to identify and reduce these disparities with non-Indigenous populations of Australia.

As the government and Coalition of Australian Governments finally pursue meaningful partnerships with Aboriginal and Torres Strait Islander communities, leaders and peak bodies to close these gaps, ACEM is continuing its work to build culturally safe emergency departments and an emergency medicine workforce that is responsive to the needs of Aboriginal and Torres Strait Islander patients. To achieve this, we recognise that this work needs to be led from Aboriginal communities and organisations. We must also better enable the growth and development of our Aboriginal and Torres Strait Islander emergency specialist workforce.

The College’s Reconciliation Action Plan (RAP) Steering Group has been working to establish partnerships with key Aboriginal and Torres Strait Islander organisations (such as the Australian Indigenous Doctors’ Association)

This year the College’s RAP Steering Group is renewing ACEM’s Innovate RAP in partnership with Reconciliation Australia. The College’s inaugural RAP was released in 2017 with design by Indigenous artist Luke Mallie. Just nine (of more than 100) deliverables in that RAP have so far not been achieved and will be reincorporated into the next RAP (2019–21), being produced by Marcus Lee Design.

The College is undertaking a broad body of work to build these relationships, including:

  • Embedding Indigenous Health and Cultural Competency into the ACEM Curriculum Framework.
  • Awarding the Joseph Epstein Scholarship to support the training and development of an Aboriginal, Torres Strait Islander or Māori advanced trainee.
  • Accrediting Indigenous Health Special Skills posts for rural health.
  • Developing careers resources for Aboriginal and Torres Strait Islander doctors working in emergency medicine.
  • Advocating for more Indigenous Health Liaison Officers to be employed in emergency departments.
  • Increasing the numbers of Aboriginal and Torres Strait Islander trainees, Diplomates and Certificants.
  • Introducing mandatory cultural competence activities into its Specialist CPD program.

The action plan guides the priorities and work of the College as it continues its commitment to equity in the health outcomes for Aboriginal and Torres Strait Islander peoples and seeks to build environments, systems and structures to support the training, development and careers of the Aboriginal and Torres Strait Islander workforce in emergency medicine.

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