Culturally focused pre-surgery screening to reduce Aboriginal and Torres Strait Islander patient surgical cancellations

Abstract

Background: There are health disparities in many countries between First Nations and non–First Nations populations. In Australia, the Aboriginal and Torres Strait Islander population have several risk factors and are more likely to experience higher rates of post-operative morbidity complications and mortality.

Purpose: To develop a culturally appropriate pre-surgery screening tool, administered by phone, to check health and wellness, identify relevant factors and support Aboriginal and Torres Strait Islander patients to ensure they are appropriately prepared to undertake surgery. The screening tool aims to reduce rates of patient-initiated cancellations of surgery and gain a greater understanding of factors contributing to patient-initiated cancellations of Aboriginal and Torres Strait Islander patients.

Method: This quality improvement project uses the Model for Improvement methodology and integrates ‘Plan, Do, Study, Act’ (PDSA) cycles to implement, assess and improve the intervention. The rate of Aboriginal and Torres Strait Islander patient-initiated surgical cancellations was measured for an Australian tertiary referral hospital.

Results: The six-month phase after implementation demonstrated a decreased mean rate (0.078 to 0.060) of Aboriginal and Torres Strait Islander patient-initiated cancellations. Responses were thematically analysed to identify contributing factors for surgical cancellations.

Conclusions: Implementing a culturally appropriate pre-surgery screening tool, developed by suitably qualified staff, positively advocated for Aboriginal and Torres Strait Islander patient’s health and wellbeing.

Implications: This study is highly generalisable as the setting has similar key performance indicators and operational governance to many other hospitals treating Aboriginal and Torres Strait Islander patients nationwide.