1. Strategies for implementing change in your department Increasing use of interpreters and overcoming barriers to use Increasing use of Aboriginal/cultural liaison officers Staff training in cultural competency Environmental changes Addressing systems literacy and health literacy issues Improving discharge planning processes, including relationships with local Indigenous or multicultural medical services

2. Interpreters: What’s Needed? Staff attitudes Awareness of need Awareness of impacts and risks Awareness of services Availability Referrals processes Access on site Phones at bedside After hours Departmental valuing of their role Senior staff modelling and encouragement Protocols Staff training Confidence in working effectively with interpreters Availability and regularity of training Mandatory vs encouraged Support for Interpreter training (for Indigenous language interpreters)

3. Aboriginal / Cultural Liaison Officers: What’s needed? Staff attitudes Awareness of need Awareness of impacts and risks Awareness of services Staff understanding of role Training vs induction Departmental valuing of their role Senior staff modelling and encouragement Protocols Availability Referrals processes ED specified vs hospital based (how busy are they) Need within department (ie # aboriginal patients seen) After hours access Support for ALO training professional development of EM skill set

4. Staff Training In Cultural Competency: What’s needed? Staff attitudes Awareness of need Open to learning Availability Regularity Mandatory vs encouraged New vs built into existing training Trainees / specialists / interns/RMOs / nursing and other staff Skilled staff to deliver training Medical / cultural Resources for training Local focus / principle based Departmental valuing of training Senior staff modelling and encouragement ACEM training curriculum Incorporation into WBAs/assessments

5. Case study A culturally safe environment for this patient would include: Easy access to an interpreter An ED Aboriginal Liaison Officer present Space to accommodate family members A culturally competent ED team (from point of triage to admission) that is led by senior staff who encourage patient centred care Resources that can assist her to understand her journey in ED and what is happening medically to her A physical environment which acknowledges her cultural background and can be adjusted to suit her particular needs 50 yo Aboriginal women From a rural community Speaks an Indigenous language and English Presents with chest pain ECG shows STEMI Is in cubicle 1 Management is starting to be implemented – nurses and doctor are present Pain is receding

6. acem.org.au/culturalcompetency e: culturalcomp@acem.org.au