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More Aboriginal interpreters result in less self-discharges from hospitals, new research finds

Rachael Knowles -
A new study has found that employing Aboriginal interpreters in hospitals can impact the rate of patients leaving treatment early. Completed at the Royal Darwin Hospital (RDH), the Communication Study published in the Medical Journal of Australia was centred on improving communication to increase health outcomes for Aboriginal patients who speak traditional Aboriginal languages. The results identified a correlation between the increase of interpreter bookings and the decrease of self-discharges at the hospital. Lead investigator of the study is Menzies School of Health Professor Anna Ralph. Professor Ralph also works as a clinician at RDH and noted that although there is a keen interest in interpreters, accessing their services is not routine in practice. She also recognised that health professionals may not be accessing interpreter services due to not knowing about the services or being unaware of the diversity and high number of Aboriginal languages. “What we recognised was the system was not working, if you could do things to fix the system people would then be able to start communicating more effectively. The first [part of the] study was to understand the barriers and how to overcome them,” Professor Ralph said. “In response to that we advocated for having an interpreter coordinator role in the hospital … the hospital paid for this person who is still employed. “Our study was about evaluating that role and adding extras like ensuring there was training for doctors on how to work with interpreters, along with some championing which meant getting doctors to really be committed to using an interpreter and encouraging colleagues to do the same.” According to Professor Ralph, the Northern Territory has the highest rate of self-discharge in hospitals nationally. “There are lots of reasons why people choose to do that … they may have social pressure, they may be the carers of a young child who they feel aren’t safe at home on their own, … they may have cultural responsibilities they have to attend to, [or] they may feel so alienated by the hospital environment,” she said.
“People vote with their feet and what they are telling us by leaving is that the care they are getting in hospital is not meeting their needs. It is not culturally safe.”
With interpreter use increasing, self-discharge rates have decreased. Professor Ralph said the implementation of the Aboriginal Interpreter Coordinator role has not only had success with self-discharge rates but also in supporting Aboriginal interpreters coming into RDH. “Aboriginal interpreters that come to work in a hospital also can feel pretty alienated and a bit nervous,” she said. “To help those interpreters to feel better supported and give them some mentoring, we ended up having interpreters pick up hospital jobs more regularly. A lot of the bookings being made were able to be completed.” The next phase of the study included rolling out a podcast, called Ask the Specialist, which delivers cultural education for health care professionals. By Rachael Knowles

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