My rehab, my journey Gadjigadji

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Communicate positively

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Support staff to communicate positively and effectively and learn to have a yarn.

Communicating in a respectful and culturally appropriate way with Aboriginal people and their families will result in a partnership, enabling shared decision-making.

Ask the question

Improving the identification of Aboriginal patients is a priority as part of Closing the Gap both Australia-wide and in NSW.[1] Asking patients whether they identify as Aboriginal is important to allow you to provide culturally appropriate care.[2]

To help staff feel comfortable doing this, the Health Education and Training Institute (HETI) offers a module to support NSW Health staff - Asking the Question: Improving the Identification of Aboriginal People.

Have a yarn

Clinical yarning is a patient-centred approach that finds common ground and creates a relationship for effective communication.[3]

A range of tools and resources to use within a clinical yarning session are available through the shared decision making model Finding your way.

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Clinical yarning has three components:

  • The social yarn: finding common ground and developing a connection and trust
  • The diagnostic yarn: develop shared understanding of the health problem
  • The management yarn: enables shared decision-making and goal-setting.[4]

Clinical yarning videos

Watch these videos to learn more about how to have a yarn.

Social yarning

Diagnostic and management yarning

Yarning with kids and families

Some tips for clinicians to consider when having a conversation with an Aboriginal person or their family:

  • Create a connection first
  • Adapt your style
  • Learn to yarn
  • Know what’s important to your patient
  • Bring your personality into the conversation
  • Be open and honest
  • Share something about yourself
  • Allow time for conversation
  • Clarify and check back for understanding
  • Assess expectations
  • Use informal language.

You should yarn daily and check back with Aboriginal patients to see if anything has changed.

Speak slowly and repeat.

Tip from Uncle Ronald, an Aboriginal person who received rehabilitation treatment.

Read more about Uncle Ronald’s story, and others

Some other tips to support better communication with Aboriginal people include the following:

  • Learn respectful and non-discriminatory language
  • Use a shared decision-making framework when goal-setting
  • Involve Aboriginal Liaison Officers (ALOs) or support workers
  • Use simple language
  • Involve relevant family/parents/carers or contact person in planning discussions
  • Use pictures, where appropriate
  • Conduct discussions with patients and their identified family members or contact person regarding the best time to accommodate family visits, times and involvement as appropriate
  • Involve relevant family or contact person in case conferences.

Most importantly, treat each Aboriginal person as an individual and get to know them and their needs and preferences.

Support services for inpatient and/or discharge management

Ensure that your staff are aware of and can readily access Aboriginal support services. This is particularly important at discharge.

You can do the following to support this:

  • Adapt and display ward template poster showing details of ALOs and other specific support services (e.g. Aboriginal Health Unit, community services, social work, 48-hour follow up)
  • Provide access to the map of Aboriginal health and medical services
  • Ensure you are aware of specific services and resources available for Aboriginal people for inpatient and/or discharge management (e.g. local health district services, non-government organisations and Aboriginal Community Controlled Health Services (ACCHS))
  • Establish links to community services for follow up and support the patient to be aware of and access these
  • Offer clear communication regarding follow-up appointments and options, including virtual care
  • Routinely ensure ALOs are involved with Aboriginal patients in the following ways:
    • Ensure easily recognised staff
    • Establish rapid communication pathways between clinical staff and ALOs
    • Involve ALOs and other community agencies in care planning, case conferences and discharge planning, where appropriate
    • Ensure appropriate documentation and communication regarding cultural adaptations and considerations.

Further resources

See our implementation toolkit for videos, templates, posters and links to references and training resources.

Resources

  1. Council of Australian Governments. National Indigenous Reform Agreement (Closing the Gap). Canberra: Council of Australian Governments; 2012.
  2. Australian Commission on Safety and Quality in Health Care. User Guide for Aboriginal and Torres Strait Islander health. Sydney: ACSQHC, 2017.
  3. Lin I, Green C, Bessarab D. 'Yarn with me': applying clinical yarning to improve clinician-patient communication in Aboriginal health care. Aust J Prim Health. 2016 Nov;22(5):377-382. doi: 10.1071/PY16051. PMID: 28442021.
  4. Lin I, Green C, Bessarab D. 'Yarn with me': applying clinical yarning to improve clinician-patient communication in Aboriginal health care. Aust J Prim Health. 2016 Nov;22(5):377-382. doi: 10.1071/PY16051. PMID: 28442021.
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