Building the Allied Health Workforce

Central Gippsland Health Services Aboriginal Allied Health Assistant Traineeship Case Study 2012

Denise McInnes

denisekaylaDenise McInnes has worked within the healthcare system for over twenty years within metropolitan Melbourne. Originally trained in operating room nursing Denise moved into a number of middle management roles both clinical and non-clinical which enabled her to fully understand and appreciate the importance of executive leadership when initiating change programs. Furthering her career path Denise successfully worked in a variety of senior and executive management roles within Melbourne before returning to her home town in Sale, Gippsland and took up a position as General Manager Workforce Capability and Learning at Central Gippsland Health Service. This position has enable Denise to bring together her background knowledge in support of the development of the Aboriginal Allied Health Assistant traineeship and the qualification of three Aboriginal people as Allied Health Assistants at Central Gippsland Health Service.

Kayla Kennedy-Hills is one of the Aboriginal allied health assistants who completed the 18 month traineeship at Central Gippsland Health Service. Before she started her traineeship Kayla went to Sale College High School where she completed half of year 11. Kayla didn’t enjoy school and wanted to leave so when her sister informed her of the traineeship she applied straight away without knowing what an allied health assistant did. At the age of 16 Kayla went on to start her traineeship and is now working as an allied health assistant in the dietetics department at Central Gippsland Health Service. Kayla has 6 siblings in her family – 2 older brothers, 1 older sister and a set of younger twin sisters. She is currently still living with her parents and younger sisters. In her spare time Kayla enjoys playing netball and spending time with friends and family.

Abstract – This case study describes Central Gippsland Health Service’s (CGHS) experience supporting five Aboriginal people to undertake an eighteen month Allied Health Assistant (AHA) traineeships in July 2011.  The Aboriginal Traineeships were made possible due to a successful $75,000 grant awarded through the ‘Closing the Health Gap’ Department of Health initiative in Victoria.

The traineeship, aligned to CGHS vision and objectives, was designed to provide a career pathway for Aboriginal health workers and improve Aboriginal health outcomes.  The trainees varied in age from sixteen to thirty-two. Each was a resident of the community in which they trained. The majority of the trainees had left school around age sixteen with two trainees moving from school to the traineeship after year 11.

Where local people can access entry level vocational qualifications in their own community, it has been demonstrated that retention rates are high and a small but significant percentage of the graduates take advantage of the pathways available to them to progress to professional tertiary qualifications.

CGHS engaged Upper Murray Health and Community Services’ (UMHCS) Registered Training Organisation, the Australian Institute of Flexible Learning (AIFL) as the training provider because of the on-line capability, at work approach to flexible learning.

The case study outlines such things as key issues, critical success factors, key processes that led to the trainees qualifying as Allied Health Assistants and lessons learned all of which has been translated into the next Aboriginal Allied Health Assistant traineeship which commenced in March 2013.

The case study describes the alignment between the recruitment of Aboriginal Trainees, the VET traineeship model and the CGHS 2009 Strategic Plan, and the commitment to continually improve organisational capability to support trainees as part of our commitment to a self-sufficient workforce.

Five Aboriginal people commenced in the 2011 traineeship, three have qualified and two have been re-employed at CGHS in Allied Health Assistant positions with the third potentially being re-employed at a later date post maternity leave. The program has enabled sustainable change to occur within the CGHS Aboriginal Employment Strategy.

The importance of an Indigenous Rehabilitation Assistant in a community rehabilitation service for people with neurological conditions: Achieving the best outcomes for Indigenous people throughout their rehabilitation journey

Marayah Taylor

Marayah TaylorPresenter Biography: Marayah Taylor is an Indigenous woman from Townsville in northern Queensland. Marayah’s mother is Maltese and her father is Aboriginal from the Cloncury, Mt Isa region of the Mitakoodi, Kalkadoon people. Marayah began working as a Physiotherapy Assistant at The Townsville Hospital when she participated in a government incentive program to attract Indigenous people into the Allied Health Professions. On completion of an 8 month contract with The Townsville Hospital, Marayah took up the position of the Indigenous Rehab Assistant at Community Rehab nQ, a new and innovative community rehabilitation service for northern Queensland.

Abstract – Background:  During both hospital and outpatient rehabilitation for neurologic conditions, our indigenous people are often isolated from their families and community. The anxiety of being away from family often means that Indigenous people leave prematurely, and as result miss out on much of their rehabilitation. Once at home, they can also become isolated because the extensive rehabilitation and education they have received might mean they are the only person in the family who understands their condition and what to do to recover.

Purpose: Community Rehab nQ, located in Townsville, is a new, innovative inter-professional community rehabilitation program for people with neurological conditions. This presentation outlines the role of the Indigenous Rehabilitation Assistant (IRA) at Community Rehab nQ, and highlights the potential benefits of this role for Indigenous people.

Discussion: The primary role of the IRA is to liaise with and support Indigenous people during their time at Community Rehab nQ ; a familiar face that is less intimidating for participants and families that they know can relate to them emotionally, spiritually, and culturally.  The secondary role of the IRA is to share with the allied health team the personal and environmental factors which impact on each Indigenous person and the anxiety they may feel that is associated with being away from home and family that might otherwise be seen as ‘noncompliance’.

At Community Rehab nQ, the IRA carries out their role by being present during assessment, during rehabilitation sessions that might include physiotherapy, occupational, speech pathology, exercise physiology and nursing, and on home and community visits. The IRA provides support and assists with explanations of tasks the participant is required to do for their rehabilitation program. The IRA needs to be flexible in the support given to ensure each person is empowered to ‘drive their own recovery’ as soon as they can.

Using the approach taken at Community Rehab nQ, the IRA also gains skills and knowledge by interacting with other allied health professionals. This can inspire the IRA to become an Indigenous allied health professional.

Summary: The IRA makes important contributions to Community Rehab nQ, by helping staff and participants in three domains: (1) to Recognise- we all don’t fit perfectly into a box; (2) to Refine – the method of practice and make it meaningful to the participant and their family; and (3) mutual Respect- for cultural and social diversity.

Building a Culturally Safe non-Indigenous Allied Health Workforce

Prof Wendy Edmondson & Bevin Wilson

Presenter Biographies

Prof Wendy Edmondson

Wendy EdmondsonA/Professor Wendy Edmondson, a Badimia Aboriginal woman, originally from WA, is the Deputy Director of the Poche Centre for Indigenous Health and Wellbeing, Flinders University, SA. She has worked in the Indigenous affairs arena for a total of 35 years, in the areas of education, the arts, and health. She has 20 years-experience as an educator, researcher and in curriculum design and development. Her professional responsibilities currently include a Masters of Public Health topic, Social Determinants of Indigenous Health, and the new Flinders MD topic, Health, Professions and Society: Culture and Indigenous Health, two Indigenous Health topics in Nursing, and a new topic, Indigenous Health for Health Sciences.

She has recently been nominated to the HWA Project Advisory Group for the Development of an Aboriginal and Torres Strait Islander Health Curriculum Framework as the MDANZ representative. She is a member of a project team for another OLT grant: Reshaping curricula: integrating culturally diverse/mental health online content to prepare work ready health professionals.

Wendy worked in the Aboriginal community controlled health sector from 2001 – 2010. She is the former CEO of the Aboriginal Health Council of South Australia, and Wirraka Maya Aboriginal Medical Service, in the Pilbara, W.A.

In 2010, Wendy was awarded a Churchill Fellowship to investigate factors contributing to improved life expectancy in Indigenous populations in Canada and the USA.

Her research involvement has included the Centre of Clinical Research Excellence (Chronic Conditions) through the NHMRC. In a landmark decision, the NHMRC awarded the CCRE grant to an Aboriginal community-controlled health organisation, the Aboriginal Health Council of South Australia, as lead investigator (she was CEO at this time), in partnership with Flinders University. Wendy was also involved in a study on urban heath inequities and Aboriginal experiences of neighbourhood life, social capital and racism through Flinders (NHMRC), undertook a scoping paper on SEWB for the CRCATSIH, and an otitis media study for the Spencer Gulf Rural Health School. (UniSA and Adel. University). She has extensive experience across a range of Aboriginal health sectors, strong networks with Aboriginal communities, community-based cultural knowledge, academic experience and research knowledge.

Bevin Wilson

Bevin WilsonBevin Wilson is an Associate Lecturer with the Poche Centre for Indigenous Health and Wellbeing where he teaches in the School of Nursing and Midwifery, School of Health Sciences and the School of Medicine at Flinders University in Adelaide, South Australia. A Secondary School Teacher for 20 years with a health/education background, Bevin was born in Barmera in the Riverland of South Australia and as such, developed close connections with the Riverland Indigenous community. Bevin also has a background working with the Southern Adelaide Health Services, initially as an Aboriginal Health Worker and later as one of seven Directors of the Southern Adelaide Health Services Board. He is currently the Topic Coordinator of HLTH2102 Indigenous Health for the Health Sciences.

Abstract

The Poche Centre for Indigenous Health and Wellbeing, at Flinders University, is responsible for the development and teaching of Indigenous health subjects across the Faculty of Medicine, Nursing and Health. Four Indigenous academics, as well as an Indigenous Senior Research Fellow, work collaboratively with four non-Indigenous colleagues, to deliver topics in Indigenous Health, with the aim of developing culturally safe health practitioners, who understand the history of race-relations between Indigenous and non-Indigenous peoples in Australia.

Cultural Safety is gaining traction in Australia after the concept was first developed by Maori Mid-wives in New Zealand. Cultural Safety requires the health practitioner to reflect on his or her own cultural identity, and recognise the impact of this personal identity on professional practice. Unsafe cultural practice comprises behaviour and attitudes which diminish, demeans or disempowers the cultural identity of individuals receiving care.

Taught in the context of the social determinants of Indigenous heath, racism, discrimination, whiteness, colonisation and hegemony, the subjects developed by the Poche Centre can be challenging to students, who often embark on a journey of transformative unlearning of previously held assumptions, beliefs and stereotypes about Indigenous peoples. Students are required to develop their critical reflection skills, in a sometimes deeply self-revealing, and often illuminating, learning process.

More recently this teaching has involved the delivery of a topic called Indigenous Health for Health Sciences. Students enrolled have included those studying Physiotherapy, Occupational Therapy, Nutrition and Dietetics, Health Promotion, Paramedics and Health Services Management.

The three Indigenous academics responsible for the teaching this topic, Bevin Wilson, Courtney Ryder, and Wendy Edmondson, will present their experiences in developing teaching material for Allied Health students, strategies for presenting confronting material, managing student discomfort, and feedback from the students themselves.

Although the numbers of Indigenous Allied Health professionals is growing, there is a critical need for non-Indigenous Allied Health professionals to transform their professional practice to one that is Culturally Safe, as they work alongside Indigenous colleagues and with Indigenous communities.

Allied Health in an Aboriginal Community Controlled Health Service

Debra Malthouse

Debra MalthousePresenter Biography – Debra is the Chief Executive Officer of the Wuchopperen Health Service Limited, an Aboriginal and Torres Strait Islander community controlled organisation delivering comprehensive primary health care to Aboriginal and Torres Strait Islander individuals, families and communities within the region of Cairns, Queensland.

Debra is a local Aboriginal woman who has spent over thirty (30) years working in Aboriginal and Torres Strait Islander affairs at a local, regional and state level in both the community and government sectors.  As a community welfare practitioner working in the community sector, Debra has been responsible for the delivery of direct client services to individuals, families and groups in the area of domestic/family violence, child protection and housing.   Her experience working in government has included a number of years in the administration arm of the Aboriginal and Torres Strait Islander Commission, the Department of Health and Ageing and Queensland Department of Child Safety.  This work primarily involved community engagement and the implementation of government policy in Aboriginal and Torres Strait Islander communities across the Cairns and Cape York Peninsula region.

Debra’s return to the community controlled sector demonstrates her belief that the health and wellbeing of Aboriginal and Torres Strait Islander people will improve only with the direct and informed participation of the Aboriginal and Torres Strait Islander community.  In her role as Chief Executive Officer of Wuchopperen Health Service, Debra is in a position to embed Aboriginal and Torres Strait Islander leadership in the organisation’s governance and operations.

Debra holds a Bachelor of Community Welfare but considers her Aboriginality to be the most important qualification that she brings to the position of Chief Executive Officer of Wuchopperen Health Service.

Abstract

Wuchopperen Health Service Limited is an Aboriginal and Torres Strait Islander community controlled organisation delivering comprehensive primary health care to Aboriginal and Torres Strait Islander individuals, families and communities within the region of Cairns, Queensland.

Wuchopperen Health Service is committed to building a strong Aboriginal and Torres Strait Islander health workforce and invests in building the leadership capacity of its staff, encouraging a range of career pathways including allied health. The organisation employs approximately 180 staff of which 75% are Aboriginal and/or Torres Strait Islander people.

Aboriginal and Torres Strait Islander Health Workers at Wuchopperen Health Service work collaboratively with allied health professionals, doctors and nurses within a multi-disciplinary team environment. This team approach ensures that Aboriginal and Torres Strait Islander people who attend the service will receive high quality comprehensive primary health care that takes into consideration their needs and the needs of their family and community.

This presentation will highlight the benefits of a holistic approach to the delivery of comprehensive primary health care to the health and wellbeing of Aboriginal and Torres Strait Islander people. It will showcase the way that the Aboriginal Community Controlled Health Sector can effectively meet the needs of their community by using multi-disciplinary teams that include and value the role of allied health professionals.