It's one of the busiest and most esteemed emergency rooms in the country, but for decades some of the most vulnerable have slipped through the cracks.
Located in the heart of Sydney's nightlife district, St Vincent's Hospital has saved thousands of lives — but it was considered the worst in the state when it came to caring for certain patients.
"A high number of Aboriginal people were coming in through our emergency department and were leaving us, not completing their treatment," said Pauline Deweerd, director of Aboriginal health at the hospital.
Some months, as many as one in three patients left the hospital before receiving the vital care they needed.
"It was because of past bad experiences, they didn't like waiting, and they didn't like the way we treated them," Ms Deweerd said.
"It wasn't that long ago that Aboriginal people weren't allowed in hospitals."
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)It was a persistent, hard to address problem, even for a hospital that has a reputation for providing top-notch emergency medicine.
"I've been here since 1982 and it's been a problem since at least then, but more and more we've become aware of it," said Paul Preisz, director of the hospital's emergency department.
"We had really good doctors and nurses and the patients needed our help but something wasn't connecting."
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)But in the middle of a global pandemic the hospital found a solution, and doctors are certain the rest of the country can learn from it.
"It's our attempt at closing the gap for our small part of the health world; we not only brought it to the level of the general population, we made it a little better." Dr Preisz said.
Worst in the state to best in the state
Yuin man Scott Daley has been the man making change happen, implementing the new Indigenous Flexi-Clinic as the Aboriginal health manager at the hospital.
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)Since June last year, he has been running the program that ensures Aboriginal patients presenting to the emergency room are quickly triaged and treated.
Often they are supported or cared for by other Indigenous staff, and where possible referred for ongoing care through the expanded Aboriginal health unit.
"You're able to make those connection points — where's your mob from, where's your mum from — [immediately] you start to get, 'oh we're related!" he said.
"That makes a big difference for outcomes and that level of safety."
Expanding the Aboriginal health unit to operate into the evening, and on weekends, was also critical to ensuring patients completed their treatment, Mr Daley said.
Since June, the monthly rate of incomplete treatment for Indigenous patients has reduced from 19.5 per cent to 1.6 per cent.
"We went from being the worst in the state [to] being the best in the state," Ms Deweerd said.
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)Chris* is frequently treated by Mr Daley and his team at the emergency department.
And the 49-year-old attests to the high level of care he has experienced.
"It's feeling safe and secure and knowing that you're going to get looked after as well as you do here," he said.
Blueprint for a national problem
The challenges this hospital faced to provide care to their Aboriginal and Torres Strait Islander patients are not unique.
Nationally, it's estimated 7.5 per cent of Indigenous patients leave hospital before receiving care, according to the Australian Institute of Health and Welfare.
"If you don't treat [emergency issues] it becomes a chronic issue, and that has serious complications, like early death," Mr Daley said.
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)The health discrepancies Indigenous Australians face are stark; shorter life expectancy, higher rates of chronic illness and more frequent hospitalisations.
According to Dr Preisz, the lessons learnt here can provide a blueprint for other emergency departments around the country.
"We've had a lot of contact from other hospitals and we've prepared something for an academic journal," he said.
"That idea of flexibility, the idea of offering options and continuity, as well as the Aboriginal health unit joining in at the outset.
"Those two elements I think will be something other places may take up."
ABC News: Brendan Esposito
)Changing the power imbalance between staff and patients is also critical, according to Ms Deweerd.
"We are treating our patients holistically now," she said.
"[Staff] want to learn more about Aboriginal culture so they can provide culturally safe care to Aboriginal people," she said.
"[Patients] just need to feel safe, to know this is a place where they will get help, when they need it."
*Chris not patient's real name
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2021-03-05 19:30:36Z
CBMiZ2h0dHBzOi8vd3d3LmFiYy5uZXQuYXUvbmV3cy8yMDIxLTAzLTA2L3N5ZG5leS1ob3NwaXRhbC1zdC12aW5jZW50cy1idWlsZHMtYWJvcmlnaW5hbC10cmVhdG1lbnQvMTMxNzE2MjTSASdodHRwczovL2FtcC5hYmMubmV0LmF1L2FydGljbGUvMTMxNzE2MjQ
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