Practis

PRACTIS: PRimary health and Aged Care Translation and Interpreting Services

BACKGROUND

Residents of aged care homes (ACHs) represent some of the sickest and most vulnerable members of the community and frequently suffer from acute, chronic and complex conditions. One third of residents of ACH in Victoria are from a non-English speaking background and the number is projected to increase over the next 10 years.

There is strong evidence that effective communication with residents in ACH is a requirement of access to equitable and high quality primary health care, improved quality and safety of care, and improved provider and patient satisfaction. Indeed, Commonwealth and State policies highlight patients’ “right to an accredited interpreter if [they] need one when using a publicly-funded healthcare service”. Yet, there is little data on the proportion of bilingual staff and clinician, rates of interpreter use and barriers to using interpreters in ACHs. Nor is there any evidence on the impact of communication barriers on the delivery of primary healthcare services and variability in unplanned emergency department transfers.

The overall aims of the PRACTIS project are:

  1. To improve the delivery of primary healthcare services in community based ACHs, particularly those that have residents from a variety of backgrounds.
  2. To enable appropriate referrals and transitions across the care continuum.
  3. To reduce transfers of limited English proficiency residents to emergency departments for procedures that could have been delivered through primary care in the ACH setting.

THE PROJECT

Phase 1 of PRACTIS has been funded by the Medical Research Future Fund to evaluate the relationship between linguistic discordance and unplanned emergency department transfers for limited English proficiency residents of ACHs. This will be addressed through two related studies.

Study 1 - Case control study of emergency department data of two hospitals to identify 600 emergency department transfers of ACH residents: 300 ‘cases’ of people with limited English proficiency and 300 ‘controls’ of people with good English proficiency. An expert panel of primary care and hospital experts will review these cases and controls to determine whether each transfer was avoidable. This will provide evidence and effect sizes on any differences in unplanned emergency transfers between ACH residents with and without limited English proficiency.

Study 2 - Interviews with 10 residents with limited English proficiency, 10 carers and 8 staff across two ACH sites to identify barriers to the uptake of Translation and Interpreting Services by primary healthcare providers attending ACHs.

Phase 2 of PRACTIS will involve the development and pilot trial of an intervention designed to improve the utilisation of TIS and address the barriers to translation and interpreting services use identified in Study 2. An application for funding to support Phase 2 is planned for late 2019.

OUR TEAM

CHIEF INVESTIGATORS

Prof Terry Haines – Monash University

Dr Shiva Vasi – Monash University

Prof Suresh Sundram – Monash University and Monash Health

Prof Velandai Srikanth – Monash University and Peninsula Health

Dr Joanne Enticott – Monash University

Dr Jim Hlavac – Monash University

Rob Macindoe – enliven


PROJECT STAFF

Dr Katrina Long – Monash University

Miss Rujuta Nikam – Monash University


COLLABORATORS

A/Prof Christine Phillips – Australian National University

Prof Erwin Loh – St Vincent’s Health Australia

Dr Bianca Brijnath – National Ageing Research Institute

Annette Peart – Monash University

Robert Hrzic – Department of Home Affairs

Prof Kathryn Burridge – Monash University

Dr Marc Orlando – Monash University

Dr Louisa Willoughby – Monash University

Dr Marissa Dickins – Bolton Clarke


MORE INFORMATION

For more information on the project, or to discuss getting involved with the PRACTIS project please contact:

Shiva.vasi@monash.edu