Evaluation of a pathway to address take own leave events for First Nations peoples presenting for emergency care: The Deadly RED project

• Published in: Emergency Medicine Australasia
• Main Authors: Davison, Michelle, Chan, Jason, Clarke, Meg, Mitchell, Caroline, Yan, Alan, Ballard, Emma, Henaway, Elwyn
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2024
• Subjects: Queensland; First Nations
• Online Access: http://dx.doi.org/10.1111/1742-6723.14397; https://onlinelibrary.wiley.com/doi/pdf/10.1111/1742-6723.14397

Abstract Objective The ‘Deadly RED’ project primarily aimed to improve culturally competent care to reduce the number of First Nations patients presenting to a Queensland ED who ‘Take own leave’ (TOL). The secondary aim was to evaluate the implementation project. Methods A pre/post‐test quasi experimental study design using mixed methods was co‐designed with adherence to Indigenous research considerations. Quantitative analysis of First Nations presentations before and after Deadly RED implementation was performed using SPSS. Qualitative analysis of transcribed research yarns in NVIVO was coded and themed for analysis. Staff experiences and perspectives were collated using electronically distributed surveys and process audits were performed. Results A total of 1096 First Nations presentations June to August 2021 and 1167 in the matched 2022 post‐implementation period were analysed. Significantly more patients were recorded as TOL post‐implementation (13.0% pre vs 21.3% post) and representations rates were unchanged. Forty‐six staff surveyed identified improvements in all parameters including cultural appropriateness and quality of care. Qualitative analysis of 85 research yarns revealed themes migrated to increasingly acceptable, accessible, and usable care. Notably, 45% of the First Nation's patients recorded as TOL self‐reported that their treatment was complete. The study was feasible as 80% of packs distributed and 73% follow‐up screening after TOL. Conclusions The Deadly RED evaluation revealed significant discrepancies in the reported data points of TOL and the ‘story’ of the First Nations persons experience of appropriate and completed care. Staff awareness and cultural capability improved significantly, and yarning allowed knowledge translation and improvements in communication which contributed to a better healthcare experience for First Nations patients attending our ED.