Embedding cultural safety in health professional child protection responses to Aboriginal families in NSW paediatric care settings

What is the problem?

The NSW SAFE-ED project (Streamlining Access to Services for Vulnerable Families in the Emergency Department) in rural and metropolitan emergency departments seeks to determine the usefulness and uptake of a child injury protocol to assist health professionals to respond appropriately to a child presenting to Emergency with a non-accidental injury. The project will determine if the protocol improves clinician documentation and referral of suspected child abuse cases, as well as clinician self-efficacy and outcome expectations when responding to non-accidental injury. This work commenced in July 2017, and is due for completion at the end of June 2019.

Implementation of the SAFE-ED project has revealed health professionals and organisations can feel unprepared to respond to child protection issues with Aboriginal children and their families in healthcare facilities. The need to extend SAFE-ED by adopting an integrated, culturally centred approach for Aboriginal children and their families was identified.

About the research translation program

The new project will consist of three key stages: (1) development of the framework; (2) implementation of the framework; and (3) evaluation of the framework implementation and write-up of results.

The new framework will be evidence-based and developed in consultation with Aboriginal and non-Aboriginal health workers. It will be based on the assessment of four key strengths of Australian Aboriginal cultural practices in family life:

  • A collective community focus on child rearing helps children;
  • Children need the freedom to explore and experience the world;
  • Elderly family members are important to family functioning; and
  • Spirituality helps families cope with challenges.

This framework will assist healthcare professionals to better communicate and work with Aboriginal families and children to achieve positive outcomes for their communities. The communication tool will follow the principles of Introduction, Situation, Background, Assessment, and Recommendation; a familiar and accessible handover framework in use across NSW Health.

What will be the impact?

It is anticipated that this project will lead to an increased awareness of culturally safe healthcare for Aboriginal patients, evidenced by successful testing of the framework. There will also be increased partnership between health professionals and Aboriginal children and their families, particularly around communication and decision making. By the inclusion of the child, family and wider community in decision making, in addition to using learnings for continuous improvement, the overall service to this group can be improved. 


For more information, contact Dr Tara Flemington – tara.flemington@health.nsw.gov.au or Dr Jennifer Fraser – Jennifer.Fraser@sydney.edu.au