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The tent card, pictured, builds on the work, resources and artwork of North East Healthy Communities and the Victorian Aboriginal Health Service.

By Helen Carter

Journalist

A tent-shaped card prompt to sit on reception or consulting desks in optometry and ophthalmology practices and clinics will help staff ask patients to identify as Aboriginal or Torres Strait Islander.

The miniature ‘tent’ desktop resource has been developed with Aboriginal and Torres Strait Islander community consultation and input through Indigenous Eye Health at The University of Melbourne. It is available to download free from the Indigenous Eye Health website and the Optometry Australia website from today, November 1, 2019, following its launch.

The resource prompts clinicians and practice staff to ask – “Are you of Aboriginal or Torres Strait Islander origin?” and encourages patients to volunteer this information. An information sheet is provided with the desktop resource.

The Australian Bureau of Statistics estimates that 3.3 per cent of the total Australian population, or 798,400 people were Aboriginal or Torres Strait Islanders as of 30 June, 2016.

‘To our knowledge there is no resource that has been developed and provided for mainstream eye care services to support identification of Aboriginal and Torres Strait Islander people, so the idea was to develop a resource that encouraged private optometry and ophthalmology practices to ask the question and think about their care to and for Aboriginal and Torres Strait Islander Australians,’ Mitchell Anjou AM, optometrist and deputy director of IEH, said.

‘Asking the question is important because Aboriginal and Torres Strait Islander people still have three times more vision loss and blindness than other Australians, according to the National Eye Health Survey of 2015.

‘Knowing whether a patient is of Aboriginal or Torres Strait Islander origin has a number of impacts on the provision of both clinically appropriate and culturally safe eye care.

‘For example, Aboriginal and Torres Strait Islander Australians who have diabetes are recommended to have their eyes examined every year, not every two years as for other Australians [NHMRC 2008].’

Identifying may help access funds

Indigenous patients may also be able to access specific funding and programs for glasses, co-ordination and transport to other services, and additional support, including gap fees, for surgery and treatment.

‘These can only be provided if our patients have chosen to identify,’ Mr Anjou said.

‘In asking this question, clinic staff are demonstrating care to Aboriginal and Torres Strait Islander patients and this is also a good and positive thing.

‘One side of the card is for the patient to read and prepares the patient for the question, and the other side is for the clinic staff member and prompts the question to be asked. It is a trigger, and sometimes the patient will just see it and may volunteer the information without staff having to ask.’

Mitchell Anjou speaking at a Roadmap to Close the Gap for vision workshop this week

Mr Anjou said the resource also provides license to ask the question and staff can explain, if needed, that this is an important element to enhance improved delivery of care.

‘My sense is that Aboriginal and Torres Strait Islander people are also increasingly more likely to identify their Indigeneity, and are comfortable, not aggravated or distressed, to be asked,’ he said.

Culturally safe practices and staff discussion

‘What is indicated by a practice that chooses to display the resource is a decision from the practice principals to take this responsibility and discussions with staff follow. This could trigger further discussion with staff about supporting culturally safe practices.

‘An optometry or ophthalmology practice that might be considered culturally safe by an Aboriginal and Torres Strait Islander person is likely to be a practice that is comfortable asking the question and therefore also comfortable in displaying the resource and having these discussions with patients.’

Mr Anjou said providing culturally safe practices was critical in the profession’s service and care for Aboriginal and Torres Strait Islander people.

‘In my view it goes some way to explain why optometry’s care to Aboriginal and Torres Strait Islander people still needs improving,’ he said.

Identification will help improve care

Work by the Indigenous Eye Health unit, through activities and feedback of more than 50 regional stakeholder groups across Australia, has found that identification is one of the remaining challenges to improve and enhance eye care outcomes for Aboriginal and Torres Strait Islander Australians.

‘Private optometry and ophthalmology clinics rarely, if ever, ask their patients on presentation whether they are Aboriginal or Torres Strait Islander, and nor do they record this in their patient records,’ Mr Anjou said.

‘Public health care facilities are better, and are required to identify Aboriginal and Torres Strait Islander patients but these practices are still far from perfect.’

Mr Anjou said the question was generally not included on questionnaires new patients fill out at optometry practices.

‘Optometrists may think they treat everyone the same and treat all patients well, which they undoubtably do, but we still have inequitable eye health outcomes for Aboriginal and Torres Strait Islander people. It is important to appreciate that patients may choose not to identify, and this is absolutely fine. Approach the question with respect and, yes, it is necessary to ask everyone,’ he said.

The resource is downloadable from the Indigenous Eye Health website and the Optometry Australia website. Cardboard copies will also be handed out at conferences and meetings including the Royal Australian and New Zealand College of Ophthalmologists’ 51st annual scientific congress in Sydney from November 8-12, 2019. Optometry Australia will publish the resource in an upcoming edition of its Pharma magazine.

 

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