Aboriginal and Torres Strait Islander community members’ experiences of care in an urban Aboriginal Community Controlled Health Service transforming to a Patient Centred Medical Home

Anton Clifford-Motopi; Renee Brown (Nununccal); Antoinette White (Palawa Iningai); Patrice Harald (Gangulu); Danielle Butler; Saira Mathew; Julie Mackenzie; Martie Eaton; Richard Mills

doi:10.1071/PY23163

RESEARCH ARTICLE (Open Access)

Aboriginal and Torres Strait Islander community members’ experiences of care in an urban Aboriginal Community Controlled Health Service transforming to a Patient Centred Medical Home

Anton Clifford-Motopi ^A ^B ^* , Renee Brown (Nununccal) ^A , Antoinette White (Palawa Iningai) ^A , Patrice Harald (Gangulu) ^A , Danielle Butler ^A ^C , Saira Mathew ^A ^B , Julie Mackenzie ^A , Martie Eaton ^A and Richard Mills ^A

+ Author Affiliations

- Author Affiliations

^A The Institute for Urban Indigenous Health Ltd, 22 Cox Road, Windsor, Qld 4030, Australia.

^B The University of Queensland, Poche Centre for Indigenous Health, 74 High Street, Toowong, Qld 4066, Australia.

^C National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia.

^* Correspondence to: a.clifford@uq.edu.au

Australian Journal of Primary Health 30, PY23163 https://doi.org/10.1071/PY23163

Submitted: 14 September 2023 Accepted: 15 April 2024 Published: 13 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Few studies have examined patient experiences of the Patient Centred Medical Home (PCMH). This qualitative study explores the experiences of patients of an urban Aboriginal Community Controlled Health Service during its transition to a model of a PCMH.

Methods

Twenty-eight community members who were registered as patients of an urban Aboriginal Community Controlled Health Service were purposively recruited to participate in yarning interviews. Yarns were conducted using a guide containing open-ended questions in the same domains as those used in patient satisfaction surveys at the participating clinic. Data from yarns were analysed by Aboriginal and non-Indigenous researchers using thematic analysis. The interpretations of Aboriginal and Torres Strait Islander researchers were privileged in the analysis.

Results

Key themes highlighted the importance of relationships, connectedness, and personal growth and empowerment to community members’ health and wellbeing, which they described as a journey of healing and recovery. Delays in implementing a process to empanel patients in a care team meant that most community members were unaware a PCMH had been implemented. However, community members commonly reported a more welcoming environment, more contact with the same doctor and more involvement of Aboriginal Health Workers in their care.

Conclusions

Aboriginal and Torres Strait Islander community members’ narratives of their experiences bear evidence of the acceptability of a PCMH model for delivery in Aboriginal Community Controlled Health Services to improve relational care between patients and health staff. A patient-directed empanelment process has been implemented to better connect patients to their care team in the clinic, and the role of the Aboriginal Health Worker reshaped to strengthen connections between patients and their care team in and outside the clinic.

Keywords: Aboriginal Community Controlled Health Service, connectedness, implementation, Patient Centred Medical Home, patient experiences, qualitative research, relational care, yarning.

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