Gaining aged care accreditation standards: the Guwardi Ngadu experience

In February 1991 Guwardi Ngadu Frail Aged Hostel was officially opened by the Hon Peter Staples the then Minister for Health. At this point in time the hostel like so many others in the Kimberley was ran by well meaning individuals, predominantly non-Aboriginal. The staff during this time were also non-Aboriginal who were dedicated to providing the old people of the Fitzroy valley with the best care possible given the remoteness of the area and the lack of appropriate services. The difficulty of providing appropriate care was highlighted by the first visit to Guwardi Ngadu by representatives from the Accreditation standards agency. The officers found that Guwardi Ngadu did not meet any of the 44 outcomes.

In 1998 the administration of Guwardi Ngadu was handed from Junjuwa Community to Nindilingarri Cultural Health Services. It would be up to the committee of Nindilingarri to take Guwardi Ngadu from what it was to accreditation in the year 2000. As it happened Guwardi Ngadu was successful in gaining one-year accreditation with a lot of work to be done before the next site audit in July 2001.

As we now know Guwardi Ngadu was successful in gaining three years accreditation with a satisfactory rating in all but cultural and spiritual for which a commendable was achieved.

The commendable rating was a very significant stage in the development of not only Guwardi Ngadu but for all people who provide services to predominantly aboriginal residents.

The commendable rating proved that the Accreditation Agency had recognized the need to accept the way in which services are provided to the old people of Guwardi Ngadu. The needs of the old people of Guwardi Ngadu are provided in such a way that it may not be totally in accordance with the standards but are provided in the way the Aboriginal culture dictates. This was perfectly demonstrated when the chairperson, two staff members and the Aboriginal assessor discussed in secret aspects of the Cultural and Spiritual side of Guwardi Ngadu. The information provided was not included in the site report and remains between those present at the meeting.

The gaining of the 3 years accreditation was also very positive for the town of Fitzroy Crossing and the Fitzroy valley in general. The people of these areas have been informed through the recent AGM of Nindilingarri and through the local radio station of the success that Guwardi Ngadu has achieved and the recognition that it has brought to services provided to Aboriginal people by Aboriginal people. Currently the only non-Aboriginal working at Guwardi Ngadu is the manager whom it is envisioned will be replaced in the near future by an Aboriginal person.

Graeme Cooper
Guwardi Ngadu Frail Aged Hostel
Fitzroy Crossing
email: guwardingadu@bigpond.com

AHMAC establishes the Standing Committee on Aboriginal and Torres Strait Islander Health (SCATSIH)

The 25 October meeting of AHMAC (Australian Health Ministers’ Advisory Council) agreed to establish the Standing Committee on Aboriginal and Torres Strait Islander Health (SCATSIH) with the following draft terms of reference:

(1) To assist AHMAC to meets its whole-of-health system responsibilities to improve Indigenous health;
(2) To coordinate and promote jurisdictional activities in relation to Indigenous health policy development, program development and delivery;
(3) To provide advice to and representation on the National Aboriginal and Torres Strait Islander Health Council;
(4) To provide a forum for coordination of health jurisdictions advice on Indigenous health to COAG (Council of Australian Governments) and other Ministerial Councils; and
(5) To convene a forum responsible for personal development, leadership and collegiate development of Indigenous staff working within Commonwealth, State and Territory health departments.

Membership of the SCATSIH, which supersedes the Heads of Aboriginal Health Units (HAHU) forum, is being finalised in preparation for the first meeting on 4 December. Details of the SCATSIH membership and other aspects will be provided as they become available.

HealthInfoNet to work with Canadian Aboriginal organisations on Internet-accessible resources

Following a series of meetings in Ottawa and Toronto on 8-11 October with people and organisations involved in Aboriginal health in Canada, the HealthInfoNet has been approached to assist in the development of a Canadian resource along the lines of the Australian Indigenous HealthInfoNet.

The meetings began in Ottawa on 8 October, when HealthInfoNet Director, Neil Thomson, and Manager, Bronwyn Gee, met with Richard Jock, Executive Director, and senior research and policy staff of the National Aboriginal Health Organization (NAHO).


NAHO was established in 1999-2000, largely in response to recommendations of the 1996 Royal Commission on Aboriginal Peoples which recognised the need for an Aboriginal organisation to serve as a support network for Aboriginal health workers and communities, to share information, and act as an advocate of evidence-based decision-making in addressing the health needs of Canada’s Aboriginal peoples. After detailed consultations with key Aboriginal organisations, communities and individuals, the five major national organisations – the Assembly of First Nations, the Congress of Aboriginal Peoples, Inuit Tapirisat of Canada, the Metis National Council and the Native Women’s Association of Canada – agreed to the form and objectives of NAHO and now serve on its Board of Directors. NAHO’s specific objectives are:
(1) improving and promoting through knowledge-based activities the health of Aboriginal peoples and Aboriginal communities
(2) promoting health issues pertaining to Aboriginal peoples by means including communications and public education activities.
(3) facilitating and promoting research and developing research partnerships relating to Aboriginal health issues
(4) fostering recruitment, retention, training and utilisation of Aboriginal people in the delivery of health care.
(5) affirming Aboriginal traditional healing practices through validating holistic traditional practices and medicines and ensuring such practices receive recognition.

TheHealthInfoNet‘s work had been recognised by NAHO in the development of a document entitled Establishing a leading knowledge-based organization, so the meeting on 8 October enabled NAHO staff to consider more closely how a similar resource could be established in Canada.

The value of such a resource was acknowledged also by the Dr Jeff Reading, Scientific Director of the Institute of Aboriginal Peoples’ Health (IAPH), and the IAPH Advisory Board (composed of representatives from the Aboriginal community, academia and governments) after a presentation to the Board in Toronto on 10 October. The IAHP, one of the thirteen ‘virtual’ Institutes of the Canadian Institutes of Health Research (CIHR), supports research addressing the special health needs of Canada’s Aboriginal people. Dr Reading and the Board recognised the very important role that a Canadian Aboriginal HealthInfoNet could play in assisting their health research agenda (across disciplines, sectors, and regions), the emerging health needs of Canadian Aboriginal people, and the information needs of health policy decision-makers.

As well as the presentation to the Board and follow-up meetings with Dr Reading, Neil and Bronwyn were guests at the official launch of the IAHP in Toronto on 11 October.

Following these meetings and presentations in Ottawa and Toronto, HealthInfoNet staff have been working with NAHO staff in the initial planning for a Canadian version of the HealthInfoNet. It is anticipated that both the HealthInfoNet and NAHO will benefit from collaboration on this development, as some of the generic aspects will be able to be shared. NAHO is planning to have a Canadian Aboriginal HealthInfoNet fully operational within two years.

Acknowledgments: The Australian Indigenous HealthInfoNet is grateful to Edith Cowan University’s Faculty of Communications, Health and Science for supporting the visit of Bronwyn Gee and Neil Thomson to Canada, and to Ginette Thomas, Executive Officer of the CIHR Institute of Aboriginal Peoples’ Health, for assisting in the coordination of meetings in Ottawa and Toronto..

Canadian authorities enthusiastic about HealthInfoNet ‘knowledge translation’ activities


Senior officials of the Canadian Institutes of Health Research (CIHR) and Health Canada expressed great interest in the work of the Australian Indigenous HealthInfoNet in meetings with the HealthInfoNet Director, Neil Thomson, and Manager, Bronwyn Gee, in Ottawa, Canada on 9-10 October. These meetings need to be seen in the context of the establishment in April 2000 of the CIHR as a replacement for the Canadian Medical Research Council (the Canadian equivalent of Australia’s National Health and Medical Research Council), and of the great emphasis placed by Canadian health authorities on the development of a comprehensive pan-Canadian Health Infostructure.

As part of its enabling legislation, the CIHR is required to excel in the support of health research and the translation of this research ‘into improved health for Canadians, more effective health services and products, and a strengthened health care system’ (emphasis added). This requirement for ‘knowledge translation’ – very uncommon among national research-funding bodies – requires processes to support the uptake of health research in a manner that improves health and health care ‘through improved understandings, processes, services, products or systems’.

Neil and Bronwyn met with CIHR President, Dr Alan Bernstein, and Senior Policy Advisor, Elizabeth Dickson, who is responsible for the development of a conceptual framework for knowledge translation (to be considered at the November meeting of the CIHR Governing Council). Ms Dickson acknowledged that the HealthInfoNet is one of the few organisations anywhere in the world already actively undertaking knowledge translation. She and Dr Bernstein were most impressed with the way that the HealthInfoNet is making that knowledge accessible by the Internet to assist decision-making by policy-makers, health program managers and health service providers, and with the HealthInfoNet‘s work in conducting workshops and Internet cafes to improve the access of Australian Indigenous people to this knowledge.

In parallel with the work being undertaken by the CIHR in the development of a framework for knowledge translation, Health Canada’s Office of Health and the Information Highway (OHIH) is coordinating the planning and implementation of the pan-Canadian Health Infostructure. An advisory committee set up to develop a blueprint and tactical plan for the Infostructure, which will be the information and communications foundation for the Canadian health system, recognised that many of the components exist already. The committee did, however, identify significant gaps in the areas of health information for the public and for health service providers, clinical decision support, telehealth, electronic health records, health surveillance, health selfcare/telecare, health data holdings, and data analysis and reporting.

Mr Jean-Claude Barre, Senior Policy Advisor with OHIH, reported that activities were underway to address many of these gaps, but that little had been done in the type of knowledge translation performed by the HealthInfoNet. Mr Barre was so impressed with the work of the HealthInfoNet that he indicated he would try to schedule a video conference presentation at a meeting of the advisory committee, whose work is supported by the Canadian Conference of Deputy Ministers of Health and the Conference of Ministers of Health (equivalent to the Australian Health Ministers’ Advisory Council and Australian Health Ministers’ Conference respectively).

Coming shortly after the HealthInfoNet‘s participation as a finalist in the prestigious Stockholm Challenge Award for the innovative use of information technology, the meetings with the CIHR and the OHIH confirm the HealthInfoNet‘s position as a world leader in the vital area of knowledge translation.

Acknowledgments: The Australian Indigenous HealthInfoNet is grateful to Edith Cowan University’s Faculty of Communications, Health and Science for supporting the visit of Bronwyn Gee and Neil Thomson to Canada, and to Ginette Thomas, Executive Officer of the CIHR Institute of Aboriginal Peoples’ Health, for assisting in the coordination of meetings in Ottawa and Toronto.

HealthInfoNet at Stockholm Challenge Award

The Australian Indigenous HealthInfoNet was one of about 60 finalists from around the world that participated in the Stockholm Challenge Award 2001 Final Events, held in Stockholm, Sweden on 23-26 October. The HealthInfoNet was represented by Sandy Angus, Bronwyn Gee and Neil Thomson.

The Stockholm Challenge is an international award that highlights the benefits information and communication technology can bring to people and society, with an emphasis of bridging the ‘digital divide’. The award is broken into seven categories covering major social justice issues. The Australian Indigenous HealthInfoNet was a finalist in the ‘Health and quality of life’ category.

President of the Stockholm City Council, Lord Mayor Axel Wennerholm, welcomed participants to several days of stimulating events. The first of the formal events was a World Café, a facilitated forum for open discussion between finalists from all the categories. The opportunity to discuss and debate IT issues with people from developing countries (such as Egypt, Uganda, Peru and India) as well as developed countries (like the United States, Canada and New Zealand) was particularly rewarding and memorable. The interaction and networking allowed sharing of knowledge and experiences between people from projects that varied immensely in resources, infrastructure and geographical location.

The Stockholm Challenge Best Practice Exhibition, held the following day, enabled finalists to promote their projects, their culture and their countries. HealthInfoNet staff benefited personally and professionally from being able to network with others across racial, cultural and geographical borders. In the words of Sandy Angus, Indigenous Project Officer with the HealthInfoNet: ‘The experience of attending the Stockholm Challenge Awards provided me with new information to plan IT education and training projects for Indigenous people. It also encouraged me to open my own mind, and to explore creative ways of working in health information in the future. By meeting other finalists I have also made new relationships and developed networks of people that I hope will work towards improving the overall health and quality of life of Indigenous people worldwide. Often Indigenous people working in partnership with non-Indigenous people are not given the opportunity to attend events such as this, so I was appreciative of having an equal part. The experience was one of the most exciting events of my life and one that I shall never forget.’

The winners of each of the seven categories were announced at the prize-giving ceremony in the Stockholm City Hall. The international jury evaluated the projects against four specific criteria: innovation; user need; sustainability; and transferability. The ‘Health and quality of life’ category had joint winners: SUMA, a humanitarian supply management system from the USA that coordinates the distribution of emergency relief to victims of disasters; and TEENEX, a drug prevention and personal enrichment project for young people worldwide that was developed in the UK. The HealthInfoNet congratulates the winning projects from all categories.

The prize giving ceremony was followed with an evening of wonderful traditional Swedish entertainment and hospitality

Staff from the Australian Indigenous HealthInfoNet were proud to have participated in this international event and to have shared with the wider world the way the HealthInfoNet aims to improve Indigenous health. This small, innovative and creative project, fired mainly on enthusiasm and passion, is recognised as a world leader in the translation of research into knowledge and the use of technology to disseminate this knowledge.

Acknowledgment: The Australian Indigenous HealthInfoNet is grateful to the Office for Aboriginal and Torres Strait Islander Health for a special grant to enable Sandy Angus to participate, and to the Edith Cowan University’s Faculty of Communications, Health and Science for supporting the participation of Bronwyn Gee and Neil Thomson.

Image collections.