Aims: To explore the health system factors that promote engagement between cancer care providers and culturally and linguistically diverse (CALD) consumers to enhance safety in cancer services.
Background: Patient engagement can enhance patient safety; this is crucial for people from CALD backgrounds who are at increased exposure to safety events . Yet there is a lack of knowledge about the system, service and interpersonal factors that facilitate engagement with patients from CALD backgrounds.
Methods: A cross-sectional qualitative descriptive study was conducted using semi-structured interviews with cancer service staff and consumers from CALD backgrounds from four cancer services in NSW and Victoria, Australia. Consumers included patients, family or supporters. Data was both deductively and inductively analysed by the research team using a Framework Analysis method grounded in Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 Model.
Results: We conducted a total of 72 interviews, 54 interviews with staff and 18 with consumers from CALD backgrounds who had accessed cancer care at participating sites. Shared understanding of care processes, tasks and instructions between staff and consumers from CALD backgrounds was identified as essential to enable consumers to seek timely, appropriate care. The theme of ‘establishing shared common understanding’ was evident in the data across the five SEIPS model domains of: person, task, tools and technology, environment and organisation. Strategies such as readily available interpreter services for both formal and informal interactions, translated information, and flexibility to incorporate family members in activities or appointments were identified as supporting engagement.
Conclusions: This research underscores the need for a systemic health service commitment to creating and resourcing environments, processes and interactions that foster engagement with culturally and linguistically diverse consumer groups. Effective strategies and resources are available, but access is inconsistent. Organisational support is vital to develop and maintain service capacity to facilitate engagement.