Whole of practice approaches

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Overview

An empathetic, person-centred, culturally responsive approach is highly valued by people from refugee backgrounds.1 It requires a whole-of-practice approach.

Consider the following at reception:

  • welcoming reception staff, bilingual if available
  • waiting spaces with information in local refugee community languages
  • clear signage about the availability of interpreters
  • flexible waiting spaces for children’s play as well as quiet areas.

Routine recording in practice systems should include:

  • interpreter required, including preferred language and gender preferences
  • country of birth, ethnicity and date or year of arrival
  • contact details of settlement worker/next of kin/supporting family members
  • preference of GP, including gender
  • updated contact details at each appointment.

The following should be considered when booking appointments:

  • long appointments
  • interpreters if needed
  • flexibility with appointment times
  • appointments with practice nurse availability, particularly when organising catch up vaccinations
  • an appropriate appointment reminder and recall system, such as text messages or in-language appointment reminders
  • a follow-up system for non-attenders
  • large consulting rooms to accommodate big families.

Clinicians should consider:

  • bulk billing
  • requesting previous health records if available
  • case conferences for patients with complex needs
  • coordinating care with refugee health nurses if available
  • Teach-Back Method of communicating.

Considerations

People from refugee backgrounds may be unfamiliar with Australian systems such as the need to make appointments, understanding prescriptions and repeat prescriptions, and referral to specialists.1 They may have conflicting settlement demands or be experiencing anxiety, sleep or memory problems, which may affect attendance and concentration.

Patients may be unfamiliar with the roles and qualifications of general practitioners (GPs) and other healthcare providers.

Resources

References

  1. Cheng I-H, Drillich A, Schattner P. Refugee experiences of general practice in countries of resettlement: a literature review. Br J Gen Pract. 2015;65(632):p171-p176.

Produced by

in consultation with

                  Refugee Health Network of Australia

Endorsed by

Funded by

The Australian Refugee Health Practice Guide was produced with funds from the Australian Government Department of Health.

Disclaimer

The information set out in the Australian Refugee Health Practice Guide (“the Guide”) is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is the Guide exhaustive of the subject matter. Persons implementing any recommendations contained in the Guide must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. The statements or opinions that are expressed in the Guide reflect the views of the contributing authors and do not necessarily represent the views of the editors or Foundation House. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Whilst the information is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Foundation House and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in the Guide for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in the Guide and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Although every effort has been made to ensure that drug doses and other information are presented accurately in the Guide, the ultimate responsibility rests with the prescribing clinician. For detailed prescribing information or instructions on the use of any product described herein, please consult the prescribing information issued by the manufacturer.