Transforming institutional racism at an Australian hospital
Transforming institutional racism at an Australian hospital
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DOI：
10.1071/ah18062
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发表时间：
2019-01-01
影响因子：
1.8
通讯作者：
Marrie, Adrian
中科院分区：
文献类型：
--
作者：
Bourke, Christopher John;Marrie, Henrietta;Marrie, Adrian
目的-本研究的目的是：（1）研究制度性种族主义的作用，创造土著和托雷斯海峡岛民的健康结果差异;（2）评估制度性种族主义在澳大利亚医院和卫生服务（HHS）的管理。方法：文献回顾告知考虑制度性种族主义和它产生的健康结果的差异。澳大利亚卫生和公众服务部提供的公开信息被用来评估澳大利亚卫生和公众服务部在体制性种族主义的五个关键领域的变化：纳入治理、政策执行、服务提供、就业和财务问责制。这些结果与2014年的一项案例研究进行了比较。结果文献一致认为，结果差距是制度性种族主义的一个定义特征，但有争议的过程。在澳大利亚卫生和公众服务部的治理、服务提供和就业领域发现了变革性变化，但在财务问责制或政策执行方面没有变化。一些种族群体的健康结果可能会受到制度性种族主义的损害。外部评估工具可以帮助医院和卫生服务部门做出改变。关于这个话题我们知道些什么？制度性种族主义理论仍在发展。澳大利亚开发了一个外部评估工具，用以衡量、监测和报告体制性种族主义。这篇论文补充了什么？这项关于制度性种族主义的研究为医疗机构提供了有用的建议，这些医疗机构在种族群体之间的结果存在差异。对从业人员有何影响？无论从业者的能力如何，制度性种族主义的有害影响都会发生。从业者在改善制度性种族主义方面的作用是认识到健康状况较差的关键指标，然后在医院或医疗机构内寻求改变。
Objectives The aims of this study were to: (1) examine institutional racism's role in creating health outcome discrepancies for Aboriginal and Torres Strait Islander peoples; and (2) assess the management of institutional racism in an Australian hospital and health service (HHS). Methods A literature review informed consideration of institutional racism and the health outcome disparities it produces. Publicly available information, provided by an Australian HHS, was used to assess change in an Australian HHS in five key areas of institutional racism: inclusion in governance, policy implementation, service delivery, employment and financial accountability. These findings were compared with a 2014 case study. Results The literature concurs that outcome disparity is a defining characteristic of institutional racism, but there is contention about processes. Transformative change was detected in the areas of governance, service delivery and employment at an Australian HHS, but there was no change in financial accountability or policy implementation. Conclusions The health outcomes of some racial groups can be damaged by institutional racism. An external assessment tool can help hospitals and health services to change. What is known about the topic? Institutional racism theory is still developing. An external assessment tool to measure, monitor and report on institutional racism has been developed in Australia. What does this paper add? This study on institutional racism has useful propositions for healthcare organisations experiencing disparities in outcomes between racial groups. What are the implications for practitioners? The deleterious effects of institutional racism occur regardless of practitioner capability. The role for practitioners in ameliorating institutional racism is to recognise the key indicator of poorer health outcomes, and to then seek change within their hospital or healthcare organisation.