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Cultural Safety in Healthcare Improves Outcomes

January 2013 – Cultural safety is an important topic in First Nations, Inuit, and Métis public health these days, and for good reason. People who experience culturally safe health care are more likely to access care earlier, and to feel more at ease and empowered throughout the process of  receiving care. As a result, they are more inclined to share details about their health concerns and care preferences, and are more willing to return and to follow treatment plans recommended by medical professionals. In short, cultural safety is a critical component for improving patient outcomes.

So what exactly is cultural safety and how do we achieve it? Two new NCCAH resources provide answers to these questions from different points of view: Towards Cultural Safety for Métis: An Introduction for health care providers and Cultural Safety in First Nations, Inuit and Métis Public Health: Environmental Scan of Cultural Competency and Safety in Education, Training and Health Service.

The first is a fact sheet that presents cultural safety as an ongoing, continually evolving process involving specific actions to adjust services to the needs and preferences of Métis patients and health care workers. This fact sheet places cultural safety at the end of a continuum that begins with cultural awareness and progresses through cultural sensitivity and cultural competency. The overall goal is to treat Métis people with dignity and respect to ensure they will feel accepted and safe from discrimination in health care environments.

Learning about different peoples and cultures is a key component of cultural safety training, and this NCCAH fact sheet begins the process by providing background information, countering popular myths and providing lesser-known facts about Métis people. For instance, many Canadians may not be aware of the wide diversity of cultures, values, beliefs, and languages that can vary between Métis communities across Canada. The fact sheet also points out important information, for example, that Métis children attended residential schools and that Métis are the only constitutionally recognized Aboriginal people in Canada that do not have access to federally funded non-insured health benefits.

In order to be of immediate use to front line health care providers, the NCCAH fact sheet translates the abstract notion of cultural safety to a very personal and practical level by describing different scenarios in which culturally aware, sensitive, competent, and safe practices are added to enhance health care services and patient outcomes.

The second NCCAH resource on cultural safety will be released in early 2013: Cultural Safety in First Nations, Inuit, and Métis Public Health: Environmental Scan of Cultural Competency and Safety in Education, Training, and Health Service. This report provides an in-depth look at the state of cultural safety knowledge in Aboriginal health care, including such things as terminology, core competencies, accreditation standards, undergraduate and graduate level curriculum, professional development and continuing education opportunities, and provincial and national projects engaging with the issue.  It reveals that a wide range of strategies are currently being used to improve the ability of health care practitioners to provide culturally safe care.

However, one of this report’s key findings is that developing and implementing standardized assessment criteria, such as a set of national core competencies, may be a needed next step in order to create a workforce that can consistently and effectively provide culturally competent and safe health services to First Nations, Inuit, and Métis peoples throughout Canada.  The report raises several questions and considerations that must be addressed in the development of new standards, from who should be involved in the initial planning stages all the way through to challenges in ensuring that changes in education, for instance, actually get translated into improved culturally safe services.

This important NCCAH report should be of special interest to forward-looking students, educators, researchers, practitioners, community leaders, and policy makers in the fields of public health, medicine, and nursing.