Research, monitoring and evaluation

Critical Element

Research, and ongoing monitoring and evaluation is identified in a number of policy frameworks as foundational to culturally safe service delivery (see for example Commonwealth of Australia, Department of Prime Minister and Cabinet, 2021; Australian Health Ministers’ Advisory Council, 2016; Government of South Australia, 2016; Western Health Alliance, 2016). Our review of the academic literature highlights a gap between policy statements and implementation, with cultural safety still emerging as a research topic in its own right, and the researchers identifying fewer studies than anticipated. Some research confirms the critical need to monitor progress in cultural safety (see for example Gubhaju et al, 2020).

The research literature provides little guidance on effective ways to monitor cultural safety, except to assert that organisations should evaluate the effectiveness of cultural safety training programs (Menzies & Grace, 2020). Service providers, however, are well placed to contribute to the sparse evidence base as cultural safety is often identified as a system outcome (see for example the TEI Outcomes Framework (NSW Government, 2019) where identifying outcomes indicators in consultation with Aboriginal clients and community representatives is the suggested starting point).

Implementation activities include:

• In consultation with Aboriginal staff and community representatives, co-design indicators of cultural safety for Aboriginal children and families accessing services, as well as mechanisms to collect data to assess if cultural safety outcomes are being achieved.
• Undertake assessment activities or evaluations of staff cultural safety training programs to determine their effectiveness in increasing staff knowledge, changing attitudes, and ability to deliver culturally safe programs and care. This should be done on an ongoing basis.
• Support knowledge transfer and the development of evidence-based sectoral practice by sharing examples of organisational and program success within your organisation.