Table 5 Recommendations provided by staff in response to the survey question: ‘Please make any comments about or suggestions to improve cross-cultural communication at Royal Darwin Hospital’

Better communication could be facilitated through improvements within the Aboriginal Interpreter Service, the interface between this service and the hospital, or having on-site interpreters,

-Appropriately trained, health literate interpreters are an invaluable asset, and a necessary one to achieve best outcomes for our indigenous clients. More effort needs to be made to recruit, train and retain well skilled and reliable interpreters in our health service. (Registered Nurse/Midwife)

-Would be beneficial to have more Interpreters based in the hospital…More consistency between Interpreters (some appear very experienced, some appear to not know their role) (Occupational Therapist)

-Overall, the quality of interpreters is good...I appreciate so much having this service available. The difficulty lies in the booking system and how difficult it is to have interpreters attend at short notice. The communication from booking staff could be greatly improved. (Occupational Therapist)

-Sometimes there are insufficient or no interpreters...There was a time I had to wait for an hour for the interpreter to show up. Sometimes cancellation of interpreter appointment was made last minute or there was a clash of appointments or a delay in appointment because of the interpreter’s previous appointment duration was extended…Overall the Interpreter service I believe is doing their best but it comes down to manpower supply and availability. (Social worker)

-I find the Aboriginal Interpreter service is very poor. It takes me a great deal of time to book them, and I need to give them two days notice to provide an interpreter. This has a huge impact on being able to communicate important messages to patients in a timely manner. Waiting for interpreters has an impact on my estimated date of discharge. The booking system needs to be simplified, and interpreters more available. (Registered Nurse/Midwife)

The hospital should aspire towards best practice in communication between healthcare providers and Aboriginal people

-Zero tolerance to culturally unsafe and poor quality care. (Registered Nurse/Midwife)

-Royal Darwin Hospital as a Centre for Excellence in Indigenous Health Training (Consultant/Specialist)

-This is an area that should be our core business if we are serious about improving health outcomes. It seems that this area needs to be better resourced. (Speech pathologist)

More Aboriginal health workers should be employed by the hospital

-More aboriginal health workers please…So much better patient engagement, feel like they actually listen to me if I have an AHW with me, and the AHW can follow up without me and feedback to me any concerns the patient didn’t want to express directly to me. (Physiotherapist)

An interpreter coordinator and/or nurse educator would facilitate better interpreter access

-The combination of an interpreter with an indigenous health educator was particularly effective. (now no longer available). Lack of permanent onsite coordinator has also made access much more difficult. (Consultant/Specialist)

Using peers (‘patient preceptors’) can improve communication and could be used more widely

-It doesn’t need to be around interpreters only. The Renal Service use patient preceptor model - which helps with care navigation and help patients understand from another patient who has been through the same process. (Registered Nurse/Midwife)