Bush Battles: The Challenges of Providing Acute Health Care in Rural Contexts in Australia

Abstract

Introduction: In Australia, the rural health care environment is characterized by increasing disadvantage in relation to access to services and resources. Within this context, health professionals are challenged to provide what they feel is good-quality health care in a community of which they are a part. This paper presents the results of a study which aimed to: • identify challenges confronting health care professionals in rural acute care settings and • facilitate interprofessional collaboration in working toward improved patient outcomes and staff participation. Method: A mixed method approach involved a consultative, participatory process. An initial survey was followed by focus groups and workshops. The target population was health care professionals across disciplines, in rural acute care facilities within one large Area Health Service in NSW, Australia. Workshops facilitated interdisciplinary collaboration to identify strategies for addressing concerns with the aim of developing priorities for practice change projects. Results: Results highlighted issues to do with staffing, isolation and communication as most significantly impacting on staff and patient outcomes. Access to resources and support services was the most frequently cited challenge. Results were consistent across professions and sites within the Area Health service. Focus groups identified a range of issues related to geographic and professional isolation, working with and apart from larger centers, generalist practice, and insufficient services and staff. Conclusion: Findings point to the urgent need to support clinicians through the mobilization of strategies that are context specific, locally based and led, but at the same time transferrable across sites.