The Impact of Aboriginal Health Liaison Officers and Culturally Safe Strategies on Emergency Department Leave Events: A Scoping Review

In Australia, First Nations Peoples are reported as 1.5 times more likely to leave the Emergency Department before treatment completion. Reasons are multifactorial and complex, including length of wait times, lack of cultural safety and persistent institutional racism. This scoping review aimed to determine the impact of Aboriginal Health Liaison Officers on First Nations Peoples' rates of Take Own Leave in Emergency Departments. The Joanna Briggs Institute methodology for scoping reviews, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews, the associated checklist, and the CONSIDER criteria enabled the synthesis of the best available evidence. The search included CINAHL Plus with Full Text (EBSCOhost), Medline (Ovid), PsycINFO (Ovid), Scopus, citation searching and Grey Literature. A total of 533 articles were screened, with seven relevant studies included in this scoping review. Robust research evidence of the impact of Aboriginal Health Liaison Officers on leave events was largely absent in the literature. Strategies designed to improve cultural safety were found to improve rates of healthcare attendance. The Aboriginal and Torres Strait Islander Quality Appraisal Tool was used to appraise the quality of the included studies, finding limited consultation with First Nations Peoples in research design. Findings highlight that improved cultural safety improves First Nations Peoples' Emergency Department attendance. All studies are specific to the Emergency Department setting with projects implemented to reduce leave events and/or implementation of Aboriginal Health Liaison Officer roles. The review provides some evidence that Aboriginal Health Liaison Officers would improve Emergency Department attendance.