Responding to cultural diversity at two Sydney-based children's hospitals

The aim of this study was to study and document the challenges of culturally and linguistically diverse (CALD) families in tertiary paediatric settings. Mixed methods, both qualitative and quantitative, were used at Sydney Children's Hospital, Randwick and the Children's Hospital at Westmead, during 2006-2007. A telephone survey of 46 questions was implemented on 269 occasions in one of nine languages. In depth qualitative studies of seven families of various migration, settlement and health experiences were undertaken over a four month period, involving a total of 25 interviews in one of four languages. Members of the respective clinical teams were also engaged in 25 formal interviews and four focus groups. A further 25 combined meetings between the clinical teams and respective families were observed and documented. In addition, 16 senior managers were also interviewed. Accessing hospital records for the study revealed that relevant demographic data were often incomplete. Quantitative analyses of the telephone survey demonstrated statistically significant differences between the CALD and Anglo-Australian cohorts in: access to appropriate information (language specific, accessible, non-technical and appropriately documented); as well as effective communication (with doctors, nurses, admission or clerical staff and other health staff). Comparisons contradicted assumptions of overuse of hospital resources by CALD clients. Interpreter services were moderately utilised but widely supplemented by informal and suboptimal channels. Qualitative exploration supported and further explained the findings. The findings of this research have demonstrated important differences, as well as gaps and shortcomings, in service provision for CALD families that lend themselves to both further study and to interventions aimed at continuing improvement.