Hospital transfers: Whānau involvement in the healing equation

About this research

While all hospitalisations can be stressful for patients and their whānau, hospitalisations involving transfers away from home can be even more so and can present unique issues in terms of how whānau negotiate distance, unfamiliarity, active engagement and help-seeking. In this study, we are interested in better understanding how whānau facilitate support and remain actively engaged in the ‘care equation’ when a whānau member is transferred or hospitalised away from their home location.    

Knowledge of where whānau go and why in hospital care is important to understanding the flows of support and decision-making between whānau members and the significance of engagements with hospital staff, structures and systems. Our aim in this project is to understand and positively influence the interface between whānau and hospitals in order to present a roadmap of ways to facilitate active involvement in achieving optimal wellbeing outcomes for whānau members hospitalised away from home.

The overarching research question for this study is: How can whānau maintain active engagement in the care of their whānau member when they need hospital care away from their home base? In order to address this research question, the project will undertake activities across three inter-related and overlapping phases:

1. Description phase - To gain a comprehensive understanding of patterns of hospital transfers and experiences of whānau who wish to stay actively engaged in care
2. Engagement phase - To engage with stakeholders to better understand how the hospital system and broader policy contexts facilitate or hinder active whānau involvement
3. Uptake phase - To identify strategies or environments that promote active whānau involvement in care, and present a roadmap for sector uptake through the development of an implementation strategy.

A fourth phase will focus on dissemination of the research in order to generate, and contribute to, discussion on this subject.

Publicly-funded hospitals are large healthcare institutions with specialised staff and technologies where people are referred for care or present for acute care in the case of emergencies. For many people, hospitals can be anxiety-raising environments with unfamiliar routines, practices and encounters. Multiple people are involved throughout a patient’s interaction with hospital healthcare. There are many reasons patients and their whānau engage with hospital health services. Alongside this, centralised care has resulted in different levels of specialist services being available at different hospitals. No matter the reason for engaging with health care (acute, elective, or for a chronic condition), the significant parties are the patient and their whānau, the hospital system, and its staff. Holistic, whānau-centred care approaches have long been integral to Māori conceptualisations of health and wellbeing. When unwell whānau members are removed from the familiar context of their everyday lives, the world around them can become strange and feelings of vulnerability often arise.

This project will bring together researchers, whānau, hospital-based medical practitioners and Māori service providers to find ways to answer the question: How can whānau maintain active engagement in the care of their whānau member when they need hospital care away from their home base? This question is particularly salient when whānau members are transferred away from their home locations for hospital care. As each context can involve many stakeholders, this project will engage with a range of stakeholders for the purpose of outlining strategies that maintain Māori preferences for whānau to remain actively engaged and feel involved in the healing equation.

Grounded in Kaupapa Māori theory, a mixed methods approach will be used in the project to ensure that the research reflects Māori aspirations and makes a positive contribution to the everyday lives of Māori. The project includes three inter-related and overlapping phases - description, engagement and uptake - that involve a range of activities: a statistical report; an environmental scan; a scoping report that includes whānau interviews; provider interviews; collaborative work with stakeholders, and; the development of a roadmap to promote active whānau involvement.