Cultural Safety and Duty of Care: The Role of Patient-Facing Administrative Staff in Hospital-Based Health Services

Abstract

Abstract

Introduction: This review examines how patient-facing administrative staff contribute to culturally safe environments in hospital-based health services in New Zealand and Australia and the implications for workplace health and safety and duty of care.

Methods: The review followed Arksey and O’Malley’s (2005) methodological framework alongside the JBI scoping review guidelines (Hadie, 2024). Ten empirical studies examining patient-facing administrative roles based in hospital settings in relation to culturally safe practice or patient interactions relevant to cultural safety met the inclusion criteria.

Findings: Three broad themes were identified, with a strengths-based approach to improve practice: improving patient experiences and expectations; increased opportunities for cultural safety training; and supportive organisational culture. Across the studies, cultural safety was inconsistently defined and operationalised. The role of patient-facing administrative staff as the initial interface between patients and hospital-based health services was often overlooked. Research and training were typically integrated with clinical staff, limiting recognition of the unique contributions of administrative staff. Role ambiguity, limited support and psychosocial workplace pressures were identified as challenges affecting culturally safe practice.

Conclusion: The findings from this review provide some important understandings of the health workplaces duty of care for both people who are accessing healthcare services and those employed to support the delivery of health care.  There is a clear need for research that prioritises patient-facing administrative staff in the design, implementation and evaluation of culturally safe practices in hospital-based health services. Future studies should define culturally safe practice for non-clinical roles and develop tailored training frameworks grounded in cultural, structural and emotional competencies. Mixed-methods approaches with methodological triangulation to better capture both patient and administrative staff perspectives are recommended. Such evidence is essential for developing tailored training, support systems and workplace conditions that enable patient-facing administrative staff to contribute to culturally safe practice across the patient journey.