We re More Diverse; Now What? Your Unwavering Commitment to Excellence

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1 We re More Diverse; Now What? Your Unwavering Commitment to Excellence Kenya Beard, EdD, AGACNP-BC, NP-C, CNE, ANEF Learning Objectives After completing this session, you will be better able to: 1. Discuss critical factors that undermine social justice. 2. Create environments that support diversity and inclusion. 3. Identify essential skills that create an ethos of respect and acceptance.

2 We re More Diverse; Now What? Your Unwavering Commitment to Excellence We re More Diverse; Now What? Your Unwavering Commitment to Excellence DR. KENYA BEARD, EDD, AGACNP BC, NP C, CNE, ANEF ASSOCIATE VICE PRESIDENT, CURRICULUM AND INSTRUCTION DIRECTOR, CENTER FOR MULTICULTURAL EDUCATION AND HEALTH DISPARITIES, JERSEY COLLEGE, TETERBORO, NJ; JOSIAH MACY FACULTY SCHOLAR 2012 Kenya V. Beard EdD, AGACNP-BC, NP-C, CNE, ANEF Associate Vice President for Curriculum & Instruction Founding Director, Center for Multicultural Education & Health Disparities 2012 Josiah Macy Faculty Scholar We work hard! Have you taken call before 7 a.m.? Do you educate our future healthcare providers? Do you have your own practice? Do you lobby to make a difference? Are you committed to excellence? Do you feel you ve made a difference in healthcare? Jeopardy! What is THE ATTAINMENT OF THE HIGHEST LEVEL OF HEALTH FOR ALL PEOPLE EQUITY Attainment of the highest level of health for all people 1

3 Advancing Healthcare Quality 62 year old with a 10 year history of type 2 DM and HTN. BMI is 32 Meds: Glyburide, Metformin, Metoprolol and Enalapril Her Hgb A1c is 8.2 Blood pressure is 154/90 This is her 3 rd visit with you and her B/P and Glucose level have not changed. What are the thoughts/assumptions? Audience Responses Poor compliance Diet, depression & stress Adherence Purpose To broaden the capacity of providers to create inclusive environments that ensure patient satisfaction Discuss critical factors that undermine social justice. Create environments that support diversity and inclusion. Identify essential skills that create an ethos of respect and acceptance. The State of Healthcare Which statement is false? 1. Access to health care has shown significant improvement. 2. Everyone receives the same quality of health care. 3. Few disparities in patient safety measures have been reduced. 4. Race and socioeconomic status related disparities persist among measures of all National Quality Strategy priorities. AHRQ 2015 Healthcare Quality & Disparities Report 2

4 AHRQ Findings 2014 Overall Quality Racial/Ethnic Disparities What are the Critical Factors that Undermine Social Justice? Provider Factors Prejudice Clinical uncertainty Provider stereotypes Health Care Disparities Patient Factors Refusal of services Poor adherence to tx Delay seeking care Racial or ethnic differences in the quality of care Healing System Factors Time constraints Geographic variability Publicly managed care Hall, W. J. et al. (2015). American Journal of Public Health Figure 1: IOM Three Pronged Approach Social Justice Haider, A. H. et al (2011). JAMA 3

5 Tsai J. et al. (2016). Academic Medicine 20 Provider Unconscious Bias or Stereotypes? Systematic review of literature on racial disparities within the VA Less aggressive management (analgesic medication) of osteoarthritis in blacks compared to whites Less cancer and cardiac related information given to black veterans as compared to white veterans Appropriate test ordering was worse for non white veterans Blacks more likely to be diagnosed with psychotic disorders (schizophrenia) and white veterans with affective disorders (depression) Implicit Bias Attitudes or stereotypes that unconsciously affect our beliefs, behaviors, and decisions pdf 21 Knowledge of Implicit Bias Could Help Strengthen Diversity & Inclusion 1. Everyone has implicit biases. 2. Implicit bias undermines efforts to advance healthcare quality. 3. Recognition of implicit bias requires a higher level of intellect. 4. Knowledge from prior experiences is used to quickly fill in gaps. 5. We rely on implicit assumptions when we feel rushed. Critical Steps for Creating an Ethos of Respect & Inclusion How can we address implicit bias in a way that is nonconfrontational or accusatory? Assess Implicit Bias (take the IAT) & reflect on your stereotypes. Believe in your intellect to recognize how implicit bias shows up. Consider how automatic cognition influences behaviors. Disconnect stereotypical links by recreating personal narratives. 4

6 1. What is one critical factor that undermines social justice? Implicit bias Critical Steps: Quiz 2. What can you do to support diversity and inclusion? Recognize implicit bias (take the IAT) Critical Steps: Quiz 3. What essential skills can you apply to create an ethos or respect and acceptance? Recreate personal narratives. Critical Steps: Quiz What Stuck? An Aha moment or pleasant surprise Something that you had to struggle with to understand Something that you don t agree with Something that you agree with strongly Something you thought was particularly interesting Something you didn t expect An insight or solution Something you want to know more about or a question that you have 5