Presentation is loading. Please wait.

Presentation is loading. Please wait.

Best Practices for Diversity and Inclusion Texas Tech University Health Science Center Paul L. Foster School of Medicine 3 rd Annual Cultural Competence.

Similar presentations


Presentation on theme: "Best Practices for Diversity and Inclusion Texas Tech University Health Science Center Paul L. Foster School of Medicine 3 rd Annual Cultural Competence."— Presentation transcript:

1 Best Practices for Diversity and Inclusion Texas Tech University Health Science Center Paul L. Foster School of Medicine 3 rd Annual Cultural Competence Conference March 28, 2014 Leon McDougle, M.D., M.P.H. Chief Diversity Officer Associate Professor of Family Medicine

2 As long as there is poverty in the world I can never be rich, even if I have a billion dollars. As long as diseases are rampant and millions of people in this world cannot expect to live more than twenty-eight or thirty years, I can never be totally healthy even if I just got a good checkup at Mayo Clinic. I can never be what I ought to be until you are what you ought to be. This is the way our world is made. No individual or nation can stand out boasting of being independent. We are interdependent. Photo Placement Here (Adjust as Needed) Excerpt from Morehouse College commencement June 1959 upon return from India King embarks on a month-long visit to India where he meets with Prime Minister Jawaharlal Nehru and many of Gandhi’s followers. http://mlk- kpp01.stanford.edu/index.php/encyclopedia/chronologyentry/1959_02_03 /

3 Objectives  Learn how to define diversity and inclusion and describe its strategic importance in patient care, education, and research.  Learn how to define your role in advancing diversity and inclusion.  Learn about best practices for diversity and inclusion at Academic Health Centers.

4 Diversity  Diversity as a core value embodies inclusiveness, mutual respect, and multiple perspectives and serves as a catalyst for change resulting in health equity.  In this context, we are mindful of all aspects of human differences such as socioeconomic status, race, ethnicity, language, nationality, sex, gender identity, sexual orientation, religion, geography, disability and age. [AAMC GDI]

5 Inclusion  Inclusion is a core element for successfully achieving diversity. Inclusion is achieved by nurturing the climate and culture of the institution through professional development, education, policy, and practice.  The objective is creating a climate that fosters belonging, respect, and value for all and encourages engagement and connection throughout the institution and community. [AAMC GDI]

6 Health Equity  Health equity is when everyone has the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance. [CDC]

7 7 Diversity 3.0 Diversity framed as means to address quality outcomes for all Focuses on differences beyond race and ethnicity Diversity acknowledged as strategic imperative to build innovative, high performing organizations Diversity 2.0 Focus on cultural competence and health disparities Closer attention to climate and culture Diversity office activities remain mostly parallel to mission and often under-resourced Diversity 1.0 Pursuit of racial/ethnic and gender access, fairness, and equality Success measured by head counts and retention rates Diversity is not central to institution’s mission or strategic planning [ Adapted from AAMC CDO Dr. Marc Nivet]

8 Diversity  Super Additive  Advances Mission  Patient Care  Education  Research

9 9 The Difference [Scott E. Page. Ph.D., Professor of Complex Systems, Political Science, and Economics at the University of Michigan]  Two heads are better than one only if they differ.  Cognitive differences can often be super additive: one plus one can equal three.  Diversity and ability complement one another.  Organizations, firms, and universities that solve problems should seek out people with diverse experiences, training, and identities. 9

10 Patient Care Minority Physicians’ Role in the Care of Underserved Patients: Diversifying the Physician Workforce May Be Key in Addressing Health Disparities [Marrast L, et al. JAMA Int. Med., Dec 30, 2013]  Methods: Cross-sectional analysis of 7,070 adults in the 2010 Medical Expenditure Panel Survey who identified a medical provider (not a facility) as their usual source of care.  Calculated unadjusted odds ratios to estimate the likelihood of having a nonwhite physician for patients who were racial and ethnic minorities, low income, Medicaid enrollees, uninsured, and non-English home language speakers.  Results: Nonwhite physicians cared for 53.5% of minority and 70.4% of non–English-speaking patients.  Patients of black, Hispanic, and Asian physicians were more likely to have Medicaid; patients of Hispanic physicians were more likely to be uninsured.  Conclusion: Nonwhite physicians provide a disproportionate share of care to underserved populations. Hence, increasing the racial and ethnic diversity of the physician workforce may be key to meeting national goals to eliminate health disparities

11 Patient Care The Impact of Multiple Predictors on Generalist Physicians’ Care of Underserved Populations [Rabinowitz HK, et al. Am J Public Health. 2000;90:1225–1228]  Methods: Questionnaire was sent to a stratified random sample of 2,600 allopathic physicians and 355 osteopathic physicians who graduated from a US medical school in 1983 or 1984 and whose self-reported specialty from the American Medical Association Physician Masterfile or the American Osteopathic Association Masterfile was family practice, general practice, general internal medicine, or general pediatrics without subspecialization.  The outcome variable of providing substantial care to underserved populations was defined as self-reports of either (1) having a medical practice in a federally designated underserved area (e.g., a Health Professions Shortage Area or Medically Underserved Area), (2) having a practice in which 40% or more of the patients are medically indigent (e.g., on Medicaid, uninsured), or (3) having a similar proportion of patients who are poor.  Multivariate logistic regression analysis was performed. 11

12 Patient Care The Impact of Multiple Predictors on Generalist Physicians’ Care of Underserved Populations [Rabinowitz HK, et al. Am J Public Health. 2000;90:1225–1228]  Results: Four independent predictors of providing care to underserved populations were (1) being a member of an underserved ethnic/minority group, (2) having participated in the National Health Service Corps, (3) having a strong interest in practicing in an underserved area prior to attending medical school, and (4) growing up in an underserved area.  Eighty-six percent of physicians with all 4 predictors were providing substantial care to underserved populations, compared with 65% with 3 predictors, 49% with 2 predictors, 34% with 1 predictor, and 22% with no predictors.  Sex, family income when growing up, and curricular exposure to underserved populations during medical school were not independently related to caring for the underserved.  Conclusion: A small number of factors appear to be highly predictive of generalist physicians’ care for the underserved, and most of these predictive factors can be identified at the time of admission to medical school. 12

13 Education Student Body Racial and Ethnic Composition and Diversity-Related Outcomes in US Medical Schools. [Saha S. et al., JAMA, September 10, 2008—Vol 300, No. 10]  Methods: A Web-based survey (Graduation Questionnaire) administered by the Association of American Medical Colleges of 20,112 graduating medical students (64% of all graduating students in 2003 and 2004) from 118 allopathic medical schools in the United States. Historically black and Puerto Rican medical schools were excluded.  Main Outcome Measures Students’ self-rated preparedness to care for patients from other racial and ethnic backgrounds, attitudes about equity and access to care, and intent to practice in an underserved area.  Results: See Figure 1. 13

14 14

15 15 Education Student Body Racial and Ethnic Composition and Diversity-Related Outcomes in US Medical Schools. [Saha S. et al., JAMA, September 10, 2008—Vol 300, No. 10]  Results (continued): Student body URM proportions were not associated with white or nonwhite students’ plans to practice in underserved communities, although URM students were substantially more likely than white or nonwhite/non-URM students to plan to serve the underserved (48.7% vs 18.8% vs. 16.2%, respectively; P.001).  Conclusion: Student body racial and ethnic diversity within US medical schools is associated with outcomes consistent with the goal of preparing students to meet the needs of a diverse population.

16 Education The Social Mission of Medical Education: Ranking the Schools. [Fitzhugh Mullan, MD, et al., Ann Intern Med. 2010;152:804-811]  Background: The basic purpose of medical schools is to educate physicians to care for the national population. Fulfilling this goal requires an adequate number of primary care physicians, adequate distribution of physicians to underserved areas, and a sufficient number of minority physicians in the workforce.  Objective: To develop a metric called the social mission score to evaluate medical school output in these 3 dimensions.  Methods: Secondary analysis of data from the American Medical AMA Physician Masterfile and of data on race and ethnicity in medical schools from the Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine. 16

17 Education The Social Mission of Medical Education: Ranking the Schools. [Fitzhugh Mullan, MD, et al., Ann Intern Med. 2010;152:804-811]  Methods (continued): Participants: 60,043 physicians in active practice who graduated from medical school between 1999 and 2001.  Measurements: The percentage of graduates who practice primary care, work in health professional shortage areas, and are underrepresented minorities, combined into a composite social mission score.  Results: Three historically black colleges had the highest social mission rankings. Public and community based medical schools had higher social mission scores than private and non–community-based schools.  NIH funding was inversely associated with social mission scores. Medical schools in the northeastern United States and in more urban areas were less likely to produce primary care physicians and physicians who practice in underserved areas. 17

18 18

19 19

20 Research Secret of Photo 51 [PBS]  James Watson and Francis Crick discovered the structure of DNA, but only by drawing on the work of many scientists who came before them, including Rosalind Franklin.  With all she did to make Watson and Crick's discovery possible, Rosalind Franklin was essentially "a de facto collaborator," says Lynne Osman Elkin. 20 http://www.pbs.org/wgbh/nova/tech/rosalind-franklin- legacy.html

21 21

22  "Homophobia is like racism and anti-Semitism and other forms of bigotry in that it seeks to dehumanize a large group of people, to deny their humanity, their dignity and personhood." — Coretta Scott King, Palmer House Hilton Hotel 1998.  “I still hear people say that I should not be talking about the rights of lesbian and gay people and I should stick to the issue of racial justice,” “But I hasten to remind them that Martin Luther King Jr. said, ‘Injustice anywhere is a threat to justice everywhere.’” “I appeal to everyone who believes in Martin Luther King Jr.’s dream to make room at the table of brother- and sisterhood for lesbian and gay people.” – Reuters, March 31, 1998. 22

23 Best Practices  Designation as Leader in LGBT healthcare across 4 core criteria 1) Patient Non-Discrimination a. Patient non-discrimination policy (or patients' bill of rights) includes the term "sexual orientation" b. Patient non-discrimination policy (or patients' bill of rights) includes the term “gender identity” c. Patient non-discrimination policy is communicated to patients and employees 2) Equal Visitation a. Visitation policy explicitly grants equal visitation to LGBT patients and their visitors b. Visitation policy is communicated to patients and employees 23

24 Best Practices 3) Employment Non-Discrimination a. Employment non-discrimination policy (or equal employment opportunity policy) includes the term “sexual orientation” b. Employment non-discrimination policy (or equal employment opportunity policy) includes the term “gender identity” 4) Training in LGBT Patient-Centered Care a. Staff receive training in LGBT patient-centered care (HRC offers free, expert online training to staff at all levels) 24

25 Best Practices  Incorporating Diversity and Inclusion within mission statement of Academic Health Center (AHC)  Designating Diversity and Inclusion as a core component of strategic plan  Developing Academic Health Center Diversity Council  Creating Diversity (Affinity) Networks  Measuring and monitoring AHC climate, e.g. Faculty Forward, Press Ganey, Diversity Engagement Survey  Comparing patient satisfaction across demographic groups  Community Advisory Councils  Minority business purchasing plan 25

26 Search Committee  Rooney Rule  Diversity Training  Unconscious Bias (Implicit Association Test)  https://www.aamc.org/video/t4fnst37/index.htm https://www.aamc.org/video/t4fnst37/index.htm  https://www.aamc.org/members/leadership/catalog/ 178420/unconscious_bias.html https://www.aamc.org/members/leadership/catalog/ 178420/unconscious_bias.html 26

27 Holistic Review (EAM) Across the AHC  Experiences: The path the applicant has taken to get where he or she is, e.g. being the primary caregiver for an ill family member, distance travelled, employment history, research experience, and experience in healthcare setting.  Attributes: The applicant’s personal characteristics and demographic factors, e.g., empathy, resilience, 1 st generation college student, sexual orientation, disability, race/ethnicity, and intellectual curiosity.  Metrics: Numerical evaluations, e.g. MCAT scores, GPA, and grade trends 27

28 28

29 Review  Learn how to define diversity and inclusion and describe its strategic importance in patient care, education, and research.  Learn how to define your role in advancing diversity and inclusion.  Learn about best practices for diversity and inclusion at Academic Health Centers 29

30  We need to help students and parents cherish and preserve ethnic and cultural diversity that nourishes and strengthens this community – and this nation. Cesar Chavez 30 Photo Placement Here (Adjust as Needed)


Download ppt "Best Practices for Diversity and Inclusion Texas Tech University Health Science Center Paul L. Foster School of Medicine 3 rd Annual Cultural Competence."

Similar presentations


Ads by Google