Where we live, learn, work and play matters to your company or organization: One hospital director highlights their work to delivering culturally competent care
A few weeks ago, patients, staff and providers at my organization celebrated our second annual Diversity Day, where staff, programs and community partners come together to “break bread” and share information about their ethnic community or affinity group. It was an overwhelming success: 12 table displays of different countries, several focusing on distinct community partnerships with refugee resettlement programs or employment programs with disabled individuals. We had delectable food samplings from around the world and a local Croatian Polka band got folks up and dancing. We also awarded our first annual Kaleidoscope Diversity Award recipient, which honors and recognizes exceptional employees or departments that consistently support diversity and inclusion in the workforce and community through their work by creating a climate of acceptance and understanding for our multicultural and multilingual employees and patients. The celebration was also simulcast to other Children’s Mercy locations, too.
Diversity Day’s intent was to be a recognition of our staff and patients’ families. It was also intended to be a celebration of our diversity. But we felt compelled to also begin a dialogue about some difficult subjects – the impact of social determinants of health and our patient’s access to culturally competent health care. It is important to point out, though, that Diversity Day could have been designed as a more general cultural competency class. But as an organization, Children’s Mercy had been discussing and designing programs and education around cultural competent health care and larger health equity issues for several years. From that process, we felt that there was a certain amount of readiness to push some of the edges and expand the discussion beyond what some might normally expect during Diversity Day. This decision to raise the issues and engage in a moderated conversation about social determinants can be delicate and potentially volatile, especially when discussing a stigmatized issue like institutional racism. An organization must have a certain degree of readiness, and executive champions to initiate the dialogue and address such issues.
For this year’s Diversity Day, in addition to the festivities, we opted to use a video series called Worlds Apart to bump the discussion up a notch and get people thinking about diversity in a new way. The celebration was important, but just as important was to honor and acknowledge some of the history. It has moving stories about cross-cultural healthcare. We chose to begin our session with Robert’s story, which focuses on his experience as an African-American, End-Stage Renal Disease patient on dialysis, who is waiting for a kidney transplant. Robert reflects on his perception of racism within the organ transplantation system. While Robert’s story is told with candor and humor, it can still be a bitter pill to swallow, because it addresses taboos that are not yet comfortable to discuss openly. Among them, he makes comments about “the system not wanting to give organs to black men,” the disturbing and painful historical wrongs of the Tuskegee experiment.
As we anticipated, there was little discussion in the public forum after the video clip; however it did generate much private conversation and reflection after the fact. I heard from one physician in the audience, over the weekend. She reflected that it took her a good 24 hours to process the meaning and relevance of the video, but that moving forward it will have an impact on her clinical decisions.
A second video clip of a Cambodian mother with a sick child was shown and generated more reflections and more discussion, and how these intertwined issues can all affect the health care we give and receive.
Admittedly, our approach to this conversation was risky. These conversations are hard to have on individual and organizational levels. But anecdotal feedback and evaluations indicate that we succeeded in raising overall awareness on social determinants of health and, more so in cultivating a safe environment for future discussions.
Looking forward, we hope to inspire even more dialogue and reflection at next year’s Diversity Day. Using the best practices identified by the National Quality Forum, we are guiding our work and making strides along the way. While some of the discussions and issues raised are hard bring up, our experience with Diversity Day has been worth it. If our work, and the work of other organizations, is able to raise the awareness of even a few people, it has the potential to change practice behaviors down the road.
Gabriela Flores
Gabriela Flores is the director of the Office of Equity and Diversity, Children’s Mercy Hospital and Clinics. For more information, contact Ms. Flores.
The opinions and views expressed in this blog and/or comments are those of the author(s) and do not reflect any position of the Center or the University.
While I think it is wonderful to offer a diversity day for people to comfortable ” analyzing” how others may perceive the world differently, a better activity would be one that teaches you how to interact with another person so that they are given the same respect,care, and empathy that you would expect or desire if you were that other person. Please understand that almost everyday people who look different from the “authoritative” figure are frequently reminded that they are being treated differently than others who look similar to authoritative figure. Unfortunately, some of those who look differently are told through direct and indirect actions, gestures, and body language that not only are they different, but they are not wanted. Those activities that solicit empathy instead of sympathy should be the ones implemented in a Cultural Diversity Program.
Thank you for your comment and observation! I failed to mention in the original blog post that we have a concurrent “Service Excellence” initiative which engages staff in a shared definition and expectations around care, service and respect. Importantly some of those concepts are entirely relative and often subjective, so we worked through a thorough consensus process to redefine shared values and set expectations from from an organizational perspective. The underpinnings of this initiative are focused on patient/family centered care through developing cultural competency skills. However, an organization must first be ready to engage in this work, which requires some general awareness raising.
I agree with most of what has been said. One area that must be address is that of the medical community being on one accord about the excess to Health care, when some are saying,” Give us affortable health care” and the other are saying,”If you don’t have money,you get what you paid for”. I have heard both sides of the subject. People will hear what the Mass media put forth on the subject. The way we treat those who where born in the country and have a long family history in this land, can’t receive excess or very limited excess, but they see more effort for the new. Manage disease will allow raceism and un-manage disease such as outbreaks of all kind will bring some unity. Money & disease & how it is applied will be the great unity builder or divider.