WORCESTER MEDICINE
JEDI or Die Diversity, Equity and Inclusion in Health Care Continued diversity in health care reflects the diversity of the communities we serve and to accept nothing less than that. This will benefit the lives and the livelihoods of our patients. Identifying and developing talent from an early age is a necessary step toward eliminating the myriad health disparities that are exacerbated by the structural and systemic inequities which are so pervasive in our society and so damaging to the lives and well-being of all of our patients. Additionally, addressing systemic and structural inequities in under-resourced communities is tantamount to eliminating racial and ethnic disparities in STEAM education. Eliminating structural inequities in education, ranging from K-12 all the way through medical education and residency training requires partnerships and collaborations with community-based organizations, including outreach and funding support from local hospitals and community health care foundations (Increasing Diversity in Science and Health Professions: A 21-Year Longitudinal Study Documenting College and Career Success | SpringerLink). A collective and coordinated effort from every segment of our community will be required to redress the original wrongs of our country, i.e., slavery, oppression, segregation and racism, and the long-term destructive impact that systemic racism has on K-12 education, health equity, generational wealth and cultural exposure. +
References 1.Mark D. Johnson, MD, PhD, FAANS Maroun Semaan Professor of Neurological Surgery, Chair, Department of Neurological Surgery, Senior Consulting Vice Provost for Mentorship, Leadership and Transformation 2.Brian Gibbs, PhD – Chief Diversity and Inclusion Officer, UMass Memorial Health Care 3.Marlina Duncan, EdD – Vice Chancellor for Diversity and Inclusion, University of Massachusetts Medical School 4.Milagros Rosal, PhD, MS – Vice Provost for Health Equity, University of Massachusetts Medical School Mark D. Johnson, MD, PhD, (1,2) Marlina Duncan, EdD, (1) Milagros C. Rosal, PhD., MS, (1) Brian Gibbs, PhD (2) 1. University of Massachusetts Medical School, Worcester, MA 2. UMass Memorial Health, Worcester, MA 14
Nursing Notes: Concordance on the Front Lines of Patient Care Delivery Kenneth Peterson, PhD FNP-BC Jaya Rawla Everlyne Njoroge shown left to right
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community leading change and improving health and well-being for many patients. We are nurses, on the front lines of care delivery, modeling effective actions through our commitment and dedication to the values, beliefs, attitudes and behaviors supporting sociocultural, ethnic and racial diversity. In these tumultuous times, where serious health threats and poor outcomes for minoritized and marginalized people in our communities continue to escalate, we need to call attention to essential provider qualities likely to mitigate the inequities of unequal care. In this short piece, we share our thoughts on what we believe matters most in the provider-patient relationship. on concordance
Patients deserve respect, dignity, peace of mind and improved health when they participate in health care. Unfortunately, health disparities reveal this isn’t always the case. How we behave and what we do to relate to and engage our patients is key to successful encounters and outcomes of care. These actions are especially important in situations where concordance in the provider-patient relationship is not possible. Concordance – matching gender, race or ethnicity and other patient characteristics to that of the provider – is a popular practice improvement strategy. [1,2] It became popular following the 2003 release of the Institute of Medicine’s report “Unequal Care.” Unfortunately, achieving concordance remains a challenge given the limited sociocultural, racial and ethnic diversity of care providers in the health care workforce. Despite challenges in achieving concordance, we believe that providers can improve in their behaviors and actions supporting respectful, equitable and health-producing care. This improvement process first begins with becoming aware of the unique identities of our patients and ourselves and second from appreciating the learning that results from valuing difference. on identity and difference
Identity is an evolving amalgamation of demographics, beliefs and lived experiences in the context of a broader sociocultural landscape. Identity is multidimensional; it can be fluid and invisible. The complexity of identity has profound implications on the provider-patient relationship. We, and nursing colleagues, as members of minoritized racial, ethnic and sociocultural groups recognize racial, ethnic, linguistic and/ or sociocultural concordance with patients as important factors in building trust, creating patient buy-in and setting up the potential for implementation of effective relationships to improve health and well-being. MAY / JUNE 2021
