(upbeat music)
-: Welcome, thank you for joining us.
I'm Stacey Barrett, a research scientist in the division
of health quality evaluation at The Joint Commission.
I'm here today with Deb Sisco,
manager of patient advocacy and engagement
at University Health in Kansas City, Missouri.
It's a pleasure to be with you today, Deb
-: It's a pleasure to be here.
-: Today, we'll be discussing approaches
to prioritizing planning,
and beginning work to address healthcare disparities.
This process can feel daunting for many,
and often involves the coordination of efforts
across multiple departments.
It may include technology solutions, training, education,
as well as new or modified processes.
It can be overwhelming for an organization
to decide where to begin and how to best focus its efforts
to reduce healthcare disparities.
Prioritizing at least one area
is a really good way to start.
Deb, would you share a bit
about your healthcare equity core team of leaders,
and how you planned and prioritized screening efforts
for health related social needs
in your UH outpatient clinics?
-: I do want to make it clear that we have
an entire department that is dedicated
to equity and inclusion,
and members of that department also sit
on the core team for the social determinants of health,
which I think is really important.
So that core group really our job is to take ideas
and make them actionable for people.
And so I kind of go back to my roots as a school principal
when I think about actionable items,
we used to always think in terms of,
when I walk in what is it that I'm going to see,
or what is it that I'm going to hear?
If you can keep those two questions in mind
it really helps you operationalize what it is
that you want to see happen.
You can't just say we want equitable care.
What does that look like?
What does that sound like?
Those types of things.
So our job really is to make people comfortable with that.
And again, give people permission to learn,
give people permission to just put it out there,
make a decision to start somewhere,
and give yourself permission to make mistakes
and learn along the way.
-: Thanks, Deb, what would you say has been most instrumental
in helping you scope or focus your work and set your goals?
-: Most instrumental is the voice of the patient,
and what the patients and their families say the needs are.
We have to be careful that you're listening
from the very beginning,
and all the way through your processes.
Once you put processes into place
you also want some evaluation back from folks
about how is this working for you?
How does this make you feel?
What's missing? What could make this better?
We very typically take just about all of our work
to the PFAC and get feedback from them
about what's going on.
An example would be also in our food pantry,
when we opened the pantry,
we made sure we had a very simple evaluation form
that people could fill out at the end.
And you know those posters that you see
when people are inpatient that show your pain level
from the happy face, all the way down.
That's what we used is those faces and ask people
can you just circle how your experience was for us today?
And then gave them a place where
they could give us feedback.
So that's the most instrumental piece.
We're there for the patients,
we have to listen to what they say.
-: So Deb, in your previous answer, you mentioned the PFAC,
for those who don't know or aren't familiar
with what the PFAC is, would you mind kind of defining that
and explaining who they are?
-: Yeah the PFAC stands for
Patient and Family Advisory Council.
So these are folks that we recruit who in our case
they are either patients,
they are caregivers or they are patient employees.
You know, some employees that actually get their care
at University Health.
And these folks have agreed to come together
and work together on initiatives
that they feel are important.
And also to be the voice of our patients
and our caregivers in any of the work that we're doing.
They really stand on no decision about me without me.
-: Deb, how about collaborations within your organization?
In what ways did sort of cross-department,
or cross team partnerships really help drive
the focus of your work?
-: Probably one of the biggest ones is the work
being done with the cultural health navigators,
where we're working with language access
and having our interpreters actually become navigators
and be able to address needs for patients.
One of the most important things of that work
is the education that happens to staff
because as our interpreters/navigators
become real important parts of the core team,
just through conversation
and friendships and those types of things
they teach people a lot about other cultures,
and what's appropriate and what's not
in your communication style.
And they do those things in a way
that isn't threatening to people.
So that collaboration has been huge.
-: Once work is planned and prioritized Deb,
we know that there's a great deal of work
that goes into education, and training,
and technology, and process changes.
Would you just tell us a little bit about the efforts
that kind of help to make some of this work actionable?
-: Sure, all right so the patient walks in,
what do we see, what happens there?
Then the patient's roomed
what do we see what happens there?
And sometimes we'll do little notes off to the side
on the whiteboard while we're brainstorming together.
That'll tell it because we think about things like,
what does that look like?
What do we have to be careful of that we say?
What do we need to make that happen?
And so somebody will say, "Well, we need IT to do this."
Or, "We need to make sure that the person is doing this."
So keeping focused on that, what am I gonna see,
what am I going to hear, will always bring you to action
when your brainstorming
and bring you down to what exactly
is that work gonna look like?
-: Yeah definitely kind of a lot done
to support the implementation of this important work.
And like with everything, Deb
we know that there was probably a lot of challenges
that you've encountered along the way.
Could you share some of the challenges
that you've encountered as you've worked
to make this work actionable?
-: Well, one of the big challenges I think is really
making sure that you're getting people on board,
and that you're getting the right people on board.
It's a big culture change.
And so you have to be forgiving the fact that some people
may not get it at first and to them
all of this work is gonna look like
a number of different things.
"What do you mean I have to listen
to what the patient has to say.
I'm the medical professional here?
What do you mean you want me to now ask people
about things that are going on in their home?
That's not what this is about."
So you have to be patient with people
as that culture is changing
and trying to get them to think about it.
-: Any other successful strategies
that you wanna share with us?
-: As much as possible, bring different people to the table.
That that's probably one of the number one strategies
is to just bring people from different areas,
people with different ideas and concepts.
And ways that they work is also really very important.
Keeping those different perspectives
and those different work styles together,
and giving people the opportunity to give that input
is probably one of the greatest strategies
to overcome any barriers that you would come across.
-: Thanks, Deb, thanks for taking the time
to talk with me today about this very important topic
planning, prioritizing, and taking action
to address health related social needs
-: Thanks Deb. -: Thank you.
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