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In this final part of a three-part video series, Briana Contreras, associate editor of MHE, spoke with Dr. Maria Hernandez, founder and CEO of Impact4Health. Maria shared not only how healthcare inequities remain to be an issue and what needs to be addressed, but also the progress that has been made over time through awareness, conversations and laws, especially due to the heightened awareness of inequities caused from the COVID-19 pandemic and the tragic deaths of George Floyd, Breonna Taylor and many more - which have now occurred over a year ago.
Below is a brief Q&A of the interview with Hernandez that has been edited for clarity.
Q: What can healthcare networks do to improve equity and inclusion for staff and patients?
A: The number one thing that we need to start off with is looking at the data. We cannot just be comfortable saying, "On average, our patients experience our hospital in a very positive way." We need to now start looking at data through those demographic groupings that are so important.
So it's race, ethnicity, language preference, sexual orientation and gender identity. Those are major groups of demographic information that we need to look at. It's hard to do, believe it or not. As much as we think that all this data is collected on us inside our medical records, not all hospitals have started to actually ask those questions of people as they come in for care. It's a journey now to try and catch up and collect that data on the patients that are being seen. So that's number one.
I think the second is that someone has to be responsible for looking at that data. I can't tell you how often we find out that a hospital might have that data available, but no one's asking about it. Peter Drucker once said, "If it isn't being measured, it's not being managed. My new thing is, if no one's asking, and everyone's even asking to measure it, we're in trouble. Right? So that energy that focuses on asking those tough questions, "how are we doing with those different communities that we serve?", "how do they experience our facility, our staff, our services?" Those are the tough questions that have to start actually, even at the board level. The boards of hospitals need to be able to hold the c-suite accountable to those metrics, and that information, and to really get out in the community and talk to people about "what can we do to improve?", "how can we make this better?"
So there's plenty of activity out there now that I think is headed in the right direction. I would say those two are the primary places to start. It's the data. It's what you know about that experience, and making sure you're responding to the communities with feedback and and testing the waters with them about what you're going to try and do, and not try to do it in a vacuum. So having a Health Equity Council formed with community members, is often a good way to hear that voice at the table.
Q: Anything else you'd like to share with our listeners?
A: The only other thing I'd share, it's something that I'm being asked in different interviews about what patients can do, right? So if you're a person of color, and you're about to go in to see your physician, what should you try to manage and look out for?
One of the interesting statistics that I read along the way is that physicians interrupt their patients 18 seconds into their appointment. That might not be hard for someone who's really comfortable speaking English (to the physician), or someone who doesn't have some anxiety about the authority figure that they're working within their patient experience.
I talk a lot about having a patient advocate with you - someone who's going to be there to support you during your appointment - a family member, a trusted friend, someone who knows what your concerns are, who can watch the interaction, support you and make sure you're getting your needs met. It can be sometimes really intimidating, or there's other factors at play -the person might be really anxious, and having someone there that they are comfortable sharing the information with is key.
So bring your own patient advocate. I think that's important for for families of color to know.