We’re More Diverse; Now What? Your Unwavering Commitment to Excellence

Kenya Beard, EdD, AGACNP-BC, NP-C, CNE, ANEF

Learning Objectives

After completing this session, you will be better able to:

1. Discuss critical factors that undermine social justice.

2. Create environments that support diversity and inclusion.

3. Identify essential skills that create an ethos of respect and acceptance.

© University of Washington School of Nursing Continuing Nursing Education | UWCNE.ORG

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DR. KENYA BEARD,EDD, AGACNP‐BC, NP‐C, CNE, ANEF

ASSOCIATE VICE  PRESIDENT,  CURRICULUM  AND  INSTRUCTION  DIRECTOR,  CENTER  FOR  MULTICULTURAL  EDUCATION  AND  HEALTH  DISPARITIES, JERSEY  COLLEGE, TETERBORO,  NJ;  JOSIAH  MACY  FACULTY  SCHOLAR  2012

We’re More Diverse; Now What?Your Unwavering Commitment to Excellence

We’re More Diverse; Now What?Your Unwavering Commitment to Excellence

Kenya V. Beard EdD, AGACNP-BC, NP-C, CNE, ANEFAssociate Vice President for Curriculum & Instruction

Founding Director, Center for Multicultural Education & Health Disparities2012 Josiah Macy Faculty Scholar

We work hard!Have you taken call before 7 a.m.?

Do you educate our future healthcare providers?

Do you have your own practice?

Do you lobby to make a difference?

Are you committed to excellence?

Do you feel you’ve made a difference in healthcare?

Jeopardy! 

THE ATTAINMENT OF THE HIGHEST LEVEL OF

HEALTH FOR ALL PEOPLE

EQUITY

What is…

Attainment of the highest level of health for all people

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Advancing Healthcare Quality62 year old with a 10 year history of type 2 DM and HTN. BMI is 32Meds: Glyburide, Metformin, Metoprolol and Enalapril

Her Hgb A1c is 8.2Blood pressure is 154/90This is her 3rd visit with you and her B/P and Glucose level have not changed. What are the thoughts/assumptions?

Audience Responses

Poor compliance

Diet, depression & stress

Adherence

PurposeTo broaden the capacity of providers to create inclusive 

environments that ensure patient satisfaction

Discuss critical factors that undermine social justice.

Create environments that support diversity and inclusion.

Identify essential skills that create an ethos of respect and acceptance.

The State of HealthcareWhich statement is false?

1. Access to health care has shown significant improvement.

2. Everyone receives the same quality of health care.

3. Few disparities in patient safety measures have been reduced.

4. Race and socioeconomic status related disparities persist among measures of all National Quality Strategy priorities.

AHRQ 2015 Healthcare Quality & Disparities Report

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AHRQ Findings 2014

Overall Quality Racial/Ethnic Disparities

What are the Critical Factors that Undermine Social Justice? 

Figure 1: IOM Three‐Pronged Approach

Health Care Disparities

Racial or ethnic differences in the quality of care

Patient Factors

‐Refusal of services

‐Poor adherence to tx

‐Delay seeking care

Healing System Factors

‐Time constraints

‐Geographic  variability

‐Publicly managed care

Provider Factors

‐Prejudice

‐Clinical uncertainty

‐Provider stereotypes

Hall, W. J. et al. (2015). American Journal of Public Health 

Social Justice

Haider, A. H. et al (2011). JAMA 

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Tsai J. et al. (2016). Academic Medicine

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Provider Unconscious Bias or Stereotypes?

Systematic review of literature on racial disparities within the VA 

Less aggressive management (analgesic medication) of osteoarthritis in blacks compared to whites

Less cancer and cardiac related information given to black veterans as compared to white veterans

Appropriate test ordering was worse for non‐white veterans

Blacks more likely to be diagnosed with psychotic disorders (schizophrenia) and white veterans with affective disorders (depression)

http://www.hsrd.research.va.gov/publications/esp/RacialDisparities‐2007.pdf

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Implicit Bias

Attitudes or stereotypes that 

unconsciously affect our 

beliefs, behaviors, and decisions

Knowledge of Implicit BiasCould Help Strengthen Diversity & Inclusion

1. Everyone has implicit biases.

2. Implicit bias undermines efforts to advance healthcare quality.

3. Recognition of implicit bias requires a higher level of intellect.

4. Knowledge from prior experiences is used to quickly fill in gaps.

5. We rely on implicit assumptions when we feel rushed.

Critical Steps for Creating an Ethos of Respect & Inclusion

Assess Implicit Bias (take the IAT) & reflect on your stereotypes.

Believe in your intellect to recognize how implicit bias shows up.

Consider how automatic cognition influences behaviors.

Disconnect stereotypical links by recreating personal narratives.

How can we address implicit bias in a way that is non‐confrontational or accusatory?

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Critical Steps: Quiz

Implicit bias

1. What is one critical factor that undermines social justice?

Critical Steps: Quiz

Recognize implicit bias (take the IAT)

2. What can you do to support diversity and inclusion?

Critical Steps: Quiz

Recreate personal narratives. 

3. What essential skills can you apply to create an ethos or respect and acceptance?

What Stuck?An ‘Aha’ moment or pleasant surpriseSomething that you had to struggle with to understandSomething that you don’t agree withSomething that you agree with stronglySomething you thought was particularly interestingSomething you didn’t expectAn insight or solutionSomething you want to know more about or a question that you have

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