Bringing DEI and Human Understanding® to individual patients

While diversity, equity and inclusion (DEI) have long been discussed in healthcare, the question of how DEI is woven into the individual patient experience is still an open one.

In a Becker's Healthcare Podcast sponsored by NRC Health, Cami Mitelman, customer success manager at NRC Health, and Peggy Greco, PhD, Chief Patient Experience Officer at Nemours Children's Health, discussed DEI in the context of Patient Experience, the link between DEI-related initiatives and health outcomes and how to use existing tools and technology to realize positive results for individual patients.

Five key takeaways were:

  1. Identifying disparities and inequities is primary and must occur along multiple dimensions "When I think of diversity, equity and inclusion, I think of rural families without access to specialty care," Ms. Mitelman said. "I think of patients who speak a language that's not spoken by the medical staff, elderly patients without money for prescriptions and people of color who are uncomfortable going to a clinic because of concerns about being treated fairly. The common thread is that ignoring diversity, equity and inclusion may cause a patient's health to suffer. When we know where and why disparities exist, we can help our partners assess these disparities and measure the outcomes of their targeted interventions, addressing their patients' needs."

  2. Associate diversity can affect the patient experience. Typically, efforts related to DEI focus on the patient. However, it is also necessary to think about the diversity of associates and staff members. "Studies show that when there's concordance, or matching, between the race and ethnicity of the provider and the patient, there can be improved health outcomes," Dr. Greco said.

  3. It is important to incorporate DEI into a health system's metrics. Healthcare is a metrics-focused discipline. Unfortunately, incorporating DEI into health metrics has not been a priority until recently. Increasingly, Nemours and other health systems are monitoring various DEI metrics to identify any potential disparities in access, care, or outcomes.

  4. Nemours is focused on Human Understanding® and going well beyond medicine. Human understanding means knowing your patient, including the social, economic, behavioral and environmental factors that affect their lives, and treating each patient as a distinct individual. Focusing on the individual patient and their broader experience is connected with a patient's health outcome. "There's a lot of exciting ways in which human understanding helps inform our understanding of what individuals need and that allows us to go well beyond medicine," Dr. Greco said.

    An example of a specific action Nemours has taken is to ensure that all patients, no matter their race, ethnicity or language, understand recommendations and know how to have their questions answered.  This goal is being accomplished through specific tactics such as an increase in interpreters, enabling printing of recommendations in multiple languages from the EMR, and providing educational materials in different languages. Improved understanding by patients is associated with a reduced risk of returning to the emergency department.

  5. Health systems can use tools and technology to address DEI within healthcare settings. "For example, most health systems administer a patient experience survey post-visit or post-discharge," Dr. Greco said. Health systems should evaluate whether their response rates are representative of their patients and communities and also consider responses in light of demographic variables. "Cami and her team at NRC developed a tool that allows us to examine individual survey items by race, ethnicity and language," she said. "In that way, we are able to identify the items that have the greatest disparity, allowing us to prioritize those for improvement."

Focusing on DEI metrics and bringing DEI and human understanding to the individual patient level can significantly improve the patient experience and potentially even health outcomes.

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