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Patient-Centered Care Requires Diversity, Equity, and Inclusion

By Dr. Veronica Martin-Posley, RN, NEA-BC, Division Sr. Vice President and Chief Nurse Executive at St. Luke’s Health


October 27, 2022 Posted in: Leadership
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Health care is evolving. We’re doing much more than treating medical conditions and sending patients home. Most of us now aspire to provide high-quality, patient-centered care, which comes with an understanding that every person who walks into a health clinic or hospital, whether a patient or a team member, has a unique set of beliefs, personal history, and identity. Meeting each of these people where they are and recognizing we are stronger, more capable, and healthier when we work together is at the core of diversity, equity, and inclusion (DEI).

Getting Started

When we focus on creating more DEI in health care, we build better relationships with other health care professionals, increase trust among our patients, and improve the health of the entire community. Three essential components to developing a strong DEI presence in your health care organization include:

  • Addressing health disparities and expanding access to services in our
  • communities
  • Improving outcomes for the individuals who live in those communities
  • Recruiting and retaining exceptional care teams that reflect the inherent richness present within our communities

Healing Our Communities Heals Our Patients

Health care services don’t begin after a doctor or nurse enters the exam room. It begins in the community. For health care to be effective, we must understand the social determinants of health—the barriers that keep some populations on the sidelines. Several factors play a significant role in how physically and mentally healthy we are, including:

  • Access to quality education
  • Community resources and services, including access to food and sanitation
  • Cultural views related to health, medicine, and wellness
  • Environmental factors, such as access to green space and air quality
  • Employment opportunities
  • Health care access and health literacy
     

The U.S. Department of Health and Human Service’s Healthy People 2030 objectives, developed by a wide range of experts from various backgrounds and cultures, focus on addressing many of these “upstream” factors, which are generally unrelated to health care delivery. This is something we all need to do. 

To build and maintain healthy communities, we need to address issues of inequity and increase fair and just access to services and resources in our clinics, hospitals, and elsewhere. Achieving health equity—when all people can reach their highest level of health, regardless of circumstances—should be our No. 1 goal as health care professionals. To do this, we can create:

  • Culturally competent community health education and health literacy campaigns. At St. Luke’s Health, we developed the ExamiNATION series to communicate the importance of putting people first.
  • Partnerships with community organizations, schools, and other stakeholders to increase awareness of health-related issues. The St. Luke’s Health S.O.D.A.S (Situations, Options, Disadvantages, Advantages, Solutions) program is a violence prevention initiative that educates young adults and helps them make better decisions.

Inclusivity 

Research shows when people feel heard and valued, health improves, as evidenced by reduced blood pressure and self-reported pain. In many cases, small interactions between people over time have the greatest impact on individual and community health and wellness.

Unfortunately, microaggressions—those tiny, negative, verbal or nonverbal messages related to someone’s connection to a marginalized group—still happen during everyday conversations or brief interactions. The behavior is often unintentional but still harmful. When people feel they are being treated differently, ignored, dismissed, and unheard, they’re at higher risk of anxiety, depression, hypertension, poor diabetes management, substance use disorders, and frequent hospitalizations.

Raising awareness of the existence and importance of eliminating microaggressions and building cultural competence help create positive experiences for patients and staff alike. Such an inclusive approach forms the foundation for building trusting relationships which can increase patients’ understanding of their conditions and motivate them to actively participate in their care plan.  

In addition, alternative health care options, such as Project E.C.H.O. (Extension for Community Healthcare Outcomes), help individuals who may skip appointments due to caregiving, chronic conditions, lack of transportation, or other barriers. Initiatives to lower the cost of care and improve access to health insurance or other payment options are also needed. Finally, training in diversity, equity, and inclusion she be required for all team members.

Recruitment and Retention 

The rich tapestry we see in our community should be reflected in our staff at all points of care. As colleagues, we learn more about the many community-based, cultural, environmental, and historical factors that influence all of us, the communities where we live, and the systems impacting our lives. 

This also builds awareness of culture-related protective factors and helpful community resources we may not have been aware of previously.

For our patients, it builds trust and sends a message they are valued and respected and will receive access to high-quality health care regardless of their age, gender, race, religion, socioeconomic class, and other factors or identities.

At St. Luke’s Health, we’re building a diverse team and inclusive workplace with:

  • Hiring programs that leverage community knowledge and resources 
  • Increased opportunities for professional development and advancement through our Career Pathways program and other initiatives
  • Supporting efforts to train and recruit people from marginalized or underrepresented communities, such as supporting scholarships for students of color who want to pursue a career in health care

From large-scale initiatives to small, simple acts of everyday kindness, we each can and do make a difference.


Learn more about how we’re working to make St. Luke’s Health a great place to work

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