Making progress on anti-racism and health equity at UCLA Health
Motivated by the protests against racism and police violence during the summer of 2020, a number of UCLA Health departments, divisions and units organically began to take measures to advance health equity, diversity and inclusion in their respective areas of influence.
On Monday, June 21, nine departments shared their efforts and progress with nearly 400 attendees including hospital leaders Johnese Spisso, president of UCLA Health and CEO of the UCLA Hospital System; Robert Cherry, MD, chief medical and quality officer at UCLA Health; Richard Azar, chief operating officer at UCLA Health; and Karen Grimley, PhD, RN, chief nursing executive at UCLA Health. Medell Briggs-Malonson, MD, MPH, chief, Health Equity, Diversity and Inclusion, hosted the internal event alongside Mikel Whittier, MHA, director, Health Equity, Diversity and Inclusion.
This system-wide presentation, the first of its kind for UCLA Health, will occur annually to highlight best practices, lessons learned and the progress of the various departments in furthering HEDI and anti-racist efforts.
Center for Community Outreach and Policy, UCLA Stein Eye Institute, presented by Anne Coleman, MD, PhD, Fran and Ray Stark Foundation professor of Ophthalmology at Department of Ophthalmology at the David Geffen School of Medicine at UCLA, emphasized the value and importance of multidisciplinary collaboration – with the DGSOM, Fielding School of Public Health, Care Harbor and Los Angeles Dodgers.
The UCLA Mobile Eye Clinic project targets populations that are under-resourced and vulnerable: school-age children, people experiencing homelessness, people with conditions that affect the eyes such as diabetes and systemic hypertension, and those who are unable to access eye health resources due to lack of insurance, transportation, access or language barriers.
It is the longest continuous eye operation on wheels since 1975 and has served nearly 300,000 individuals.
The LGBTQ+ Equity Pilot Program was presented by Colleen McCord, LCSW, associate chief social worker and Erika Lozano, MSN, RN-BC, clinical specialist in the child and adolescent unit at 4 West Child and Adolescent Psychiatry.
The program, an in-patient unit for children and adolescents at the Resnick Neuropsychiatric Hospital at UCLA, is improving gender affirming care for youth by supplying safe chest binders which can be used during their hospitalization. Chest binding is a method people employ using sports bras, bandages or elastic materials to give the appearance of a flat chest.
Lozano said LGBTQ+ youth are more likely to experience adverse mental health outcomes due to rejection, trauma and discrimination. For some LGBTQ+ adolescents, supporting their identities can be especially difficult in a health care setting where access to materials may be limited.
Using sensitive and evidence-based care, 4 West aims to add more chest binders and gender-affirming practices to ensure all youth feel accepted and themselves.
The MarComm HEDI Workgroup represented by Shonda Peterson, strategy program lead; Nick Carranza, senior content marketing strategist' and Jocelyn Apodaca Schlossberg, senior writer – diversity, shared the progress of the dedicated HEDI work group.
The group was created organically to affect change within the Marketing and Communications Department at UCLA Health. Those efforts include purposefully creating stories, language and images through an HEDI lens, according to specific goals and timelines.
Members also recently created a paid pilot internship for high school students, which will provide students from historically overlooked and excluded areas and backgrounds with an opportunity to learn about marketing and communications in health care. Two interns were chosen out of 165 applicants; they begin in July.
The Perinatal EDI Coalition and Anti-Racist Neonatal Care Working Group presented together to discuss how their work is improving maternal and infant mortality among Black and Indigenous and People of Color (BIPOC).
Presenters Tara Goldberg and Ronda McPhail, clinical quality improvement specialists; Mya Zapata, MD, obstetrics service chief at Ronald Reagan UCLA Medical Center; Animesh Sabnis, MD, MSHS, medical director of UCLA Newborn Nurseries and medical director of Neonatology Antenatal Counseling; and Debbie Suda, senior director of Mattel Children’s Obstetric Services, shared the multidisciplinary approach these teams are taking to ensure quality and safe practices for birthing people and their babies.
For example, the Perinatal EDI Coalition partnered with the California Maternal Quality Care Collaborative to better understand their birth equity data and implemented a patient experience survey to measure their impact.
The LGBTQ+ Early Authentic Clinical Experience was presented by Gifty-Maria Ntim, MD, primary care physician at UCLA.
There is a lack of formal education in medical schools on LGBTQ+ training which can negatively affect patient care and experiences, Dr. Ntim said. To fix this, she and her colleagues created a curriculum for first-year medical students that takes into consideration the many nuances, experiences and health concerns of the LGBTQ+ community, including mental health and gender health. With feedback from the first cohort of medical students, the curriculum is being restructured to provide more patient touchpoints with students.
A Systemwide Approach to Community Service Referral Platform was presented by Nikki Miller, director of business operations for the UCLA Health System Faculty Practice Group and Naveen Raja, DO, medical director of population health at UCLA.
They found a digital communication gap when referring patients out to community-based organizations such as food banks and housing programs. The pain points, they said, happened during the referral process when staff were unfamiliar with community organizations, the organizations had incomplete or out-of-date resource lists, and when the organizations lacked electronic referral methods.
Miller discussed the need for a University of California Health (UC Health) single vendor system with embedded technological capabilities and CareConnect integration.
Last year, UC Health established a social determinants of health work group with subject matter experts from each UC location to collaborate on this single vendor system. In June 2021, UC Procurement and UC Health launched a request for proposal (RFP) to identify a community service referral platform vendor. They expect to make a selection this summer.
This platform will make it easier to refer patients to community-based social services, track their outcomes and measure data.
The UCLA Health IT EDI Collaborative was presented by Tiffany Barrett and RoShawnda Willingham, both Care Connect analysts in the Information Technology Department at UCLA Health.
Three subcommittees emerged out of their discussion on ways to incorporate EDI and anti-racism concepts into the workplace, Barret said:
- The Listen and Learn Workgroup, with the help of an EDI consultant, explores how to dismantle white supremacist organizational culture.
- The Black Advocacy Workgroup focuses on action and representation of Black colleagues, closing the diversity gap and standardizing hiring and recruitment.
- The Patient Advocacy Through Technology Workgroup helps to better optimize technology, data collection and analytics to improve patient care through an EDI lens. They began a journal club to explore how technology, medicine and EDI intersect.
The Talk: Addressing Racism and Anti-Diversity was presented by Michelle Marlowe, LCSW, manager in Pediatrics at Ronald Reagan UCLA Medical Center, and Alexandria Hagler, LCSW, social worker at UCLA Health. The two say their goal was to encourage diversity, anti-racist efforts and action in the Care Coordination Department after the messages UCLA Chancellor Gene Block and UCLA Health leadership sent out following the murder of George Floyd.
“It was the first time for many that a large organization had a clear stance on what was going on,” Hagler said.
The group created a curriculum filled with podcasts, journal articles, TED Talks and movies to recommend to the department and discuss in small groups. The team wanted to gather measurable data on this effort, so they submitted their proposal to the Institutional Review Board, which monitors research involving human participants.
Based on their pre- and post-survey results, Hagler and Marlowe say participants feel relief from anxiety, and that it has been therapeutic to share how they feel among the department.
A review of the data they’ve collected over the past eight months, they say, shows that the care coordination department has an increased awareness of the effects and impact of racism, and intends to continue reflecting on personal biases.
Prehospital Care Equity, Diversity and Inclusion was presented by Carmina Lu, center administrator for the UCLA Center for Prehospital Care. On June 10, she said, following the protests seeking justice for the murder of George Floyd, the Center shut down academia and didn’t want to have “business as usual,” to address what was happening in our country.
“We wanted to make an effort so that everybody could participate, including those people who are often at the front lines and can’t just shut down their office, their practices,” Lu said.
The group conducted an EDI Waggl survey and in October began working with Ky Pham, senior organizational development consultant at UCLA Health, to formalize Cultural North Star discussions. The Center has also completed the Courageous Civility Training, by Shola Richards, and intends to kick off an EDI curriculum committee.
The Center, which comprises phlebotomy, paramedic, EMT and American Heart Association courses, serves 15,000 students each year.
Read more about health equity, diversity and inclusion efforts at UCLA Health.