In 2018, the University’s Health System was recognized by BlackDoctor.org as among the top 60 hospitals for diversity nationwide. In the three years since, medical professionals in the School of Medicine, School of Nursing and University Hospital have continued to make it their goal to uphold this reputation, even in the face of a pandemic.
One of the biggest ways that diversity efforts across the University Health System have changed since 2018 is in the nationalization of the program Stepping In — an initiative led by Gregory Townsend, diversity consortium chair at the School of Medicine.
“[Stepping In] is ... a multi-pronged effort to address acts of disrespect largely revolving around discriminatory or prejudicial acts in the Health System,” Townsend said.
The training program — founded on Nov. 9, 2016 by the University Medical School, the day after the federal election that year — utilizes short videos and a two-hour workshop in order to prime staff across the health system to be more aware of and advocate for inclusivity. Topics covered include race, religion, LGBTQ+, implicit bias and equity. It is one of the consortium’s flagship efforts to foster inclusivity in not only the hospital but also the nursing and medical schools.
As of November 2019, Stepping In began its multi-institutional collaborative component, which focuses on introducing its training program to other schools so that they can incorporate it into their curriculums. This is done by inviting representatives from each school to the University for a “training the trainers” session so that they can provide more diversity education to their students. University hospitals participating include the University of Michigan, Oregon Health and Sciences University, Wake Forest University, Duke University, Johns Hopkins University and Oakland University.
As with most programs, the COVID-19 global health crisis created difficulty for inclusion programs across the health system. The Stepping In program, for example, has moved its previously large in-person workshops to online, in smaller groups in order to accommodate obstacles such as social distancing protocols.
Although COVID-19 may seem like it would derail the focus of committees like these in order to prioritize the urgency of a health crisis, medical personnel and public health experts have found that COVID-19 has only called more attention to issues of health inequity.
“I think … the reality that has been brought into the open for many people [is] that racism is a pandemic as much as the COVID pandemic,” Townsend said. “I really have found that there are a great many people [whose] job is not diversity work, but … take this very seriously even now.”
This is not always the case though. In the University hospital, where the influx of COVID-19 [pandemic] was a more immediate problem, there was some difficulty.
This was true of the pediatrics unit, where Irène Mathieu, director of the department of pediatrics’ equity and inclusion committee, works. She found that in the first months of COVID-19, diversity efforts were reduced in order to focus resources, time and effort on the immediate problems of stopping the spread within the University hospital while effectively treating COVID-19 patients.
“To some extent in the first few months [the pediatric diversity committee’s work] did [take a back seat] because people were kind of panicked,” Mathieu said. “The first priority was really ensuring the safety of our staff and the safety of our patients and figuring out how to shift resources to ensure that people were being treated appropriately and we had the pandemic under control.”
However, since acclimating to the “new normal”, the pediatric ward has been able to reprioritize diversity efforts. One of the ways in which they do so is by offering interpreter services for those whose first language is not English. Most services cater to native Spanish speakers. On a case to case basis, when specialists are available, interpreters of other languages can be brought in. Otherwise, pre-recorded video translation services are utilized to communicate with the patient. Bilingual doctors like Mathieu also treat patients directly in both English and Spanish.
Emphasizing the importance of inclusivity is also a student-based effort as much as it is a staff-based effort. This is seen in many ways, such as with the Inclusivity, Diversity, & Excellence Achievement program at the Nursing School, which aims to foster a more inclusive and diverse environment at the University Nursing School.
Senior Coordinator Emerson Aviles deals directly with students and knows how important it is to get students involved. In the past, IDEA has focused on implementing intensive inclusion training and education for staff members as well as organizing programs to help underrepresented students get the help they need to succeed.
“Mainly I do a lot of student engagement, which, you know, I can’t really do much in-person right now because of the pandemic, which is something that I totally miss,” Aviles said.
Like many, Aviles and the students he supports have experienced the way COVID-19 isolates people, but IDEA has managed to persevere. This has taken the form of optional Zoom meetings where students can seek guidance and support from staff as well as other students.
Recently, the health system has also been compelled to adjust to increasing incidences of police brutality against Black people, such as the murders of Breonna Taylor, George Floyd and Ahmaud Arbery. After these violent incidents, Nursing School students came to Aviles and the rest of IDEA looking for guidance. IDEA responded by creating four working groups that each address unique problems, out of which has come an anti-racism pledge, student advocacy and the integration of LGBTQ+ content into the curricula.
A key aspect of the groups is the student leadership.
“We've had great, incredible student leaders step up to the plate and lead,” Aviles said. “It’s by their requests. The students kind of just came up and volunteered their time for that.”
The students have also started a book club. The club serves as a way for students to constructively learn more about systemic racism from experts on the issue and then discuss the role it plays in their future nursing careers. The most recent book they read is “So You Want to Talk About Race” by Ijeoma Uluo, who also recently spoke at the University.
“We've read how to be an anti-racist,” Aviles said. “That's sort of one of the requests that came out of our students, just like the ability to have a space to … read, educate and talk about these issues.”
These Nursing students recognize that the political situation is integral to their future role as healthcare providers, and are therefore actively taking the steps necessary to create a better future.
The University Hospital, Medical School and Nursing School recognize that diversity and inclusion efforts require continual improvement and work and are always looking for ways to improve. To learn more about each program, you can visit the University Hospital Support Services page, the Nursing School’s IDEA page or the Medical School Diversity Consortium page.
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