A True Story
A sweet, pale-skinned little girl is brought to the hospital by her mother, complaining of fatigue and dizziness, trouble breathing and headaches. The doctors run the standard tests and, when they come back normal, they prescribe plenty of fluids and a simple antibiotic.
A few days later, when Anna’s parents rush her back to the hospital, she is practically unconscious. In the presence of both parents, the registration clerk realizes the crucial error made during Anna’s last visit: despite the girl’s fair skin, her father is black. Anna is biracial.
By assuming that the girl was white rather than asking the question, the previous clerk had started a series of events that led to to Anna’s misdiagnosis and decline. Without knowledge of her African American father, the doctor hadn’t even thought to test for the sickle cell anemia predominant among African Americans.
Ensuring Equitable Treatment for All Patients
The month of February is always a time to reflect on the changes wrought in every part of American society by the growth of the African American (and Asian and Latino) population. There may be no area where these reflections are more critical than medicine.
Toni Green, VP of Diversity & Inclusion
Anna’s story, shared by Toni Green, the Vice President of Diversity & Inclusion for Trinity Health, is a prime example of the importance of the demographics questions in any patient interview and the need for cultural competence training and awareness in medical staff.
When explaining the purpose behind her department, Toni shares the simple truth that, “when we assume a patient’s race and ethnicity we may miss diagnosing chronic illnesses that may impede an equitable patient healthcare outcome.”
In fact, Toni sees her job as a necessity in 21st century healthcare. The past hundred years has seen a steady growth in the populations of first, second, and third generation immigrants. There are already predictions that by 2039 the majority population of the US will actually be made up of the current minority groups.
This trend was recognized in 2007 by Trinity Health’s CEO and led to founding of the Diversity & Inclusion Office. The Diversity & Inclusion department was created to ensure, through education, talent management, and communication, that the daily operations of the Trinity Health System delivers safe, quality care that actually meets the unique needs of every patient.
From the Top Down
The focus on cultural competence training covers everything from the recruitment of staff, to the collection of patient health histories, to the language used to deliver healthcare information.
Toni attributes the success of Trinity Health’s D&I department to the support from above and “the fact that we have diversity leaders who champion the D&I strategy. We operate in 10 different states, soon to be 21; these leaders help to cascade our strategic objectives in their locations.”
This is one of the reasons that Toni and her team work so closely with the talent management team to recruit, develop, and retain associates from all walks of life. By starting with a leadership team that inherently understands how crucial cultural competency is in the delivery of the very best healthcare, Toni hopes to ensure that, in the future, all patients can benefit.
“We need to have an intentional and deliberate focus on safe and quality care and if you don’t have the element of cultural competency in that dynamic then we are going to miss the mark.”
There is an old story of an African American physician from World War II named Charles Drew. He worked for the Red Cross in the war and was a pioneer in the science of blood storage and transfusion, saving lives innumerable.
He was also a crusader in the cause of equitable healthcare and eventually resigned his position when he was forbidden to give white blood to African Americans and vice versa (which is hardly surprising for his time, but no less tragic even so).
The heart of the tragedy arises from Dr. Drew’s own fate. Stateside once more, Dr. Drew was behind the wheel in a terrible car accident in North Carolina. He was rushed to the closest emergency room with severe internal injuries.
The first hospital turned him away. The African American ward was full and they refused to give a white room to the profusely bleeding man. They wouldn’t even give him the necessary plasma to save his life before sending him along.
“He died on his way to the negro hospital,” Toni relates. “Our society was not prepared to address the needs of an African American. I believe if we had physicians at the time that benefited from coaching in cultural competence, Dr. Drew would not have suffered needlessly.”
A Personal History
Whether legend or fact, the chilling story of Dr. Charles Drew rings true. Toni is well-aware of the need to repeat such tales.
“It is important for current and future generations regardless of heritage, gender, and language to know of the historic struggles endured by minorities and females. In the spirit of the African Griot, storytelling is key to identifying our past. The knowledge of our past helps us move forward to achieve even greater success in our future and those that come behind us.”
And Toni is uniquely qualified to speak on the continuing necessity of understanding those struggles. She has a story of her own to tell.
“In 2005, my husband suffered a massive heart attack while returning home from his job as a high school educator. He was walking home when a passerby saw him collapse on the side of the Houston, Texas road and notified a county sheriff.
“I was teaching an evening college class and had my telephone turned off. When I was notified, I rushed to the hospital only to discover he had passed away.
“One year later, my son had just celebrated his daughter’s second birthday. He walked outside to greet friends when a vehicle drove down the street shooting from the windows.
“A bullet found it’s way into my son’s heart.”
And the horrifying truth is that the plain facts of these tragedies are not the totality of the story. There is the lingering unease that will be with Toni for the rest of her life.
“I often ask myself if the physicians really did all they could to save the lives of these two outstanding African American men. Or did they just assume they were up to something of no good and probably deserved to die? Would cultural competency coaching amongst physicians have made them work harder to save such loved and valued lives?”
Doing Better for Future Generations
When Toni began her position as a Diversity & Inclusion executive, she was determined to find ways of ensuring that history would not repeat itself, that no human person should ever be kept awake at night by the same haunting fears that their loved ones had died for want of the necessary care.
Eventually, she discovered Blue Mesa Group’s Transformational Coaching Program and was excited by the possibilities it presented.
“I wanted to learn how coaching could help us transform our organization, our associates, and myself. Using coaching to ensure we are able to influence leaders, influence positions, influence hospital staff about the importance of delivering patient centered care.”
The Transformational Coaching Program focuses on an understanding of the self and how that influences interaction, communication, and behavior. This was a philosophy that exactly served Toni’s needs.
“When I think of linking cultural competency to coaching, I believe this is a learning opportunity for myself and physicians, clinicians, and staff to better understand the nuances that exist in us and our patients. Together we can examine our unconscious biases and recognize that the delivery of patient centered care is first and foremost.
“Regardless of race, ethnicity and language differences all human life is meaningful. When patients present to a doctor they are at their most vulnerable and quality health care is a civil right.”
Trinity Health is only one organization to benefit from a correct understanding of diversity and inclusion. Blue Mesa Group has a focus on cultural competence training and, as Toni says, in the spirit of the African Griot, we are always looking for stories on how lives can be affected by this understanding. Or its lack.
Do you have a story to tell? Share it here or contact us and send it along. We welcome your histories.