By Serena Agusto-Cox | News & Views
Diversity, equity and inclusion (DEI) are no longer just buzz words. Cardiovascular rehabilitation (CR) and pulmonary rehabilitation (PR) teams have patients from diverse cultures, religions, generations and backgrounds. DEI is a priority item on leaders’ punch lists that will nourish CR/PR teams as they strive for better patient outcomes.
Cynthia Walters, EdD, and Victoria Yandle, DNP, MSN, RN, CCRP, from Prisma Health in South Carolina, along with Ginny Dow, RN, BSN, BC, CCRP, FAACVPR, at Emerson Hospital in Concord, Massachusetts, will explore what diversity means beyond the demographics of your patients at AACVPR’s 38th Annual Meeting. In their rapid-fire session, the presenters are eager to provide practical advice on building inclusive teams within your practice.
DEI Starts with Leaders and Ourselves
Dr. Yandle’s interest in diversity and inclusion was planted in 1975 when she moved from Long Island, New York, to South Carolina. She attended an all-Black college and entered the workforce but was surprised in 1990 to see that the majority of healthcare professionals at a South Carolina CR/PR symposium were predominantly white. Dr. Yandle responded to these experiences by seeking greater diversity and inclusion in her personal and professional life.
AACVPR has been a large part of that journey. “Being able to call up Dr. Walters, who is a lead on diversity, equity and inclusion at her healthcare facility, to discuss how to handle a staff nurse who had offended about four different demographic groups in one week was so helpful,” says Dr. Yandle. Since the ‘90s, when she started, the needle has moved in South Carolina, where now there are more women leaders and professionals in the CR/PR disciplines.
According to Dr. Yandle, Dow and Dr. Walters, it’s not all about race and gender. It’s also about socioeconomic factors like whether patients have transportation that can take them to sessions or if they can afford the co-payments for the care. Dr. Yandle says a lot of her patients live below the federal poverty level, and she asks, “how can we as professionals address their needs and make them comfortable if the profession is predominantly from one kind of background?” In the back of Black patients’ minds, Dr. Yandle suggests, “Issues from the past (i.e., the Tuskegee syphilis project and a documented reluctance to medicate Black women during childbirth due to perceived higher tolerance of pain) prevent trust and compliance. Being diverse and inclusive helps patients of all races build trust.”
Dr. Walters points out that what leaders need to remember is that CR/PR teams have the same goal — the health and welfare of the patient — and should act with respect and trust with their colleagues and patients. As the only African-American professional in her workplace upon entering the healthcare field, for years she felt like she didn't have a voice — an experience she strives to help others avoid.
“I've always had a passion for this work. I want to make sure that no one feels invisible, not respected and not seen,” she says. Leaders need to be strategic and intentional in their DEI approach, especially since everyone has a story, a religion, different generational perspectives and other factors that make up who they are.”
“We can’t be culturally competent in everything, but I think we can have cultural humility, empathy and sensitivity,” Dr. Walters explains. “When the patient senses that you see all of them, hear them and try to understand their perspective, the relationship and healing can grow.”
Multidisciplinary Teams Are Key Components in DEI
CR/PR professionals treat the whole patient, which, according to Dow, means teams should have dieticians, social workers, nurses, exercise physiologists and others who can treat not only different generations and races but also those who can help with socio-determinants — such as food access and financial issues — to ensure a patient’s recovery is optimal. Leaders will have teams that have younger and older generations working side by side, as well as team members from diverse cultures and circumstances.
At Emerson Hospital, Dow’s team holds meetings where everyone has an equal voice. “Every decision we make is stronger because of our multidisciplinary team. For instance, when our social worker comes up with a killer idea, we are eager to put it into action.” She adds, “When you’re renovating a house, you can’t just hire a carpenter. You also need plumbers, electricians, landscapers, project managers and many others. That’s what it is like on a CR/PR team. We need a multidisciplinary team to address all aspects of a patient’s recovery.”
CR/PR teams are highly skilled professionals, but sometimes they need a little help getting comfortable enough to talk to people who are not like them. Dow says every team faces roadblocks, and it is how leaders address those challenges that ensure success.
Dr. Walters agrees and says that part of those efforts should include understanding what skills and experiences colleagues bring to the table for patients and determining how best to incorporate it. “Don’t assume you know everything. Ask questions,” she advises. “Get to know the people that interact with the patients. Give them a voice and listen. When they see you listening, you can start building trust and respect.” Dr. Yandle agrees, adding that being transparent is key.
Through open communication, empathy and understanding, CR/PR staff can improve patient care outcomes and strengthen multidisciplinary teams. Dr. Yandle, Dr. Walters and Dow ask you to look at your teams from a new perspective. Whose voice is missing? How can an inclusive culture improve patient outcomes? Bring your questions to “The Role of Leaders in Building an Inclusive Culture” session at AACVPR’s 38th Annual Meeting this September 13-15, and share your experiences with DEI programs.
The rapid-fire session will take place on Thursday, September 14, 2023, at 5:15 p.m. CT at the AACVPR 38th Annual Meeting in Milwaukee, Wisconsin. Register for the event today.