January 19, 2012

Health equality for children goal of new office

Arie Nettles, Ph.D.

Health equality for children goal of new office

Recognizing the increasing diversity of patients and families served, the Monroe Carell Jr. Children's Hospital at Vanderbilt and the Vanderbilt Department of Pediatrics has launched a new office devoted to ensuring the best care possible for “every child, every disease.”

The Office of Inclusion and Health Equity (OIHE) will work to meet the unique and specific needs of patients and families from a rich array of diverse cultures and backgrounds. Several initiatives will be carried out to address health equity and inclusion.

Arie Nettles, Ph.D.

Arie Nettles, Ph.D.

“Whether you do transplants or whether you plant flowers, we are all a part of Children’s Hospital and it is our job to make sure that each child is provided excellent care and that the families understand that and buy into that and that we partner with them,” said, Arie Nettles, Ph.D., director of OIHE and associate professor of Clinical Pediatrics in the Division of Developmental Medicine.

“We have to have a good understanding of what our children and families bring to us — their cultures, backgrounds, religions, lifestyles, etc., and that is going to be significant in terms of getting every child well, which is the ultimate goal.”

The foundation for the office’s mission has long been laid at Vanderbilt University Medical Center in Interpreter Services and the Office of Diversity, among other efforts.

Two years ago, Children’s Hospital leaders saw Tennessee’s, as well as the nation’s, community evolving and realized an office such as OIHE could support the hospital’s mission.

Research shows that racial and ethnic disparities in health care are pervasive and persistent across the United States, including: mortality, access to care, special needs, cancer and chronic disease.

Tennessee, and more specifically, Davidson County, has experienced tremendous growth in diverse demographics over the past decade.

Populations that have seen increases include Hispanic, Asian, Somali, Kurdish, Bhutanese and Burmese. According to the 2000 U.S. Census, the state had the sixth-fastest growing foreign-born population and the fourth-fastest growing Hispanic population in the nation.

Census projections show that by 2042 racial ethnic minorities will become minority/majority, accounting for more than 50 percent of the national population. Minority children are expected to be the majority by 2023.

The OIHE’s plans go hand-in-hand with the School of Medicine’s objective to attract students, staff and faculty from underrepresented minority populations. Similarly, OIHE will ensure efforts are woven “seamlessly as part of the fabric of the administrative structure to achieve diversity.”

Andre Churchwell, M.D., associate professor of Medicine (Cardiology), Radiology and Biomedical Engineering, serves as associate dean for Diversity for the School of Medicine and is also an adviser for the OIHE along with Leah Harris, M.D., associate professor of Pediatrics and vice chair for Academic Affairs in Pediatrics, and William Cooper, M.D., MPH, professor of Pediatrics and Preventive Medicine.

Churchwell hopes that over time the OIHE can serve as a model of incorporating programs focused on diversity and inclusion throughout the Medical Center.

The OIHE will focus on four areas initially: workforce training/education; continued evaluation and improvement of patient satisfaction in cross-cultural communications; expanded inclusion and health equity efforts through a strategic vision and plan; and supporting research to identify and eliminate racial and ethnic health disparities.

“It has been exciting to support this initiative from concept to early implementation,” said Meg Rush, M.D., acting chair of Pediatrics and chief of staff of Children’s Hospital.

“Dr. Nettles has led her team in the development of a program that will ensure our faculty, house officers, students and staff have the most optimal background and training to deliver high quality, effective and culturally competent care to all members of our community, but also to interact with each other on a daily basis.”

In an effort to better serve families, they are asked ethnicity and preferred language at registration, but have the choice to opt out. Data collection will help OIHE in strategic planning.

Though in its infancy, the office was recognized for excellence by a national disparities leadership program, the Disparities Solutions Center at Massachusetts General Hospital, Boston. Vickie Thompson, MSN, R.N., Special Projects nursing manager and OHIE designated nursing leader, Kimberly Rogers, MHA, and Nettles devoted a year in this executive leadership and training program developing the OIHE model.

The award, the Most Improved Project, recognized OIHE for fostering a culture that embraces and promotes diversity, inclusion and respect, and strives to meet the needs of the patient population.

“Children’s and the Department of Pediatrics are committed to serve every child to every disease, and are committed to the concept that discovery brings hope,” said Nettles. “The basis of this has always been here. It’s what we do every day — the excellence, the passion. We’re taking it to the next level.”