Spurred by nationwide protests against racism and social injustice, unit-based team members are launching cultural  competency projects aimed at delivering more equitable outcomes for their patients by looking closely at their own beliefs. 

Mid-Atlantic psychotherapist Erin Seifert knows that big change often involves many small steps. Delivering equitable care is no different, she says. 

“To give our patients the support and resources they need, we have to start with ourselves and our own biases and cultural competence,” says Seifert, labor co-lead for the North Baltimore Behavioral Health team and a member of UFCW Local 27. 

Team members, who are represented by unions belonging to the Alliance of Health Care Unions and the Coalition of Kaiser Permanente Unions, began a monthly lunch-and-learn series about bias awareness in November. Activities include a pre- and post-evaluation and guided learning exercises that stimulate conversation about differences. 

“It’s very informative,” says Regina Foreman, a mental health assistant and member of OPEIU Local 2. “I’ve learned a lot, especially about implicit bias. The training is helping me be more aware of my own biases.” 

Such responses are encouraging, says Kristin Whiting-Davis, operations manager and the team’s management co-lead. 

“We need to be able to talk about our own privileges and our own biases,” Whiting-Davis says. “I hope it will help people practice having those discussions that, ultimately, will translate into the work we do with our members.

Welcoming all

Eager to protect their young patients from the effects of racism, members of the Southwood Pediatrics team in Jonesboro, Georgia, began by educating themselves. They held listening sessions for staff and read about the impact of intolerance on children.

Their efforts informed discussions on ways to create a more welcoming environment for patients, families and each other. Ideas include a coloring contest featuring uplifting images, adding diverse artwork to the department and creating resources for families coping with racial biases.

Next steps call for staff members to vote on the most promising proposals for further action.

“We want all cultures and races to feel welcome when they come to our pediatrics unit,” says Stephanie Henry, MD, physician co-lead of the Southwood Pediatrics team. “We all have biases. We need to be open and honest about how to confront them. Then we can build bridges to start having conversations about the patient’s health.”

With reporting by Brenda Rodriguez and Tracy Silveria.

LaTisha Thompson has nothing but positive things to say about breastfeeding her 1-year-old daughter, Teigen Roberts.

“It was a no-brainer for me,” says Thompson, an on-call pediatrics nurse at Kaiser Permanente’s Capitol Hill Medical Center in Washington, D.C. “I decided to do it because of the benefits that breastfeeding gives to my baby and me.”

Indeed, breastfeeding has many health benefits for babies and mothers. But Thompson stands out among African American mothers, who are less likely to nurse their children than women of other racial and ethnic groups because of cultural beliefs that formula is more filling than breast milk. Many Black moms also lack family support and access to breastfeeding resources.

“It’s a national problem,” says Lori Franklin, RN, a lactation consultant and member of UFCW Local 400 who is working to close the gap with her colleagues at the regional Newborn Care Center in the Mid-Atlantic States.

Learning from moms

To better understand the challenges African American women face, the Level 4 unit-based team surveyed 45 Black moms as part of a “voice of the customer” project in January 2019.

The results were revealing.

“They were looking for prenatal education,” says labor co-lead Francesca Klahr, RN, a lactation consultant and UFCW Local 400 member. “We went back to the drawing board, and when we offered it, they came.”

The team doubled the number of prenatal breastfeeding classes and partnered with ob-gyn nurses to encourage African American women to enroll. The response was dramatic.

The percentage of Black mothers taking prenatal breastfeeding classes jumped from 3% to 15% between September 2018 and September 2019.

Kathleen Fulp, a mother of 2, joined the class after experiencing initial difficulty nursing her firstborn child, Savannah, now 2 years old. She’s glad she did. “I probably would have given up had I not had support.”

Such enthusiasm spells success for Nia Williams, clinical operations manager and the team’s management co-lead.

“We can empower and encourage our African American moms to push through, and that has been really successful.”

When Terri Imbach, Family Practice manager at Mt. Scott Medical Office in the Northwest region, and labor co-lead Christina English, a licensed practical nurse and a member of SEIU Local 49, began to work together as UBT co-leads several years ago, they knew they needed to shake things up with the department’s unit-based team. 

The staff worked hard to meet the demanding needs of the fast-paced medical office, but morale wasn’t great—and team members weren’t taking ownership of improvement work. UBT meetings were poorly attended and often turned into complaining sessions.  

The co-leads’ first move was to go to UBT training classes together. That experience gave them an idea for their next move—which was to shake things up between the two of them by stepping away from work and getting to know each other outside the office. 

“Getting out of the work environment is a good way to get away from the stress of the department,” explains English. This mindset set the tone for how they would operate together and helped them sustain a good relationship over time.

The co-leads also adopted “fun” as part of their regular UBT agenda, and meetings now are attended by nearly 100 percent of the staff.  

“We think of fun ways to get to know each other in and out of the office, and we work to include fun elements in all of our meetings,” Imbach says. During the holidays, team members played relay games at their UBT meeting, and they participated in a fundraiser for a local youth organization that included playing basketball on donkeys. 

The creative energy of the co-leads has helped engage all 40 members of the Level 5 team, who are juggling more than a dozen quality projects. 

“Team members step up to take on projects now,” English says, “and there are friendly competitions to meet our goals.”