Addressing disparities in Western New York's health-care industry starts with workforce

By Tracey Drury
Buffalo Business First

Ekua Mends-Aidoo of Evergreen Health: “Inclusion is a choice. So how are you including these folks in your organization? We look at equity as a must, so we really need to put systems in place that support those folks internally.” (Joed Viera/Buffalo Business First)

The region’s top health-care employers say they’re continuing to implement programs to address and grow awareness of equity and disparities. But they’re also working to address the diversity of their workforces.

Tackling inequities starts, they said, with a diverse workforce that helps patients feel more comfortable and willing to come to care, but also includes proactive measures to reach all populations of people.

At Erie County Medical Center, a diversity and inclusion initiative was started several years ago. Training centered on cultural competencies and unconscious bias aimed at improving the patient experience.

But the organization is also striving to make the workforce more diverse at all levels, said Andy Davis, chief operating officer.

“That’s important, because the people we serve on the East Side of Buffalo come from so many different walks of life,” he said. “Our staff has to be taught that — we can’t assume they’ve learned that.”

The same is true at Roswell Park Comprehensive Cancer Center, where CEO Candace Johnson said the organization recognizes it has had difficulty recruiting physicians and nurses of color.

That points to the importance of developing lower-level allied health professionals, possibly with new career ladders.

When it comes to decreasing health disparities, Roswell Park researchers have found molecular and genetic determinants that show how cancer affects some populations disproportionately. Now, teams are going into the community to identify and connect with these populations, Johnson said.

“We’re also looking at more ways to intervene and help, because if you are one of these individuals that is at high risk, early screening can pay off even more,” she said.

Evergreen Health is working with a top-down approach, led by Ekua Mends-Aidoo, chief equity and inclusion officer.

First, she said, the organization is looking inward at the employee experience and how it treats staff. Evergreen has used internal data to examine pay equity, rates of hiring and termination, as well as employee satisfaction and how that varies.

Data is also being used on the patient side, with disaggregated data from satisfaction surveys broken down by ethnicity, race, gender and sexual orientation wherever possible.

Then, if disparities or gaps are identified, interventions are implemented, she said.

“What’s most important is making sure you’re listening to the voices of those most impacted, creating a space for those voices to be at the table and to talk about their own experiences at your organization in order to really make a difference,” she said. “We know when employees are happy and they really feel like they’re a part (of the organization), that translates to the patients.”

Data is also used at Buffalo Medical Group and G-Health Enterprises, which take information from electronic medical-records systems and value-based care programs to study problems faced by patients.

“I think it’s a real culture shock for many of our providers to focus on those social determinants they’re not as physicians particularly trained to be thinking about,” said Dr. Robert Zielinski, associate medical director at BMG, which sees significant differences between patients at the Williamsville practice site versus downtown on High Street.

Dr. Raul Vazquez, president and CEO at G-Health, said his practice groups are using social determinants of health data to partner with churches and community-based organizations and to create medical neighborhood partnerships.

The more integrated approach is helping to cut disparities.

“We’re really engaged in the community,” he said.

On the provider side, G-Health has gotten involved with the Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo to help sponsor efforts to increase the number of students of color.

Those efforts have helped grow the number of minority students to 46 this year, the largest number in the medical school’s history, Vazquez said.

Spectrum Health & Human Services is also working to expand access into the community and reduce disparities by meeting patients where they live.

The behavioral-health practice plans to launch two mobile RVs as licensed mental-health clinics to provide access in rural areas. That’s in addition to an expansion of telehealth services.

“We’re looking to make sure access is not an issue,” said Bruce Nisbet, CEO. “Those are two pieces that fit together with all the things we’re talking about in terms of cultural competencies.”

The region’s two largest health systems say they’re working internally and externally to address disparities.

Joyce Markiewicz, executive vice president and chief business development officer at Catholic Health, pointed to major changes on the board and among the senior leadership team.

Those changes at the top have a way of trickling down into the workforce, and how programs and services are designed for patients, she said.

“We look very different than we did just a couple of years ago when you’d walk into our board room and you would not see a single person of color and very few women,” she said. “It looks very different now, and it was done with great intent: We need to look like the people we serve every day.”

So, too, do efforts to partner and collaborate with organizations across the community, said Allegra Jaros, president of Oishei Children’s Hospital, part of Kaleida Health.

But all of it starts with listening to employees and patients and working harder to empower everyone to make a difference, she said.

“It really comes back to the community coming together, taking health care and education and higher ed, the transportation system, food banks and supporting one another and empowering one another to listen and respond better and eliminate those barriers,” she said.

This article originally appeared in Buffalo Business First.