Learn how healthcare systems can improve outcomes by building trust with diverse communities, prioritizing equity, engagement, and whole-person care, with Bergen New Bridge, the fourth-largest publicly-owned medical center, as an example.
Written by: Karen Lin, CEO, Emotivo Health
People can feel left out of conversations and decision-making related to their healthcare due to many factors. For some, they feel it is because of their ethnic and racial identities, but also because they may be single parents, members of the LGBTQ+ community, or their religion. For others, it could be a diagnosis of a rare disease or hidden trauma a provider may not know about. In healthcare, when a patient feels they are not in control, a care plan that is not individualized can lead to distrust and possibly disengagement.
For decades, the healthcare industry focused on medical interventions and acute care. In recent years, the industry has taken a long hard look at the social determinants of health that can impact patients and their care including housing, transportation, food security, preferred language, health literacy, and community engagement. Increasingly since the pandemic, many healthcare systems have been focused on Whole Person Health.
Vulnerable populations covered by Medicare, Medicaid, and Charity Care can experience worse health outcomes due to these social determinants of health. When community needs and healthcare interventions do not align, they can lead to a cycle of patient disengagement, poor outcomes, and preventable high costs. Acknowledging this reality, payers and providers have begun to prioritize a comprehensive approach that addresses the social needs of individuals to achieve better health and wellness outcomes for all.
Building Trust in Multicultural Communities: A Success Story
Leaders in health equity, like Bergen New Bridge Medical Center in New Jersey, offer a compelling example on how a health system can expand access to equitable, high-quality care. I sat down with their Chief Quality and Equity Officer, Shari Gold, who is also their Senior Vice President for Regulatory Compliance.
In a testament to their existing best practices, the Medical Center recently earned the Joint Commission’s Advanced Certification in Health Care Equity. Four specific steps seem to be the key to their success:
1. Identifying each specific community you serve through data collection and analysis.
2. Engaging and actively listening to those communities.
3. Incorporating those perspectives in daily processes across the organization.
4. Codifying how to gather and review data regularly across different cohorts.
Identifying and engaging with specific communities
It is critically important to identify specific communities your organization serves as well as engaging with them to determine their needs. Regular needs assessment surveys are a starting point to gather this critical information. Bergen New Bridge conducts a Community Needs Assessment every three years which allow community members to be heard. Their team then develops a Community Health Improvement Plan which serves as a blueprint for developing and expanding programs and serves that meet the needs of the community.
But a lot can change in three years. The Medical Center has recognized that every patient visit and admission is another opportunity to gather social needs data, by using the American Academy of Family Physicians (AAFP) evidence-based Social Determinants of Health screening form. Additionally, Bergen New Bridge’s robust Community Health Team goes into communities where they are able to listen and respond to the current needs and priorities.
Once community data is in hand, how does an organization turn that into engagement? Bergen New Bridge identifies trusted community hubs, partner organizations, and local events for direct engagement. For example, during the pandemic, “We saw a need for some of the marginalized groups such as communities of color who weren't coming to the Medical Center to get vaccines,” Gold said. “So, we set up vaccine programs at houses of worship and different community centers where they would feel more comfortable getting vaccinated.”
Incorporating Diverse Perspectives Daily
Bergen New Bridge doesn’t stop their engagement efforts there. They hire clinical staff that reflect the communities they serve, which contributes to developing trust with patients and community members. “You want to have a staff that is as diverse as your patient and resident population,” said Gold. This practice not only taps into the communities outside the Medical Center but enables them to more easily incorporate the communities’ voices into all aspects of the processes and services provided.
Gold said, “Throughout our organization, we support our diverse staff and their interactions with members of their own communities and beyond, which makes it a great place to work and cared for.” When a patient feels understood, they are more likely to trust their healthcare providers and members of the clinical and support staff. The quicker trust is established with a patient, the better health and wellness outcomes can be.
As part of its Diversity, Equity, Inclusion and Belonging Committee, Bergen New Bridge has staff ambassadors who represent their cultures. They help host events that offer presentations about their cultural roots, often featuring a shared meal of their traditional cuisine. Past events have included Black History Month, Puerto Rican Heritage Day, Native American Heritage Month, and more. These events both educate staff while connecting diverse communities. “We love trying different food and seeing images and educational posters at these events,” said Gold. “People are learning, and they don't even realize they're learning.”
Externally, Bergen New Bridge recognized the pressing need to develop a food security program which would address the stigma around accepting help while taking care of an essential need for patients. “It's a matter of how you introduce it,” said Gold. “We have an in-house pantry that provides a small bag with some non-perishable items with a referral to a local food pantry or other meal service.” To respect the cultural diversity of patients’ diets, gift cards to supermarkets are provided so that they can select items familiar to them and their loved ones.
Establishing rapport with patients is a key component of successfully introducing assistance for food insecurity, or any other social determinant of health. It’s no surprise that a patient is more likely to trust a staff member from their community to know what food would be most appropriate for their dietary preferences and medical needs.
Codifying for long term results
Without turning their equity work into tracked measurements, Bergen New Bridge’s efforts would have been difficult to maintain year after year. After going through the Joint Commission’s certification process, they streamlined their process for documenting their health equity work. It became easier for new team members to learn the process and made a daily review of disparities and unintended biases possible. “When we talk about bias, the organization has no tolerance for it,” said Gold. “That comes from the CEO, from the top, because everything we do about equity and quality starts at the top.”
The next chapter
As the Trump Administration prepares to transition into power, there will likely be significant changes to healthcare policy and existing programs. Yet, amid the political ebb and flow, one constant remains – social determinants of health significantly impact health and wellness outcomes. The future of healthcare will hinge on how well we listen to and address the unique needs of our communities.
Just days after election results, there was an increase in hateful messages sent to many targeted groups. It’s difficult to predict what effect that will have on daily lives and the treatment of patients through the health system. As a Jewish woman, Gold has had no choice but to know discrimination and anti-Semitism. “If we do more to educate others about our diverse communities, it will help us in our quest for improved equity and peace,” said Gold. “For us in healthcare, it ultimately leads to safer care.” Healthcare leaders should go beyond baseline compliance, and demonstrate their commitment to delivering equitable care for all.
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We periodically highlight provider and payer organizations that move their industry forward in increasing inclusive care and representative workforces, in order to propagate best practices. If your organization would like to share learnings from making an impact in this area, please reach out at contact@emotivohealth.com.
Learn more about how Emotivo can streamline gathering social needs data through conversations that your staff already has with patients/members.
