A Trauma-Informed Approach to Address Systemic Racism in Outpatient Clinics
- Diversity and Equity: Other Research
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
- Nwanji, Valerie Ofune, University of Pennsylvania, Philadelphia, Pennsylvania, United States
- Brown, Kimberly M., Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States
- Reddy, Yuvaram N.V., University of Pennsylvania, Philadelphia, Pennsylvania, United States
The primary objective of this project is to mitigate perceptions of racism noted among Black Veterans with kidney disease at the Crescenz VA Medical Center (Philadelphia). Understanding that racism can be traumatic, we hypothesized that a trauma-informed care intervention to address systemic racism would reduce perceptions of racism, improve trust in our healthcare system, and lead to improvements in overall health (e.g., reduction in no-show visits).
Informed by the Center for Health Care Strategies, we developed a multi-level intervention: provider training, environmental scan (health equity walkthrough), developing a patient advisory board, and creating a referral pathway for racial trauma.
We provided two 60-minute workshops to clinicians. We provided a framework to define interpersonal discrimination from structural racism and tools to help center Black Veterans and their experience with systemic racism. The training provided guidance to create an inclusive environment during clinical encounters. Clinicians were surveyed to evaluate the acceptability and feasibility of the surveys.
We conducted a “walkthrough” of the Renal clinic to assess how the clinic infrastructure could be redesigned to be more inclusive for all Veterans. A health equity researcher, led the walkthrough and invited Veterans and clinicians to conduct their own walkthroughs of the clinic. Findings were compiled to generate action items to improve the clinic infrastructure.
Eight clinicians (42%) attended the 2 workshops conducted in November 2022. The clinicians included 5 advanced practice providers and staff, 2 MDs, and 1 social worker. Five participants completed the surveys, all of whom ranked the workshop quality as “high” (on a scale from “very low” to “very high”) and noted they would recommend the training to others. Participants “completely agreed” that the workshop was appropriate to education, experience, and skill level. All “agreed” or “completely agreed” to use the information and skills provided by the workshop during clinical encounters with their patients.
Our pilot demonstrates that 1) it is feasible and acceptable to deliver trauma-informed care training to clinicians to help address perceptions of systemic racism in clinics and 2) health equity walkthroughs can generate action items to expand inclusivity in healthcare settings.
- Veterans Affairs Support