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Obstacles to Opportunities: Rethinking Care Delivery for Health Equity | E11 -Amplified RN News Show

Advocate with Carter Todd, MS, MBA RN, CCRN, ANA\California member and media-trained nurse, for community-driven solutions and innovative care delivery models between the health care systems and the communities they serve.


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Jared Fesler 0:17

Welcome to the Amplified RN News Show where we're turning up the volume on nursing news in California. I'm your host, Jared Fesler. And today we're going to be diving into the topic of obstacles to opportunities, rethinking healthcare delivery system for health equity. We're joined by ANA\California's 2022 Advocacy Institute fellow and media-trained nurse Carter Todd. Carter, thanks for joining us today. Would you tell us a little bit about why you're an expert on this topic?

Carter Todd 0:44

Jared, how are you doing, sir,? Good to see you, again. Thank you, ANA\C again, for this platform, for being able to come speak with you all. So as Jared said, my name is Carter Todd, I'm a nurse manager here in the greater Sacramento region. Why I think I may be an expert in this topic is I've been very fortunate to work with some great people out in the community, starting a local chapter of the National Black Nurses Association here in Sacramento, named the Capitol City Black Nurses Association, which has been thriving as recently. And I'm immediate past board member on the NBNA, the National Black Nurses Association. So been very fortunate seen several different programs that have worked really well and excited, maybe talk about it here.

Jared Fesler 1:28

Awesome, I feel the same way. You know, Carter, there's been a lot of recourse over the last couple of years throughout the pandemic of how equity impacts different communities, maternal death rates and the list goes on. Can you tell us what we're talking about today and specific?

Carter Todd 1:47

Sure. So today, I think we're trying to discuss a problem around health disparities that are still existing, and then the barriers to access the community driven solutions that need to take place, and then the innovation of care delivery models between the healthcare systems and the communities that we're working in. We know that our hospitals or clinics, our you know, our providers are not operating in silos outside of the community, we're ingrained in the community, right. So how do we, how do we make that next step to increase or get our exposure out there?

Jared Fesler 2:20

And so when we were talking a little bit before, I remember you were telling me about a story of a person within a pediatric unit, perfect explanation of what you're talking about here today. Can you share that story again, if you don't mind?

Carter Todd 2:39

Sure. So in the pediatric ICU is where I got my, you know, cut my teeth as a new nurse as a new grad. And I remember just seeing a large amount of asthma exacerbation patients coming to the pediatric ICU. Now, a lot of people have asthma, we know that it's more prevalent in some communities than others. But for to get to this to the stents where they need to have ICU. That's pretty extreme, right? There's different modalities that can be used before someone either has to come to the hospital or to get to an ICU, right. So what I seen as the recurrent, same handful of patients that would keep needing the escalation of care, and then when you're having the discussions as a care team, we asked, you know, why are these people coming back. And an example that I found was, well, they don't have the access to the medicines, but they were prescribing them when they're going home. And that aha moment for me was the first example that I had is okay, you know, we are doing our job here, great. But we could be doing our job better for our patients when they leave our care, because especially in the hospital setting, on the inpatient side, we're getting people for a snapshot of their whole disease process or who they are as a person, we're only seeing them for a very short amount of time. So if we're really going to take holistic care of people, and build health equity in the community, we have to look at that as a whole.

Jared Fesler 3:57

How do you begin to do so? Or what assessments are you utilizing?

Carter Todd 4:02

Yeah, I think there's several tools that we have at our disposal right now that have been used at different varying degrees. From an executive standpoint, I think the leadership and closing the health disparities gap is important. So you know, making sure that our hospital systems and organizations are leaning on a strategic plan to address you know, health disparities, and call that out as one of the pillars of marching forward. I think we need to create well informed voices. So how that happens is with health education, you know, health literacy. And when we talk about health, health, education and health literacy, it's meeting people where they're at whether it be translation, whether it be reading level reading ability, you know, ability overall, we have to make sure that we're when we're telling our patients when we're discussing their health with them that they're truly understanding and grasping, and maybe it isn't reading maybe it's not a pamphlet, maybe it's a demonstration, but you know, with technology and the advancement of some have the tools that we have at our disposal leaning on just the standard. Try, you know, trifold brochure is a thing of the past. And then lastly, I think great partnerships between the healthcare industry and the communities. And that's something that I'm really passionate about.

Jared Fesler 5:15

You know, ultimately, those health systems, those institutions are looking to serve those community members. Right? So what are those tasks? What are those first action steps that you're asking health systems and the community to take?

Carter Todd 5:30

So my strategy and tack that I've used that's been successful is leaning on the community needs assessment. So you know, most institutions, if not all are completing these health needs assessments, it could be annually, every couple of years, or you five years. And sometimes they have different names depending on where you're at. But really, what it's doing is it's taking a pulse on the people that are in, you know, inside of our health systems geographically, or the service areas that we're working with, right. So the community's assessment will help to identify some of the gaps that are already existing. So it doesn't make sense for us to put efforts and resources in areas that we think you know, the hospital side that we think are going to make the biggest impact, but the needs assessment helps to help steer some of our actions moving forward. I think that that's a really good one. And then mobilizing the use of data and process improvement so operationalizing you know health equity, it's along with care experience right it's initially can be a squishy topic to try to wrap your head around but when you're doing performance improvement projects, building health equity and and being able to measure that is very important.

Jared Fesler 6:43

Carter, amazing suggestions and actions to take. Incredibly important topic isn't going to be going away anytime soon. We see health systems out there putting more of a focus on this hiring people to work on issues like health equity, diversity, inclusion, etc. So just thank you for your knowledge and insights and your expertise. So those that are joining us on the Amplified RN News Show, thank you so much, and we'll see you in the next episode.


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