DNP- Patient Outcomes And Sustainable Change

PEER RESPONSES FOR Patient Outcomes and Sustainable Change

Assessment Description

Reflecting on the “IHI Module TA 102: Improving Health Equity,” describe two causes of health disparities in the United States, or in your local community, that lead to health inequity. What ethical issues inhibit access and quality for care for these issues? Outline an initiative, integrating your faith and ethical principles surrounding practice, to reduce these health inequities and sustain the change within the health care system.

Veronica Montemayor

Orji & Yamashita (2021) noted that greater cancer-related mortality rates among racial or ethnic minority women compared to white women are mainly attributable to cancer screening disparities. They also noted that higher incidence rates and higher cancer-specific mortality rates are still evident among racial and ethnic minority women compared to white women. This study aimed to examine associations between routine health checkups and adherence to cancer screening guidelines among women and by race/ethnicity in the USA (Orji & Yamashita, 2021). Lack of proper routine health checks for all women will lead to health inequity. As healthcare professionals, we need to understand why according to the literature, certain ethnic groups are being screened for cancer. Physicians who fail to provide the same services to all patients regardless of their race are practicing unethically. Physicians also have to stay informed on the latest evidence-based practice guidelines on patient screening to prevent delays in their care.

Holmes et al. (2020) noted that health equity occupies a central place in society; an essential aspect of this is the issue of racial disparities in healthcare delivery; such disparities have now been highlighted in the provisioning and delivery of cardiovascular care, most recently in the field of structural heart disease with transcatheter aortic valve replacement (TAVR). With TAVR beginning with its initial Food and Drug Administration (FDA) approval in 2011, the clinical application has documented a substantial discrepancy in TAVR placement, with Caucasians being treated significantly more frequently than either African Americans or Hispanics based upon data of the racial make-up of the US population greater than 65 years of age (Holmes et al., 2020).

An initiative to reduce health inequities and sustain change within the healthcare system is to treat the patient regardless of their faith, values, culture, or race. Sometimes we treat the signs and symptoms a patient exhibits; however, we must also think about preventive measures. My faith and ethical morals empower me to speak up when something is wrong and advocating for patients never ends. Research studies are critical even when we believe there is no problem because the current practice is working; still reflecting on the IHI modules, it is everyone’s responsibility to speak up.

References

Holmes, J. D. R., Mack, M. J., Alkhouli, M., & Vemulapalli, S. (2020). Racial disparities and democratization of health care: A focus on TAVR in the United States. American Heart Journal, 224, 166–170. https://doi-org.lopes.idm.oclc.org/10.1016/j.ahj.2020.03.008

Orji, A. F., & Yamashita, T. (2021). Racial disparities in routine health checkup and adherence to cancer screening guidelines among women in the United States of America. Cancer Causes & Control, 32(11), 1247–1256. https://doi-org.lopes.idm.oclc.org/10.1007/s10552-021-01475-5

Bonnie Flores

The IHI Module TA 102 was an excellent eye-opener on health inequities in the United States and globally. Within my community, the two most prevalent disparities are poverty and mental health, both of which lead to a lack of access to equitable health care. Much light has been shed recently on the increasing need for improved mental health screenings; however, many minority patients have poorer outcomes in relation to mental health compared to Caucasian patients (Kyere & Fukui, 2022). This may be due to racism that exists within healthcare organizations and possibly cultural and linguistic biases and barriers (Kyere & Fukui, 2022). Covid-19 led to even greater numbers of people seeking mental health treatment, with a significant need for mental healthcare practitioners (Summers-Gabr, 2020). Therefore, it is particularly essential that people of diverse backgrounds be trained in mental health to help increase the disparities that currently exist (Kyere & Fukui, 2022). When there is diversity within healthcare, people feel more comfortable seeking out treatment which serves to increase trust and inclusion (Kyere & Fukui, 2022).

Poverty is another factor that greatly contributes to the lack of equitable care. Though there are programs to help those with little financial means, many people need to work multiple jobs, leaving little time to seek preventive medical care. Those with lower income also spend more money on healthcare than those who are more financially secure, thus leading to fewer resources to spend on education and housing, which perpetuates the cycle and shows how social determinants of health play a role in life expectancy and well-being (Chokshi, 2018).

A health initiative that could be devised within my community is comprehensive physical and mental health screenings at local community centers and churches. Advanced practice nurses could partner with parish nurses to help screen patients and refer them to local clinics for mental health and primary care. All healthcare workers who are involved could perform a cultural bias assessment so they can understand what their own biases are prior to working with diverse patient populations. It is vital that all patients feel that they are respected, valued, and that they are listened to. It is important to treat all people as we would want to be treated, which is part of my faith and Christian worldview.

References

Chokshi, D. A. (2018). Income, poverty, and health inequality. JAMA, 319(13), 1312-1313. Doi: 10.1001/jama.2018.2521

Kyere, E. & Fukui, S. (2022). Structural racism, workforce diversity, and mental health disparities: A critical review. Journal of Racial and Ethnic Health Disparities, 1-12.

Summers-Gabr, N. M. (2020). Rural–urban mental health disparities in the United States during COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S222.

Misty Walton

Happy Saturday, Bonnie! Your post provides a great discussion around inequalities in healthcare and prevalent disparities. Unfortunately both poverty and mental health impact my surrounding community the most also. The syllabus this week offers some great readings and a video that are very insightful in addition to the IHI module this week. Davis (2021) suggests that the nurse must advocate and assess social needs across the continuum of care from the office to policy making. I recently learned that the county in partnership with a local community foundation is opening an urgent care for mental health. I am hoping that our local hospitals follow and help to open up additional urgent cares and provide resources within the communities. In the meantime providing mental health screenings and licensed therapists at community centers and churches would be very beneficial. I also learned that we have launched mobile access to care in lower income communities for primary care visits, sick visits and preventative screenings. The mobile care units are able to provide medications also accept narcotics and prescriptions to food.

References

Davis, C. (2021). 4 areas where nurses can make an impact on social determinants of health. Healthcare Leadership Review, 40(8), 10-12.