equity

Aparna Gulati, MD, was growing alarmed. Many African American patients with high blood pressure were missing their doctors’ appointments.

“Due to COVID-19 fears, many of our patients weren’t coming in for even a blood pressure check,” said Dr. Gulati, medical director of Chronic Conditions Management for the Greater Southern Alameda County area in Northern California.

“African Americans are at the highest risk for all kinds of morbidity due to hypertension.”

Nationally, more than 40% of African Americans have high blood pressure — a rate much higher than other racial and ethnic groups.

Like providers across Kaiser Permanente, Dr. Gulati is working to reduce the disparity. In November, she and her team collaborated with Coalition union members to host 2 free blood pressure fairs for African American patients with hypertension.

Cashier service receptionists, members of OPEIU Local 29, called nearly 2,000 patients to notify them about the event. Lab workers from SEIU-UHW also provided their services.

“Many of our patients have critical needs,” said receptionist Alexis Machado, who worked at both events. “They might have slipped through the cracks if they hadn’t shown up. They all seemed happy to be here and get their preventative screenings taken care of right then.  It was very rewarding for me.”

Meeting patients’ needs

In all, 500 African American patients drove up to receive blood pressure checks. Flu shots, lab tests, mammograms and colorectal cancer screening kits also were available.

“We can both get our blood pressure checked without getting out of the truck,” said Kaiser Permanente member Tanya Leno, as she and husband William Leno drove through the outdoor event.

Organizers were thrilled with the turnout — and results. About 25% of patients with high blood pressure didn’t have it under control and needed their medication adjusted. They also received follow-up appointments.

“We used the opportunity to teach patients the importance of measuring blood pressure and keeping it controlled, investing in a blood pressure machine, and following up with their physician,” said Dr. Gulati. “Coming from a physician, it tends to stick more, and will hopefully increase awareness.”

LaTisha Thompson has nothing but positive things to say about breastfeeding her 1-year-old daughter, Teigen Roberts.

“It was a no-brainer for me,” says Thompson, an on-call pediatrics nurse at Kaiser Permanente’s Capitol Hill Medical Center in Washington, D.C. “I decided to do it because of the benefits that breastfeeding gives to my baby and me.”

Indeed, breastfeeding has many health benefits for babies and mothers. But Thompson stands out among African American mothers, who are less likely to nurse their children than women of other racial and ethnic groups because of cultural beliefs that formula is more filling than breast milk. Many Black moms also lack family support and access to breastfeeding resources.

“It’s a national problem,” says Lori Franklin, RN, a lactation consultant and member of UFCW Local 400 who is working to close the gap with her colleagues at the regional Newborn Care Center in the Mid-Atlantic States.

Learning from moms

To better understand the challenges African American women face, the Level 4 unit-based team surveyed 45 Black moms as part of a “voice of the customer” project in January 2019.

The results were revealing.

“They were looking for prenatal education,” says labor co-lead Francesca Klahr, RN, a lactation consultant and UFCW Local 400 member. “We went back to the drawing board, and when we offered it, they came.”

The team doubled the number of prenatal breastfeeding classes and partnered with ob-gyn nurses to encourage African American women to enroll. The response was dramatic.

The percentage of Black mothers taking prenatal breastfeeding classes jumped from 3% to 15% between September 2018 and September 2019.

Kathleen Fulp, a mother of 2, joined the class after experiencing initial difficulty nursing her firstborn child, Savannah, now 2 years old. She’s glad she did. “I probably would have given up had I not had support.”

Such enthusiasm spells success for Nia Williams, clinical operations manager and the team’s management co-lead.

“We can empower and encourage our African American moms to push through, and that has been really successful.”

“Everyone must put on their leadership hat. It doesn’t relate to title or overall responsibility —  it’s what you control and influence from where you stand,” said Ronald Copeland, MD, senior vice president and chief equity, inclusion and diversity officer, at the National Equity, Inclusion, and Diversity Virtual Conference Series in October.

The Labor Management Partnership is designed to foster leaders at every level, to encourage everyone to use their voice and add their ideas to solving the challenges at hand. As our nation and our organization seek new ways to advance equity and diversity — including equity in health care — doing the right thing has never been more important.

“Action matters more than passion, and impact matters more than intent,” Dr. Copeland said. “It’s great to say, ‘I want everybody to achieve equity and inclusion,’ but we have to do the actions that make that occur.”

See equity in action in this issue of Hank with inspiring actions taken by 4 unit-based teams from across the organization. Together, their commitment to achieving equitable outcomes in maternal-child health, and in treating diabetes and high blood pressure, is reshaping what culturally sensitive care looks like for thousands of our members and patients.

This past year has been filled with pain and loss, from COVID-19 to the killing of George Floyd. These crises have been immense and intense.

But thanks to the tireless efforts of our entire workforce, we at Kaiser Permanente have responded to meet the moment of today’s historic challenges.

This issue looks at how our Labor Management Partnership has addressed systemic racism amid the pandemic, advancing equity in care and in the workplace.

Kaiser Permanente and the Partnership unions believe in equity and inclusion for all, and are committed to delivering affordable, high-quality care and service. As we move along on our journey to equity for all, we’re highlighting examples of this work across our Partnership.

Our cover story focuses on unit-based teams working to minimize health care disparities for the most vulnerable among us, from improving maternal-child health to treating diabetes and high blood pressure. You’ll also find resources to foster workforce and health equity.

Read about teams cultivating an inclusive workplace. See how physicians play a key role in partnership, and how our education and training resources are expanding opportunities for employees to advance their careers.

Try our puzzles and games to explore elements of equity. View our SuperScrubs comic for a thought-provoking take on the topic. And don’t miss our back cover for an inspirational quote from our chairman and CEO, Greg A. Adams.

Let’s build on these examples and commit to actions we can take to advance equity and partnership. Kaiser Permanente, and the members and communities we serve, will be better for it.