e013. Cultural Competence with Vanessa Nazario

Full Interview with Vanessa Nazario

Interview Transcript

[00:00:46] Amy: Welcome back to including you. My name is Amy C. Waninger. I’m your host. I’m also the founder and CEO of lead at any level. My guest today is Vanessa Nazario. Vanessa’s the corporate director and chief diversity officer a Memorial healthcare system. Memorial is one of the largest not-for-profit healthcare systems in the US.

[00:01:08] Amy: It’s based in south Florida and employs 14,000 people. Vanessa, welcome to the show.

[00:01:14] Vanessa: Good morning. Good morning. Thank you so much for that warm introduction.

[00:01:18] Amy: I’m so glad to have you here. I am curious as I am with all of my guests, with 14,000 employees having a commitment to diversity and inclusion is a big commitment, right?

[00:01:31] Amy: Because you’re talking about folks from all different kinds of professions and all different sorts of roles from hourly people to salary, from people who are in food service to people who are doing brain surgery, and that’s a big swath of stakeholders and interests. Why is diversity and inclusion such a priority for Memorial?

[00:01:57] Vanessa: Oh, thank you for that question.  I think that’s a good place to start, right? Because at the end of the day, you always have to go back to the why this matters for an organization, particularly in healthcare. If you think about what we’ve been through over the last several years with the pandemic, I think more than ever, we have to really stay laser focused on creating an environment where people can bring their whole self to work really their authentic identities.

[00:02:18] Vanessa: And you have to be really intentional about going to market with strategies to make that happen. I’m a firm believer that, you can let it sort. Try to happen organically, but what happens is sometimes you don’t get it sort of right, so to us, in terms of building a culture of inclusion and having a specific strategy was super top of mind for us again,

[00:02:38] Vanessa: and the other thing I’ll share with you that in south Florida, we’re very fortunate to have a rich, diverse marketplace, right? We have an abundance of diversity within our own organization. So that’s a really great place to start with, but the area that again, we have to be very intentional about is making sure that those individuals who come to us every single day for as part of their career and employment, the 14,000 employees, that they feel that sense of belonging,

[00:03:04] Vanessa: and that’s the why for us, right, connecting it back to, why should they show up each and every single day and really give 150% of themselves to this organization? If they’re not feeling respected right, and treated with dignity, and for me as a leader in DEI was to make sure that we focus on that because if you do that and you do it well, you get the best results from comradery among peers, right?

[00:03:26] Vanessa: How they show up in front of our diverse patients, maybe the ideas that come from having, these diverse sort of individuals around a certain space. So, there’s just so many benefits to this for this reason, right? And many others was the why behind we wanna do this, right, it’s essential.

[00:03:40] Vanessa: It’s an integral to make us the best healthcare organization. Not only is south Florida, but honestly my aspirational goal is you know, countrywide that we’re recognized as leaders in this space because we’ve been so focused on really supporting diversity equity inclusion from the ground up.

[00:03:56] Vanessa: And it, and I guess for me, I would probably say I would see it successful when you hear employees show up, and it shows up in our employee engagement scores when they themselves are talking it up and really being DEI champions. So, for me, that’s how I would know that we are trending in the right direction.

[00:04:13] Vanessa: But for us inclusion was top of mind and that’s why we’ve been so laser focused on it. So, thank you for that question. I think that’s a question that again, many DEI professionals have to start with in terms of like, why does this even matter? How does this impact the business and us in healthcare?

[00:04:27] So thank you for.

[00:04:30] Amy: You bet. I wanna,  I wanna pull on this thread a little bit about, the constituency or the marketplace that you’re serving because when I work with hospitals, especially, I always think about when somebody walks through the door to be served at a hospital or to see a doctor, they are likely at the most vulnerable point, they’re going to be

Vanessa: Absolutely.

[00:04:50] Amy: Kind of, once you walk through those doors, you have very little control, right? Because people are gonna tell you what they’re gonna do, and you can say yes or no, but you don’t really always understand what’s going on, you don’t always understand the impacts cause we don’t walk in with all that medical knowledge,

[00:05:03] Amy: and I would imagine that having a diverse and inclusive and authentic workforce in a hospital really changes the patient dynamic as well. Because the level of trust that people need to have to even walk through the doors is so high. Can you talk a little bit about that and how that translates into the services that you provide?

[00:05:23] Vanessa: Oh, absolutely. Absolutely. So obviously, when you always hear people say, no one really wants to come to a hospital, right? It’s not Ooh, let’s go to the hospital today. What a fun activity it is. So obviously, when they do come into our facilities, any one of our facilities.

[00:05:35] Vanessa: The expectation, I would hope, that they hold us accountable for delivering the best care to them. The piece that we’re trying to make sure that we weave into this whole conversation is that its culturally competent patient centered care, that at the end of the day, understanding the diverse marketplace where we’re in again, that we understand our patients come from all walks of life, all different cultures, backgrounds, customs,

[00:05:57] Vanessa: religion, speak different language. So, for us to meet them where they’re at and be in a place where we understand and appreciate that makes the world of a difference. They, what we’ve seen is that patients trust their providers when we take the opportunity to learn a little bit more about them.

[00:06:13] Vanessa: Yes, you wanna treat, whatever’s happening and get them outta here as soon as possible. But if you’re taking consideration, if they speak a different language that you wanna be able to make sure they have an interpreter as an example, that the documents that they’re reading is in their preferred language, that their provider may be

[00:06:29] Vanessa: speaks their specific language or, and, or is cognizant of maybe something about their religion, that they abstain from certain foods. And for us to customize that experience, it’s gonna make the difference for us. That’s what’s gonna make us again, the best healthcare providers in south Florida market.

[00:06:44] Vanessa: And again, I think big, I think across the country in terms of being a best in class. So, for me and for our organization, that’s, we’ve been focused on, and that’s the other piece of that question in terms of the why this matters for us, because again, if you’re meeting the patient, when they’re at making sure that you take into account again, their background, their customs or culture, it’s just gonna feel as though we really do care because we do, we do, and a part of that in terms of how do we even get ready for that is on our side is raising our cultural awareness.

[00:07:13] Vanessa: So, we focus a lot on educating our staff around all the different cultures we serve, and as a matter of fact, yesterday for pride month, we had an amazing speaker that really took the opportunity to teach our caregivers around understanding how to create an affirming environment for the LGBTQ plus community, right?

[00:07:32] Vanessa: Raising our collective level awareness, understanding why pronouns matter preferred names in our identity, all these things that we should know. Because if you’re sitting in front of someone who identifies as transgender, and they’re saying, hey, please use my preferred pronouns. I would expect that our caregiver would understand the significance of that request.

[00:07:51] Vanessa: So, for me, and for us, that’s what we’re focused on. And that’s what it makes a difference, and we could probably start to see the impact of this work. When you look at our patient experience scores, and we see this back in our surveys when our patients are saying, Hey, I’m gonna select Memorial healthcare system for my care because they really do care about who I’m as a person, I’m not just, a number that comes in and I’m treated and released. They actually do care, and that goes back to that emotional sort of connection, that sense of belonging. And that’s for me, top of mind when it comes to seeing our patients who select us for their care quite honestly, I and it’s a tremendous endeavor.

[00:08:28] Vanessa: It’s not an easy on, I keep going back to what I said earlier. In south Florida, there’s such rich diversity that we’re not gonna know every single thing about every single customer culture, but if we’ve raised our awareness and terms, by at least understanding that, hey, this person might have a custom in practice that we need to be mindful of

[00:08:46] as we do their care plan, then we’ve gotten it, we’ve gotten it, we’ve elevated that conversation.

[00:08:53] Amy: Absolutely, and I think from a patient perspective, having been in the hospital a few times, it’s hard to trust that your care is going to be good if, or that it’s gonna be appropriate

[00:09:03] Amy: if your nurses, your doctors, even the people at registration, if they don’t see you. How can they treat you?

Vanessa: Absolutely.

Amy: And if they don’t see you, how will they treat you? And that’s a big fear for a lot of patients, especially those that have been in the past, excluded from, for example, medical trials or who have been part of groups that have been mistreated by the medical industry or, by this the broader medical institution, right, there’s a lot wrapped up in that for them, and when they walk in and they feel seen and they feel heard. Some of those barriers come down and can lead to better outcomes.

[00:09:38] Vanessa: Absolutely. It’s you have to build a level of trust with your patients, right? They have to trust that, you really have their best intentions on top of mind and we do, we do

[00:09:47] Vanessa: and I think again, when you inject sort of the diversity equity inclusion, sort of conversation into this fold. It just elevates that whole experience for that individual, right. So, taking the time to understand, again, someone’s preferences and again, meeting people where they’re at, it just makes the world of a difference.

[00:10:04] Vanessa: And I want them to walk away saying Memorial really got it right for me, and they go back home to their family and friends to say, hey, let me talk about this experience at this hospital, you know. They were considerate about the foods I consume, my religion, as an example, my language and all that kind of stuff that really really matters to people.

[00:10:22] Vanessa: Absolutely, and you have to build that trust factor and take the opportunity to understand where they’re coming from and meet them where they’re at.

[00:10:29] Amy: You talked a little bit about, building cultural competence within your organization. How are you doing that specifically? Is this through training and education?

[00:10:38] Amy: Is it, what are the media or delivery mechanisms that you’re using to build that kind of competence? Because it’s not a once and done right. It’s over time and it just layers upon layers. Can you talk a little bit about that?

[00:10:50] Vanessa: Absolutely, you have to use different modalities when you’re

[00:10:55] Vanessa: teaching and really trying to inject this cultural awareness, thinking among, 14,000 individuals, right? So, we’re a large organization. So, you cannot do a one webinar and expect like transformation to occur. You have to constantly build on sort of the content, the conversation.

[00:11:14] Vanessa: So, we do webinars, we do in persons. The last two years, obviously, because the pandemic, we had to hold back on the in person. So, we’ve transit transitioned to virtual. However, the aspirational goal is to get back to those in person conversations. I will share though that even with our leadership

[00:11:30] Vanessa: we do have a forum, a leadership forum that occurs quarterly and we’ve injected conversations around unconscious bias as an example and different topics and themes that connect back to the DEI conversation to make sure that again, that as leaders, they’re walking away with something new in terms of learn around this and that they take it back to their staff.

[00:11:50] Vanessa: And we’re testing different models in terms of how we go to market. Because again, it gets a little hectic, as you can imagine, because patients are first and foremost, and when you have clinicians who are on units, you can’t pull them off the floor for three hours, right? So, we do, in-services where the nurses for example, will huddle for 20 minutes and we’ll pick one topic microaggressions, let’s say as an example, and we’ll talk about microaggressions, how they might show up and leave them with some resources that then they can read and digest

[00:12:19] Vanessa: after that conversation. So, we have to be really creative but we’ve tested out the in person, the virtual webinars. We’ve also looking at doing some more lunch and learns as an example. We do send out email communications every single month, but specifically if we’re celebrating a national sort of cultural holiday.

[00:12:39] Vanessa: So, for black history through my office, a DEI office, I put together a really thoughtful communication to race our level of awareness around the importance of that particular historical month. What are the things that we need to know and learn about? So that’s the other way is sending information electronically.

[00:12:55] Vanessa: We really try to figure out, what are the best modalities to get this information out there, and that way, again, people can start to absorb. However, to your earlier point, it can’t be a one and done, right? So, I talked about pride month and the conversation we had with our staff now, what happens next is an additional session that we can now put in our e-learning platform and push out to them

[00:13:17] Vanessa: so that way they can enroll and complete an additional sort of session around this conversation to continue to build on what they were exposed to as part of sort of their introduction, if you will during the dialogue on pride month. So, you have to really think about how to get it to market within healthcare, because it’s a little different, like I mentioned we’re in a very unique sort of situation where we just can’t pull people off units in Florida.

[00:13:40] Vanessa: Doctors are, treating patients or clinicians, even our environmental services, they’re making sure rooms are sanitized and safe, and so you have to think about how do I get this information out there. So, we’re very fortunate that we have different modalities that we can test

[00:13:53] Vanessa: to bring them the information it’s been pretty successful. It’s been pretty successful, and I do receive emails back from staff who participate in these sessions and many of them are like, wow, I had no idea about, fill in the blank, right? and it’s remarkable and it’s amazing.

[00:14:07] Vanessa: It’s exactly what I’m looking for that people say, wow, I had no idea, but now I know now I’ll understand a little bit more if I have a patient from fill in the blank from this country or someone who’s LGBTQ plus, and that to me, it’s those, it might seem so small and minute in terms of the learn.

[00:14:24] Vanessa: But again, I, if you continue to build the impact, you’ll feel it you’ll feel it eventually again when it shows up and how they show up in front of that patient for us.

[00:14:33] Amy: So much of this is just about challenging one’s own assumptions, right? That, that we all go about the world as if our worldview is truth and is fixed and is objective.

[00:14:46] Amy: And when you can start to introduce different lenses onto reality. When you can start to interject and interrupt those patterns, then people can start to see them on their own. It’s almost like a muscle memory that comes to them when they say, oh, I wonder what I’m assuming about this person or what I’m assuming about this situation, or did I hear this the way they intended it and just breaking down those barriers bit by bit can make a huge difference.

[00:15:11] Vanessa: Oh, my gosh. It absolutely can. I, Just going back to and I keep referencing this pride conversation we had only cause it was just yesterday. So, it’s top of mind, but one question, for example, from one of our clinicians to the speaker, a phenomenal speaker from the pride center she asked, how do I make sure that if someone I’ve never met as an example of patient

[00:15:30] Vanessa: that I’m not addressing them inappropriately, misgendering them, for example, and I wanna use the right pronouns. How do I even broach that conversation without messing up, so to speak? And, we were able to address that question specifically about how do you do that, right? and maybe you start with just introducing yourself.

[00:15:46] Vanessa: My name is. Vanessa Nazaro my pronouns are she her hers? And all of a sudden it sets the stage for, wow. Okay, now I see where this person’s coming from and then you can engage with that other person. Even just asking those questions and raising the level where it is, there they’ll take that back to the hospital and then they’ll share with their staff and say, Hey,

[00:16:04] Vanessa: let’s start introducing ourselves to our patients and then asking for how do they wish to be addressed and what are your pronouns? So again, when you talk about impact and how you see how learnings are really being grasped onto by our staff, it’s remarkable. It’s phenomenal.

[00:16:18] Vanessa: And that’s why I totally believe and I’m a big firm believer that this education, it works. You just have to constantly sort of again, be at it and not have it be the one-time conversation and not really revisit it again. Because, and then it’s outta sight out of mind in many cases

[00:16:33] Vanessa: and that way its people lose sight of again, what we’re trying to do here.

[00:16:39] Amy: Yeah, and I wanna touch on this too, because it occurs to me as you’re talking about all these things that you’re doing, that your hospital system you’ve been dealing with COVID for the last two plus years and two and a half years now at the time of this recording, and you’ve kept this work going despite or perhaps because of or especially because of all of the pressures on your staff.

[00:17:05] Amy: and so many hospitals, especially right now are dealing with burnout from doctors and nurses and support staff. They’re dealing with people, really high turnover, they’re dealing with overwork just fatigue around compassion and empathy, and there’s really some trauma going on within the hospital staff as well with what you’ve been through

[00:17:26] Amy: and I’m curious, cause I’ve heard people say we can’t start that until we’re through this. What would you say to the hospital systems or to the companies that say, look, we gotta get through COVID first, then we can address this.

[00:17:36] Vanessa: I would say don’t delay you can actually do it, so, I’ll share that.

[00:17:40] Vanessa: I actually started my journey with Memorial in January of 2021. So, it was year the year, the second year of COVID and to start a DEI strategy from the ground could, and on the onset it might feel a little daunting that, can I even do this? but then you fast forward and here it is a year and a half into it

[00:17:55] Vanessa: and what we’ve been able to accomplish in just a year and a half in terms of acceptance, adoption of what we’re trying to do has been nothing but shorter, remarkable. We’ve been able to launch new education programs, we’ve signed a CEO action, diversity inclusion pledge, which is a national pledge, American hospital association, 1 2 3 for equity pledge.

[00:18:15] Vanessa: We kickstarted our physician diversity equity and inclusion council to talk about how do we bring an equitable lens to the physician community right in our stakeholders there, we’ve done so many remarkable things. We’ve launched our curriculum around understanding different cultures and backgrounds.

[00:18:31] Vanessa: And to be honest, the feedback I’ve received from staff has been, you know what, this is something that we needed because when you’re only here about COVID and COVID, COVID COVID, to see something different, that’s exciting, right? That’s gonna help us be better professionals to build a culture of inclusion and, and get people excited about coming to work each and every single day, because we’re honoring their identities and who they are.

[00:18:55] Vanessa: It’s exactly what was needed. It was like a blessing for us to be able to launch this andI think you could put, ’em a hundred excuses in terms of why you can’t get it done, but we did it and as a matter of fact, we’ve been invited to speak at national forums about the work we’re doing at Memorial relative to diversity equity inclusion,

[00:19:11] Vanessa: and the word is getting out about what we’re doing here, which is remarkable, and maybe that sounds a little boastful, but that’s okay. I think we’ve earned it. And I was saying at the end of the day, Amy. It takes an entire team and village to bring us to life, right? and it starts with our CEO (inaudible first name) Fernandez, who, again, because of his leadership and his vision, you know, to, for us to embark on this journey, my leader, Margie Vargas, who’s CHRO of our organization, she and her vision to make sure we were able to get this done and all those support in terms of resource.

[00:19:42] Vanessa: That is what has made it so successful for us, and I can only imagine that we’ll continue to build on this great momentum in making things really happen. I mean, just in one year we were able to do new policies, a gender transition policy, to make sure again, that our colleagues who identify as transgender, that we’re creating an environment space for them to feel safe and comfortable as a transition.

[00:20:03] Vanessa: We’ve done certain things around patient populations and making sure again, that we’re looking at our policies or procedures, does it read from an equity perspective at an equity launch? Is there bias comments within that policy? So, we’ve done those reviews, so there’s so much you can do, I think people think that you have to have in person everything and what have you to be DEI, but there’s so much more that you can do in terms of the internal infrastructure just to move this thing forward, and that’s what we focused on the first year and a half. So, it’s a feasible absolutely proof in the pudding that you can actually do it.

[00:20:35] Vanessa: And again, I invite anyone who wants to reach out to me to ask, about how we’ve done this, I’m always, I’m an open book, I’m an open book and I do speak to others chief diversity officers and other diversity professions about this work. And hopefully through this podcast, they’ll be able to also get some glean some of the information that I’m sharing and hopefully get them excited about continuing their work regardless of what’s happening, pandemic, right?

[00:20:58] Vanessa: There’s just so many things. There’s always gonna be something, let me put it that way. There’s always gonna be something. However, if you stay really laser focused and really surgical about your approach, you can get it done.

[00:21:10] Amy: Absolutely, and I think so many people need to hear that, there’s always a reason not to do the right thing, and if you’re committed to doing the right thing, you’re gonna get it done anyway.

[00:21:20] Vanessa: Absolutely. You have to come from a good place, right? If you’re coming from a good place with really good intentions, I think it’s and that’s where we started the conversation about being very intentional about the approach and we have been really intentionally thoughtful about it,

[00:21:31] Vanessa: and that’s why I do believe we’ve had the success we’ve had in a short amount of time given, the backdrop of a pandemic and everything that’s going on, right? I think for staff specifically, again, it’s been a welcome sort of change in terms of the conversation and, to hear about different cultures and their cultures being celebrated, whether it’s black history month women’s history, month pride month and all of a sudden wow, this organization, like they actually care, about me and my culture, I feel seen and hurt, which by the way, I’ve had employees say that to me, I feel seen and heard, how powerful is that?

[00:22:06] Vanessa: How powerful is that for an employee to say that, and you think about their head space, coming to this organization each and every single day, bringing you know their true selves to work and how that shows up in terms of in front of our patients with their colleagues. It’s impactful work.

[00:22:21] Vanessa: It really is. So, you can get it done.

[00:22:24] Amy: Absolutely, Vanessa, thank you so much for your sharing your expertise for your openness and for your time today. I really appreciate hearing about what Memorial’s doing and how you’re driving this in your organization. Thank you.

[00:22:36] Vanessa: Oh, thank you so much for the opportunity.

[00:22:38] Vanessa: And I’m glad that I was able to share, and again, if there’s ever, if anyone who’s listening to this wants to reach out to me. I do make my information available and it’s a journey for all of us. It really is, and listen, are we gonna get it right all the time? Absolutely not.

[00:22:52] Vanessa: But we learn from our mistakes. We continue to grow right? and move forward, and when you have the right resources, leadership, commitment, and the right people around the table, supporting this, your internal stakeholders, you will be successful and you can do it. So, thank you again for the opportunity to have this conversation it’s it was great.