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Peer Insights | The Power of Patient-Centered Care

What’s important to know about patient-centered care? PEN’s Aïcha Diallo discusses key aspects and benefits of patient-centered care, the impact of patients engaging in shared decision-making, and treatment adherence in relation to cultural factors. 

See More from EPEP CLL

Related Resources:

Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

Peer Insights | Cultural Humility Case Studies and Practical Applications

Peer Insights | Cultural Humility Case Studies and Practical Applications

Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

Transcript:

Dr. Nicole Rochester:

Every one of us wants to receive care that addresses our individual needs. It seems like a given, but unfortunately, this is not the same story for everyone. I’m fortunate to be joined today by Patient Empowerment Network’s Vice President of Programs, Aicha Diallo, to discuss this important topic. Aïcha, what are the key aspects of patient-centered care? And why is this an important area for providers to focus on?

Aïcha Diallo:

The key aspects of patient-centered care include respecting your patients’ preferences, hearing them out, and really understanding where they’re coming from and what they want. Coordination and integration of care is also very, very important. Providing patients the information and the education that you can provide to them. And if those resources are not available, it’s important to seek the resources and be able to connect them with even additional external resources that they may benefit from.

It’s also providing them the access to care that they need. It’s physical comfort. It’s providing emotional support. It’s that continuity and transition and that involvement of family and friends. It’s making them a part of the patient, a part of them being present, about them making the decision to either engage in a specific treatment option or coming up with the best treatment option for them. And why this is important for healthcare professionals to be aware of is because it allows them to meet their patients and their families exactly where they are and be able to provide them with the equitable care and the services that they need.

Dr. Nicole Rochester:

Thank you so much, Aïcha. Can you speak to the importance of involving patients in decision-making processes at the outset of care?

Aïcha Diallo:

Absolutely. Involving your patient in general and shared decision-making is key. I would say it’s important to be able to speak to your patients and speak with your patients as opposed to speaking at them. It’s about respecting where they’re coming from and what their needs and their wants are. It’s about opening up the door for them to share what their goals are, so they could be involved in their care. It’s about giving them that platform, the autonomy to make their own decisions and to be at the driver’s seat of their care.

Dr. Nicole Rochester:

Thank you. And lastly, Aïcha, we know that cultural factors can sometimes impact treatment adherence. So given PEN’s strong presence in the cancer community, I’d love for you to talk about treatment adherence and its connection to various cultural needs and differences.

Aïcha Diallo:

Adherence is really important. Without shared decision-making I feel that it’s very difficult to obtain as a healthcare professional adherence from your patients. One thing that is important for healthcare professionals to understand is that adherence is an active choice that is made by the patient to follow a daily regimen, whether that is taking their medications or exercising every day or even honoring their doctors’ appointments. And while this may have been a conversation with their patient or even prescribed by the healthcare teams, one thing to keep in mind is that the patient is taking the responsibility for their own well-being and is making those actions, not because they were told, but because they fully understand what needs to be done in order for them to achieve their goals.

And without great communication and without the ability to engage your patients in their care, some patients may feel or may be compliant while they’re not necessarily adherent. So that may create a confusion, but what you really need is both. Some of your patients may not feel entirely comfortable asking you questions that could even benefit them because maybe culturally speaking, they don’t want to question their healthcare professional, they don’t want to question their authority. So they will do as they’re told, but it’s important for patients to be adherent and compliant. It’s important to give them that platform to make them feel comfortable and present in their care, so they could be entirely engaged and empowered.

Dr. Nicole Rochester: 

Absolutely. Thank you so much, Aicha. Another wonderful discussion and thank you for your expertise.

Aïcha Diallo:

Absolutely. Thank you very much.


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Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

What is implicit bias, and how can patients’ choices be respected? PEN’s Aícha Diallo discusses implicit bias and unconscious bias, how to engage with patients to practice cultural humility, and tips for involving patients and families in shared decision-making. 

Download the Recognizing Implicit Bias and Respecting Patients’ Choices Infographic

See More from EPEP CLL

Related Resources:

Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

Peer Insights | Cultural Humility Case Studies and Practical Applications

Peer Insights | Cultural Humility Case Studies and Practical Applications

Peer Insights | The Power of Patient-Centered Care

Peer Insights | The Power of Patient-Centered Care

Transcript:

Dr. Nicole Rochester:

As healthcare providers, we know that it’s incredibly important to recognize and to respect patients’ choices. For many of us, that is a given, but I also think it’s important to be thoughtful as we explore this question. So I have the privilege today of connecting with the Patient Empowerment Network’s Vice President of Programs, Aïcha Diallo, a leading voice on this topic. It’s such a pleasure to connect with you today, Aïcha.

Aïcha Diallo:

Thank you so much for having me.

Dr. Nicole Rochester:

So, Aïcha, can you define what is bias? And can you also discuss the different types of bias?

Aïcha Diallo:

Absolutely. Implicit bias is also known as unconscious bias. It is a cognitive process that is intentionally activated when a person automatically classifies another person as a member of a group and applies stereotypical characteristics of the group. This could be positive or negative, but the issue with implicit bias is that it could be common and persistent, and it can be activated very quickly and unknowingly by situational cues.

That could be the color of someone’s skin or an accent that they’re hearing, and it can also impact a person’s perception of a situation and a memory, and even their behavior without that person’s intent and awareness. So the different types of biases that you will find in the healthcare system are race and ethnicity bias, age bias, sexual identity, gender, education, even appearance and ableism. Social-economic status and geographic location are also huge biases that tend to be seen.

The impact that bias does have on healthcare delivery is that it can lead to lower quality care among patients, specifically from underrepresented communities, and it can also result in, unfortunately, incorrect diagnosis, mistakes, delays in treatment, and even further mistrust and distrust from the patient community. So it’s really important for healthcare professionals to be aware of any implicit bias that they may have and really work hard to remove them. And they also have to pay very close attention to any blind spots that can be often present, that can obstruct their views. And the other thing I would also add is that they need to really have the willingness to suspend the “what they know” about a person based on generalizations about their culture and really be open to what their experience as their personal culture.

Dr. Nicole Rochester:

Thank you, Aïcha. And so, you mentioned the types of biases, and you mentioned the impact that they have on healthcare delivery and the type of care that our patients receive. You also said that it’s unconscious. And so I would love for you to share how can providers actually recognize this implicit bias? Are there some practical ways that they can actually recognize their biases?

Aïcha Diallo:

Absolutely. I think it’s very important to reflect on one’s own identity. It’s important to keep in mind that your patient should be treated equitably, with respect, with dignity, empathy, regardless of what they look like, who they are, what language they speak or where they live. I would also and continue to encourage to practice cultural humility, which is really taking a step back, listening to your patients, being present, allowing them to share what their thoughts, questions, concerns are, and to really avoid making any assumptions. And I would also add that it’s important to participate in courses to educate yourself on health disparities and cultural identities. Also check in with your colleagues and make sure that you are on the same page with the way that you are interacting with patients.

Dr. Nicole Rochester:

And finally, can you explain the importance of respecting patients’ choices even when they differ from our own and how this extends to including our care partners in the process?

Aïcha Diallo:

I think it’s very important to understand as a healthcare professional that you are the expert at what you do, but your patients and their families are experts at who they are, what they feel, what they want and need. So making sure to always engage in shared decision-making and including them in the process as well as their care partners in all the conversations and remembering that their care partners are an essential part of their loved one’s care and often make the decisions with or even for them.

So listening to both your patients and their care partner or whoever is in the room with them, that also extends to any additional loved ones that they bring with them. Ask them about their goals and their concerns. Make sure that you make eye contact with them. It makes them feel included as well in the process and direct your questions to both parties. I think applying these strategies are very important in this process.

Dr. Nicole Rochester:

That was wonderful. Thank you so much, Aicha. So if I could summarize what you’ve said, you’ve told us about bias and that implicit bias is unconscious, and so we’re typically not aware of it. You’ve shared some strategies for us to mitigate our biases, and you’ve talked about the importance of including our patients and their family members and support people in the decision-making. So thank you so much for sharing your expertise with us today.

Aïcha Diallo:

Absolutely.


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Peer Insights | Cultural Humility Case Studies and Practical Applications

What are some cultural humility examples? PEN’s Aicha Diallo discusses the concept of cultural humility and provides real-world scenarios of healthcare provider reactions to perceptions about patients versus exercising cultural humility.

See More from EPEP CLL

Related Resources:

Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

Peer Insights | The Power of Patient-Centered Care

Peer Insights | The Power of Patient-Centered Care

Transcript:

Dr. Nicole Rochester:

What do real-world scenarios teach us about cultural humility? I have the pleasure of connecting with Aïcha Diallo, Vice President of Programs at Patient Empowerment Network to really dive into this topic. Aïcha, could you share some real-life scenarios or challenges where cultural humility comes into play in healthcare settings?

Aïcha Diallo:

First, I think it’s important to get a better understanding of what cultural humility is. As a healthcare professional, practicing cultural humility is taking a step back to say, I have a patient in front of me, or I’m interacting with a patient, and I don’t know who they are. So I’m going to take a step back. I won’t make any assumptions. I’m going to listen to them. I’m going to let them share with me who they are, where they’re from, what their needs are, and what’s going on in order to meet them exactly where they are and to understand who is sitting in front of you and be able to then engage in shared decision-making and coming up with the best treatment option for them. So really, taking the time to see the unique elements of your patients instead of automatically characterizing them can also demonstrate respect and can help healthcare professionals give their patients the care that they need and want.

For instance, a physician is seeing a patient and to him the patient looks Latina. The patient has an accent, and the doctor assumes that she doesn’t speak English and automatically requests medical translation services for her in Spanish. Come to find out that the patient is fluent in English, is not Latina, but is from North Africa. So in this scenario, if the physician had taken the time to really listen to their patient and ask more questions and not make any assumptions, it would have really helped them identify their patient’s needs during their diagnosis.

Another scenario that I have that we should always try to avoid is, for instance, a patient of color comes to their doctor’s appointment, and the doctor assumes that they live in a lower income neighborhood and may not have a high level of education. And with that, assumes and chooses not to share any information about clinical trials with them because they believe that they may not be able to access those resources.

So one of the things that I would encourage that we do is to work really hard to remove any biases that we have and to really continuously practice cultural humility with your patients and their families and really remember that we can all be on the same page even though we have different stories.

Dr. Nicole Rochester:

Thank you, Aïcha, for explaining what cultural humility is and for sharing those life scenarios. Can you talk about what these actions look like in reality, how can providers truly apply cultural humility in their daily practice?

Aïcha Diallo:

I think it’s important to identify any personal biases that you may have, reflect on your own identity, remember to treat your patients with respect, dignity, and empathy, and listen to them more, hear them out, find out who they are, what their needs are, what their goals are. Have conversations with them, it’s important to hear them share where they’re coming from and where they’re headed, and this will really help in terms of coming up with the best treatment option for them. I think it’s also important to participate in courses to educate oneself on the different aspects of cultural humility, and how do you integrate that within your daily practices.

I think it’s important to not confuse cultural competency with cultural humility and really understand that you cannot be an expert at somebody else’s culture, that you have to take a step back and be humble and really listen to them and let them tell you and share with you who they are and what really matters to them. I think it’s also important to avoid making any assumptions as you could entirely be wrong, unless the person shares with you exactly what is important to them and who they truly are. And don’t forget to show some interest in what your patients are saying. And remember to recognize and really celebrate the uniqueness of their backgrounds, of their trade, and really do see them as people. I think that’s very important.

Dr. Nicole Rochester:

Aïcha, thank you so much for, again, sharing your wisdom. You’ve taught us a lot about what cultural humility is, the difference between cultural humility and cultural competence, and some real-life scenarios that we can all take away and some tactics for truly applying cultural humility in our practice. Thank you so much.

Aïcha Diallo:

Thank you for having me.


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Peer Insights | Appreciating Patient Diversity and Respecting Cultural Differences

How can diversity be appreciated by healthcare providers? PEN’s Aicha Diallo discusses diversity, how to recognize cultural values and unique backgrounds, and the benefits of appreciating diversity.

Download the Appreciating Diversity Infographic

See More from EPEP CLL

Related Resources:

Peer Insights | Cultural Humility Case Studies and Practical Applications

Peer Insights | Cultural Humility Case Studies and Practical Applications

Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

Peer Insights | Recognizing Implicit Bias and Respecting Patients’ Choices

Peer Insights | The Power of Patient-Centered Care

Peer Insights | The Power of Patient-Centered Care

Transcript:

Dr. Nicole Rochester:

Appreciating diversity means many things to many people. As healthcare providers, it’s important to navigate complex cultural landscapes and also learn how to foster genuine connections across differences. Well, Patient Empowerment Network’s Vice President of Programs, Aicha Diallo, is joining me to look at the power of valuing diversity in our patients and their families. Aicha, how can we as healthcare providers appreciate the unique differences among our patients, and how does this enrich healthcare?

Aïcha Diallo:

The ways to appreciate the uniqueness of your patients can include a lot of different strategies, but I would really focus on putting the patient at the center of everything you do. It’s important to also recognize and celebrate their cultural values and the uniqueness of their backgrounds. Do practice cultural humility, which means listen more, make less assumptions, focus on what your patients and their families are sharing with you, ask them questions that will allow you to get a better understanding of who they are and what their needs are. Also show respect and see your patients as people. And this is shown to really help in terms of improving healthcare outcomes for everyone, especially patients who are in underrepresented communities. And this very much helps in terms of further decreasing health disparities.

Dr. Nicole Rochester:

Well, thank you so much, Aicha Diallo, Vice President of Programs at Patient Empowerment Network. We appreciate your wisdom. 


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