First Diversity Week at Stanford Medicine tackles tough topics in medical education, health care | News Center

People are a composite of many interconnected identities, Lassiter said, and taking an “intersectional” point of view is helpful in assessing how diverse, equitable and inclusive a workplace is. As an example, Lassiter described a case study of a particular organization that touted the number of women and people of color in their workforce. 

 The “statistics sound great on the surface, but … when we look at the data from an intersectional perspective, we see that the women in the organization are mostly white women, and the largest group of men in their organization is white men,” Lassiter said. 

 “When organizations say, ‘We’ve increased our numbers of women,’ who are those women?” Lassiter said. Similarly, when groups claim, “’We’ve increased our numbers of people of color,’ who’s included in [their definition of] people of color?” These are the questions that the framework of intersectionality helps us address, Lassiter said.

Diversity, equity and inclusion in medical education

We have to be willing to employ the same kind of rigor we apply to studies of science and medicine to efforts designed to eliminate bias and racism and promote diversity and inclusion, several speakers said.

In 2017, a 10-month program called Leadership, Education and Advancing Diversity, or LEAD, was created to pair Stanford Medicine residents and fellows with mentors who are Stanford Medicine faculty or educational administrators. 

“I had no idea how impactful this work would be,” Carmin Powell, MD, clinical assistant professor of pediatrics, told attendees at the Diversity and Inclusion Forum on Oct. 9. Powell co-directs LEAD with Lahia Yemane, MD. 

Every month, LEAD’s participants take part in discussion-based lectures on various topics related to equity, diversity and inclusion. They also work with their mentors to develop a presentation to deliver at the annual Diversity and Inclusion Forum.

 In just four years, LEAD has tripled in size, growing from 30 scholars and mentors to more than 100, Powell said. Part of the program’s success is its engagement with medical residents and fellows early in their careers, making equity, diversity and inclusion a part of their training.

Knowledge is key

Educating yourself on the history of racism and how to foster diversity and inclusion is essential, said Marc Nivet, executive vice president for institutional advancement at the University of Texas Southwestern Medical Center and keynote speaker at this year’s Diversity and Inclusion Forum.

“If you get nothing else out of today’s talk, I would just implore you to read and to get educated,” Nivet said. 

“You can no longer be an effective leader, period — not just in academic medicine — but period, without being much more elevated in your ability to understand these issues,” he said. “And that comes from reading and learning.”

Learning, trying new things and sharing what does — and doesn’t— work is important for progress, Nivet explained. “I think we don’t share the results of failure, which is typical in academic medicine. We don’t get points for writing about failures or initiatives that didn’t work and why

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Outbreak Fueled By Small Get-Togethers, Puts LA In Tough Spot

LOS ANGELES, CA — At least a third of the people recently infected with the coronavirus in Los Angeles admitted to attending small get togethers while about 10 percent admitted to attending larger gatherings, according to ongoing USC study. More than half of those recently infected reported being close contact with people outside their household.

The study also found that roughly one-third of recently infected respondents reported visiting another person’s home in the previous seven days, while one- third said they had visitors at their own home. About 10% said they had attended a gathering of 10 or more people in the past week.

The study is among the mounting evidence that the outbreak is on the rise again in large part because of small gatherings and parties in defiance of health orders. The damage such gatherings can do during the pandemic is staggering.

“I know this sounds like a small number, but if 10% of L.A. residents attend gatherings, this translates to 1 million people gathering with others not in their household,”Los Angeles County’s Public Health Director Barbara Ferrer said. “And if we assume that 2% of people can be infected, we could possibly have 20,000 people capable of infecting others who are milling about at these gatherings each week.”

The findings should serve as a warning that the virus can as easily spread among friends and family as it can among strangers in public places. Los Angeles County’s public health director warned Monday of an already worsening COVID-19 situation becoming even more dire during the upcoming holiday season without rapid behavioral changes.

Patients who have become infected with the coronavirus show steady increases in interactions with people outside their own households,Barbara Ferrer said . The ongoing USC study found that for the week ending Oct. 20, 57% of survey respondents reported being in close contact with someone they don’t live with in the previous seven days.

Ferrer said the USC data, combined with information collected during contact-tracing interviews with virus patients, shows “there’s ample evidence that gatherings are increasing and are one of the drivers of the increases in cases in L.A. County.”

And with Thanksgiving just weeks away, Ferrer said concern is mounting that the holidays could make things worse.

“With our case numbers already on the rise, we are concerned about the upcoming months,” Ferrer said. “Holiday gatherings and cooler weather, when people are more likely to gather indoors, are perfect conditions for spreading COVID-19.”

Ferrer announced another 1,406 coronavirus cases on Monday — a day that is typically marked by relatively low daily case numbers due to reporting lags from the weekend. She noted that the county has reported almost 3,000 new cases over the last two days, a time of week when numbers are always lower than the rest of the week.

“So if that trend holds true, then we’re going to see higher numbers for the rest of this week,” she said. “And that would in fact not only create a

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CMS imposed few penalties at nursing homes despite promises of tough enforcement

The federal agency and its state partners, Verma said, would conduct a series of newly strengthened inspections to ensure 15,400 Medicare-certified nursing homes were heeding long-standing regulations meant to prevent the spread of communicable diseases. It was another key component of a national effort, launched in early March, to shore up safety protocols for the country’s most fragile residents during an unprecedented health emergency .

But the government inspectors deployed by CMS during the first six months of the crisis cleared nearly 8 in 10 nursing homes of any infection-control violations even as the deadliest pandemic to strike the United States in a century sickened and killed thousands, a Washington Post investigation found.

Those cleared included homes with mounting coronavirus outbreaks before or during the inspections, as well as those that saw cases and deaths spiral upward after inspectors reported no violations had been found, in some cases multiple times. All told, homes that received a clean bill of health earlier this year had about 290,000 coronavirus cases and 43,000 deaths among residents and staff, state and federal data shows.

That death toll constitutes roughly two-thirds of all covid-19 fatalities linked to nursing homes from March through August.

Patient watchdog groups acknowledge that not every outbreak could have been prevented, even with adequate infection-control practices in place. But as the pandemic raged, the number of homes flagged for infection-control violations remained about the same as last year.

The facilities that were cited for breakdowns often escaped significant penalties, The Post also found.

Inspectors reported violations at about 3,500 homes, ranging from dirty medical equipment to a lack of social distancing. Though federal law allows CMS to levy fines of roughly $22,000 for each day a serious violation lingers, most providers were fined little or nothing at all.

For failing to ensure staff members wore masks, Sterling Place in Baton Rouge, with more than 80 coronavirus cases and 15 deaths, was fined $3,250.

For failing to separate residents in a common area, Heritage Hall in Leesburg, Va., with more than 100 cases and about 18 deaths, was fined $5,000.

For failing to use protective gear, the Broomall Rehabilitation and Nursing Center in Pennsylvania, with more than 200 cases and about 50 deaths — among the highest nursing home death counts in the country — was fined $9,750.

Broomall spokesperson Annaliese Impink attributed the lapses to “covid fatigue” and said staff members are corrected when concerns crop up. Officials with Sterling Place and Heritage Hall did not return calls seeking comment. In its written response to the inspection, Heritage Hall said tables had been rearranged and a nursing supervisor would monitor for compliance. Heritage Hall went on to suffer a second deadly outbreak last month, state records show.

The inspections follow a three-year push at CMS to ease rules long considered burdensome to the nursing home industry, whose lobbyists and leaders include former politicians and government insiders. Even before the coronavirus crisis, the agency took steps to limit the use of some

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Hospital Chief Says We Are In For ‘Tough Winter’

CONNECTICUT — The number of positive cases of the coronavirus will continue to climb through mid-January, according to projections by John Murphy, the president and CEO of Nuvance Health, one of the state’s leading healthcare providers.

Murphy joined Gov. Ned Lamont at a press conference Monday, where he made the predictions of a “tough winter.” He said he makes the forecast after carefully following six models of the spread of the virus, and forming a consensus.

Driving those calculations, Murphy said, will be students returning home for the holidays, colder weather keeping people indoors, and end-of-year festivities creating large family gatherings.

Despite the forecast, Murphy was upbeat about what overall outcomes could be expected. The average hospital stay at the start of the pandemic was around 14 days, he said, and now it’s a week, a statistic that “effectively doubles our capacity.”

Healthcare professionals in Connecticut have gotten “much more aggressive about getting out in front of this,” Murphy said. Testing and tracing is much better, and the data is now shared widely. Communication is “light years ahead of where it was” early in the pandemic.

“The setting is different today than 5-6 months ago,” Murphy said. Hospital therapies are more effective, and staff is better prepared. “Seven months has taught us a great deal of how to combat it.”

Nuvance operates hospitals in Norwalk, Danbury, New Milford and Sharon within Connecticut, and three more in New York.

Patients over the age of 80 who end up on a ventilator are still at a very high risk, Murphy said, but the COVID-19 patient admitted at a Nuvance hospital today is on average 5-10 years younger than they were in the spring. “What that means is there are fewer comorbidities.”

Lamont said he is drawing inspiration from the way countries and municipalities are handling the pandemic in Europe.

“Europe is the canary in the coal mine,” according to Lamont. He said that, unlike the U.S., European countries favor curfews as a means to limit the spread of the virus.

“The lockdowns are much more limited,” the governor said, pointing to riots in Italy to illustrate the intolerance the population has for them.

As in the U.S., Europe is keeping school grades K-8 open as much as they can, Lamont said, but noted that gathering restrictions in some countries are kept to a minimum of six.

With just 6.54 hospitalizations per 100,000 population, Connecticut is on the healthier end of the U.S. spectrum, 7th best overall. North Dakota is at the far end, with over 40 hospitalizations per 100,000 people. The national average is 14. France, which Lamont said is about three months ahead of the U.S. in terms of the coronavirus spread, is now at 105 hospitalizations per 100,000 population.

In Connecticut, the number of hospitalizations was up by 37 beds over the past weekend, according to the latest data from the Department of Public Health.

See also: Former Dulos Family Home Is Back On The Market; Sale Pending

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