DEI Initiatives

Tell us about a DEI initiative in your division that you would like to highlight.

A current initiative is to enhance diversity of clinical trial accrual at Wilmot Cancer Institute and foster more inclusive trial design and development in investigator-initiated trials. To accomplish this, we have organized a three-part series on inclusive clinical trial design, and recruitment/retention strategies for hematology/oncology faculty members, clinical trial office staff, trainees, and others. An outside organization with expertise in this content area, Inside Edge, will be conducting the sessions.

What advice would you give others who want to undertake similar DEI initiatives in their division?

Align DEI experience, training, etc. with other active goals in the division. For example, we aligned SOGI training series last year during the roll out of SOGI data collection at the cancer center. (SOGI=Sexual Orientation and Gender Identity). This helps to capitalize on momentum and ensure DEI principles and practices into areas of emphasis within the division.

Tell us about a DEI initiative in your division that you would like to highlight.

Over the past year, Nephrology has undertaken several impactful DEI initiatives. A significant change was the early 2023 revision of waiting times for African American kidney transplant candidates. This change, aligned with US Organ Donation System recommendations, addressed a long-standing bias by removing a race-based calculation in estimating kidney function. The transplant team, led by Jeremy Taylor, MD, and Erika Venniro, PAC, made the adjustments for the applicable patients very quickly, and patients were also notified about these changes in their waiting time. This significant step towards equity has improved transplant opportunities for these patients.

Our Chronic Kidney Disease (CKD) education program, spearheaded by Richard Wing, MD and Fahad Saeed, MBBS, has also seen remarkable progress. The team's efforts in developing comprehensive educational materials and organizing informative sessions, facilitated by our skilled nurse practitioners and registered nurses, have significantly improved patient understanding of CKD, its progression, how to slow CKD progression, and management options.

Additionally, our community outreach has also grown. The H2O program, created by division chief Thu Le, MD, Fahad Saeed, MBBS, and the local PUSH Theater performers, focuses on educating school-age children about hydration, nutrition, and physical activity. This program, supported by pediatric and adult Nephrology faculty, will reach numerous schools this year. Furthermore, our collaboration with UR Well to have nephrology clinics at St. Joseph Neighborhood Clinic, led by Scott Liebman, MD, MPH and Catherine Moore, MD, alongside establishing a nephrology subspecialty clinic at Jordan Health, underscores our dedication to accessible healthcare. Our local National Kidney Foundation will collaborate in this clinical program to bring their support and resources in nutritional education to patients at St. Joseph Neighborhood Clinic.

What are the future plans for the DEI initiatives that are being highlighted?

Looking ahead, we are enthusiastic about the growth and sustainability of our DEI initiatives. Our CKD education program is set to become more inclusive, with classes soon offered in Spanish by Mary Nowak, NP, our fantastic nurse practitioner. She is a native Spanish speaker, and she is very passionate about improving patient education and communication. This will allow us to effectively reach a wider patient demographic and be a first step to offering these classes in ASL and other languages, depending on the patient's needs. Expanding the H2O program to additional schools will further our mission of promoting healthy living among children. Lastly, our St. Joseph Neighborhood Clinic and Jordan Health clinics are poised to strengthen our community presence, fostering trust, and improving health care access for those in need. These efforts are foundational to our mission and reflect our commitment to inclusivity and equity in healthcare.  

What advice would you give to others who want to undertake similar DEI initiatives in their division?

For those looking to embark on DEI initiatives, my advice centers on understanding your core motivation and building a supportive network. Our achievements stem from a unified effort, bolstered by strong leadership support and team collaboration. Such a collaborative approach not only sustains our initiatives but magnifies their impact, moving us closer to achieving equitable health care for the patients we serve.

Tell us about a DEI initiative in your division that you would like to highlight.
One DEI initiative within Palliative Care has been working to specifically include some mention of health care disparity or social justice within didactic sessions. We have done this by reaching out to each person who is giving a lecture, explaining our expectation that every lecture includes at least some mention of this topic, providing some resources to assist with that, and then finally offering to brainstorm ways to weave this into their topic if they are not sure. Our hope is that this initiative will improve the awareness of both the fellows as well as the large group of faculty who generously volunteer their time to teach our fellows.

What are the future plans for the DEI initiatives that are being highlighted?
The next step of this initiative is to gather actual data on how often lectures are specifically including this information, and to address whatever barriers exist to achieving 100 percent inclusion.

What advice would you give to others who want to undertake similar DEI initiatives in their division?

Here are some links we provide to our lecturers to help them improve the inclusivity/equity of their presentations.

• CTSI Presentation Diversity Audit Tool
• Integrating Health Equity Content (article from the AMA Journal of Ethics)
• Racism, Not Race, Causes Health Disparities (from the Institute for Healing and Justice in Medicine)

Tell us about a DEI initiative in your division that you would like to highlight.
The biggest DEI initiative our division is pursuing is improving the health and well-being of people with sickle cell disease. This means continuing to develop our clinical site to become what is considered a center of excellence for sickle cell disease. We already have medical providers with enhanced knowledge about sickle cell disease, an interdisciplinary team consisting of MDs/NPs, care coordinators, nursing, PharmD, dietician, respiratory therapist, SW, BH, care management, and dental services. We provide evidence-based sickle cell care as well as primary care, hospital-based care, and infusion services (for sickle cell-specific specialty medications and acute pain management).

What are the future plans for the DEI initiatives that are being highlighted?
Our future plans are to engage with some of the subspecialty divisions to bring them into our care model so that people with sickle cell disease can have access to subspecialists within their center visit. We have started that process with Pulmonary & Critical Care Medicine, and hope to add a hematologist in the next year. We are also hoping to increase our patients’ access to advanced care (exchange transfusions/apheresis) and partner with researchers to increase engagement in sickle cell research.

What advice would you give to others who want to undertake similar DEI initiatives in their division?
My advice to others is to listen to patients and what they need, bring in team members from other disciplines, and partner with other divisions. 

Tell us about a DEI initiative in your division that you would like to highlight.

In 2016, I (Susanne Miedlich, MD) learned about the high prevalence of obesity and diabetes in people with serious mental illness during a meeting of the UR Healthy Weight Initiative, and as an endocrinologist, I felt well-placed and inspired to help improve cardiometabolic outcomes in those patients. In studying the literature and more importantly through actively screening patients with mental illness on antipsychotics for diabetes mellitus at the Medicine-In-Psychiatry-Primary Care clinic (MIPS-PC), I learned first-hand that these patients sometimes struggle with multiple health barriers which include depression, substance use, social isolation, poor living conditions, as well as limited access to healthy foods. This project has been funded by a DOM pilot award, and was executed in close collaboration with my dear colleagues in the Department of Psychiatry, Telva Olivares, MD, Steven Lamberti, MD, Kevin Brazill, DO, and Diane Morse, MD, as well as the wonderful nurses and staff at MIPS-PC. 

I have since started a weekly, embedded diabetes care clinic at MIPS-PC, and I hope our interdisciplinary work there, in close communication with care managers, primary care providers, pharmacists, and psychiatrists will continue to flourish and lead to improved health outcomes in this high-risk patient population. During my work there, I also learned that, just like in my regular practice, connecting to patients and teaching them can make a huge difference. My personal highlight this year was to recruit two patients for the annual Tour De Cure, a local fundraising event of the American Diabetes Association, which includes a bike ride between 12.5 and 100 miles. Both women were rather inexperienced riders, yet both did it, they crossed the finish line with me and both vowed to join our team again in 2024, next time with more training ahead of the race. We all had a lot of fun that day.

What are the future plans for the DEI initiatives that are being highlighted?
In reflecting on what I learned so far, I hope to put more emphasis on healthy lifestyles and diabetes education, ideally peer-led, into our diabetes care clinic, and for MIPS-PC patients in particular. And of course, for the next Tour De Cure in 2024, I hope to recruit and train with at least four patients from MIPS-PC and ride with them. There is no greater reward for one’s work as a physician than to see one’s own teaching points in action.

What advice would you give others who want to undertake similar DEI initiatives in their division?
Health equity, to me, is a basic foundation of my work as a physician, its implementation can be difficult though. For example, not being able to provide a much-needed medication for a patient because it is not covered by their insurance or because they cannot afford it, or because they do not have insurance in the first place, can be extremely frustrating. Yet, small successes in helping our patients make all the difference. In our division, examples include assisting patients in applying for patient assistance programs, joining national patient advocacy initiatives as my colleague Sara MacLeod, DO, MPH, has done to increase access to evidence-based diabetes medications, or providing care to underinsured patients at St. Joseph‘s Neighborhood Center during our monthly Endocrine Nights alongside our ambitious medical students, as most of my colleagues are doing. I am sure you will find your next endeavor if you remain open and connect with your patients.

Tell us about a DEI initiative in your division that you would like to highlight.
First, I (Emily Salib, MD) would like to highlight my amazing colleagues at Highland who contribute so much to our DOM DEI committee. In alphabetical order, this includes Chin-Lin Ching, MD, Jeff Harp, MD, Mike Hudson, MD, Aameera Khan, MD, FACP, Jennifer Muniak, MD, Ruth Odoi, MD, MPH, Saadia Sherazi, MBBS, MS, and Valerie Vetter, PAC.

Over the last year, our Highland DOM DEI Committee developed a standardized tool to help review Root Cause Analyses from an equity perspective. We have also worked to have one DEI representative attend all RCAs and write up their conclusions so this data can be tracked.

What are the future plans for the DEI initiatives that are being highlighted?
Going forward, we would like to continue improving and streamlining this process and making sure we have an appropriately diverse group of people at the table doing these equity reviews. We also believe our tool and process could be used across the institution and we would be happy to see it implemented in our partner hospitals as well. We are also proud of our growing engagement with our local community. Members of our Highland DOM DEI Committee regularly volunteer with the Barakah Muslim Charity as well as the Peck Park Health Fair that occurred a few weeks ago.

What advice would you give others who want to undertake similar DEI initiatives in their division?
Feedback from our Highland DEI Committee about advice includes being careful about “spreading yourself too thin.” There are a lot of different directions and DEI initiatives that are exciting to get involved in, but we've learned it's often necessary to have a narrow focus so that actual progress can be made. Additionally, it's not just enough to have a “token DEI person” in committees and projects. It's necessary to have leadership support as well as a regular check-in to ensure the DEI person's involvement in the committee is meaningful and helpful for both the committee and the DEI representative. Similarly, it is easy to get pulled in many different directions when responding to the needs of a large institution. Your time is precious so always keep your mission and values at the forefront of your endeavors and don't be afraid to refocus on what's most important to you and your group time and time again.

Tell us about a DEI initiative in your division that you would like to highlight.
We are most proud of our division's multidisciplinary approach to diversity, equity, and inclusion work. All faculty, nursing, and staff have been invited and encouraged to participate in activities and initiatives aimed to improve how we interact with each other, our patients, and the community. We have also sought feedback from our patients on how we can improve. Our main aim is to create a culture of humility and ongoing learning where everyone is valued and able to contribute.  

We have multiple initiatives that warrant highlighting:  

• Trauma-Informed Primary Care led by Andrea Garroway, PhD, has included staff training in the concepts of trauma-informed care and creating debrief champions from each workgroup to support each other when discriminatory or disruptive behavior occurs.  

• The Pronoun Project led by Dee Fuller, RN, provided training in improving communication with transgender and gender diverse patients.  
• The Medical Legal Partnership led by Mahala Schlagman, MD, has provided our patients with legal support regarding important issues that impact health including insurance, housing, and other social determinants. 

What are the future plans for the DEI initiative that is being highlighted?
Each of the initiatives mentioned have led to projects outside of our division. Within our practice we have continued routine trainings with all staff covering important topics to promote health equity. Our next steps include creating a system to track, review, and identify opportunities for systemic improvement when discriminatory or disruptive behaviors occur in our practice.

What advice would you give others who want to undertake similar DEI initiatives in their division?
For anyone looking to undertake similar initiatives, don't reinvent the wheel! We often work in silos and often do not realize what amazing work is already being done both within and outside of URMC. Looking for ways to support and expand successful initiatives is more sustainable than working in parallel. Reaching out to your division's DEI champion or the DICE board is a good place to start. We don't have all of the answers, but we may be able to connect you with someone who has similar ideas or goals.  

Tell us about a DEI initiative in your division that you would like to highlight.
An important DEI initiative in the Cardiology division is the development of a Health Equity and Quality Improvement Curriculum by Erica Miller, MD. The curriculum was developed by Dr. Miller and used to educate our fellows during the last academic year. The curriculum included sessions led by many leaders in Health Equity throughout the United States. The curriculum ended with the fellows working together in small groups to propose an equity-focused QI project.

What are the future plans for the DEI initiative that is being highlighted?
Erica Miller, MD, received a grant from the department of Medicine to work with other divisions to develop similar curricula.

What advice would you give others who want to undertake similar DEI initiatives in their division?
Certainly, a key component of being successful with DEI initiatives is the sharing of like ideas between people dedicated to DEI work. That is a highlight of Erica Miller’s work that she will share this with other divisions.

Tell us about a DEI initiative in your division that you would like to highlight.
The Geriatrics & Aging division is highly engaged in the community while partnering with multiple departments of the University. We want to let the multiple facets of our community know that we are here to support them. One particular initiative that accomplishes this is our ongoing partnership with the Ibero-American Action League’s ‘Centro de Oro,’ the only senior educational center designed to meet the unique needs of primarily Spanish-speaking older adults in the city of Rochester.

Our Geriatrics team, working with Raquel Serrano, Ibero’s director for Elder Services, and Maria Quiñones-Cordero, PhD, from UR’s School of Nursing, goes out to provide education and information in an interactive way to support ongoing education aimed at improving health literacy, providing education in Spanish language with a focus on the 4 M’s framework of Age-Friendly Care: Medication, Mentation, Mobility, and What Matters. The pictured event is from an information session on dementia and memory loss. 

What are the future plans for the DEI initiative that is being highlighted?
The future plan is to grow this partnership and hopefully involve various other departments of the University to ensure our community recognizes URMC as approachable, supportive, and willing to help.

Expanding on this community relationship, and continuing with our goal to improve health literacy in older adults in the city of Rochester, our division is now working on the next phase of our health education initiatives, which is to expand our community involvement to include in-person visits to a few other Senior Living Facilities in the city of Rochester, where again, most residents are Spanish-speaking. 

People who live with language barriers, lack of transportation, etc., find it more challenging to be able to communicate with health care professionals, which is key to improving their health literacy, which then empowers them to better navigate the health care system. 

What advice would you give others who want to undertake similar DEI initiatives in their division?
Our advice to others seeking to help address similar DEI initiatives is for them to attend as many community events as they can, because at these events is where we are able to network and meet others with similar goals, who are more than willing to share info about resources and contacts they have discovered. There are plenty of opportunities available. There is true joy in doing meaningful work and engaging with people in the community.

The AIR division has been focused on recruiting new members to get involved in DEI initiatives. Meet the two newest members of the DOM DEI Council!

Tell us about yourselves. What is your role in AIR?
Nicholas Beaver: I currently serve as a PSS (physician support specialist) within AIR. My primary responsibility is to provide support to the allergy and immunology providers at our clinic in the Lattimore building. I also provide support and assistance to the Allergy/Immunology Fellows. I am always on the lookout for ways to improve processes and drive positive change within my department.

Tyler Cavin: I am the Clinical Research Manager of the Allergy, Immunology & Rheumatology (AIR) division. I oversee and manage all research staff in the adult AIR research team and I help start, recruit, and close all clinical trials and institutional research in AIR.

What inspired you to join the DOM DEI Council?
Nicholas: As someone who is always wanting to grow and improve themselves, I have always strived to do the same for the department I am a part of. There is only so much change I can bring about on my own. By becoming a part of the DEI council, I will be able to cause a greater positive impact. I also found it necessary to bring a voice for the rest of the staff, since I wanted to be sure that their thoughts and feeling were taken into account.

Tyler: I was inspired to join the DEI council because of my passion for research. In the realm of research there is a lack of diversity. My passion is improving medicine through research and in order to improve medicine for everyone, we need to have representation from everyone. I joined the DEI council to try and change the systemic barriers that may be preventing under-represented populations from having a voice in research and in medicine as a whole.

What advice would you give to other staff who are interested in DEI work?
Nicholas: There is only one piece of advice I can give to anyone that is either thinking about or hesitant on getting involved in DEI work, and that is to speak up. One of the major ways that improvements can be made is if someone who has “boots on the ground” speaks up and starts the conversation.

Tyler: I would encourage those that are interested in DEI work to look into the resources and trainings available from the DEI Office. Last year I had the privilege of participating in the University’s Safe Space Training to become a better ally in the LGTBQ* community. Taking the initiative to better yourself and to learn is the first step in getting involved and supporting positive change.

Tell us about a DEI initiative in your division that you would like to highlight.
Hospital Medicine IDEA (Inclusion, Diversity, Equity, Advocacy) committee members worked with the Office of Equity and Inclusion learning specialists, OJ Shepard, Carli Gaughf, and Isabel Chandler, to create a yearlong educational program for our division titled “Encountering Bias in Medicine.” It provided education about unconscious bias, microaggressions, and power and privilege at work; which culminated in defining allyship and provided practical strategies to interrupt bias in real-life scenarios submitted by the faculty.

What are the future plans for the DEI initiative that is being highlighted?
We are having our "201" session taking our learning further through more group problem solving of newly submitted real-life scenarios later this month!

What advice would you give to others who want to undertake similar DEI initiatives in their division?
The HMD IDEA committee wanted to provide education on topics that our colleagues were interested in and needed. We started by adding DEI content questions to our faculty development needs assessment and used their input as our ask when we met with our Office of Equity and Inclusion learning specialists to develop our curriculum. We then met with educational stakeholders within the residency programs to get their support for faculty participation. We were then able to reach out to Dr. Panzer’s office to make participation a qualifying activity for the malpractice premium reduction credit, and to ABIM for MOC/CME credit, which provided extra incentive for faculty to participate and provide support for their time.  We have a wealth of people within our Office of Inclusion who are both passionate and compassionate in their work as educators. You can submit an education request at URMC Celebrates.