Health Equity in Hospital Medicine
Springer International Publishing (Verlag)
978-3-031-44998-7 (ISBN)
Hospital-based physicians are privy to some of the most meaningful moments of people's lives, including life-changing diagnoses, pivotal medical procedures, complex medical decisions, and critical end-of-life decisions. Yet, hospitalists have no framework for how to incorporate the varied social factors that impact care such as race, gender identity, cultural background, immigration status, sexual orientation, primary language, housing status, and poverty into clinical decision-making. As hospital physicians, we may use interpreters for our limited English proficiency patients, or try to incorporate questions about cultural practices into our admission histories, or even ask our patients about the ways in which they feel racism has affected their care, but these practices are inconsistently applied and lack a systematic framework for ensuring that the hospital care we provide is truly equitable.
In my own practice as a hospital-based physician, I can recall scores of hospitalized patients where we tried hard to provide equitable care, but fell short. I remember the Spanish-speaking patient with multiple comorbidities who received neurosurgery and was on the road to recovery on an acute care unit, when on day three, he complained of vague abdominal discomfort and ended up dying of a perforated bowel. No interpreter was used by the team to fully delve into the details of the pain he was experiencing. I remember the young Black patient with terminal malignancy who had multiple repeated conversations with physicians recommending hospice care but refused until he saw a physician who was able to explain hospice within the context of racism that has historically defined clinical care for Black people, and was able to present hospice not as a way to hasten death but rather as a way to live the remainder of his days in comfort. I remember the elderly Pakistani female patient whose demanding son antagonized staff and clinicians alike until he was banned from visiting because of his aggressiveness with staff and whose inability to visit his mother caused her extreme distress as she felt that she had lost the unique voice that only her oldest son could provide.Imagine if the hospital physicians in these cases had a resource to help them provide care that is culturally humble, that goes beyond just speaking in the patient's first language but that also includes active listening and truly takes into consideration the life experiences and culture that have made this patient who they are. This is what this book will provide for hospital medicine physicians, a framework to help hospital physicians deeply incorporate social factors into the care they provide.
Sujatha Sankaran is an Associate Professor of Medicine with the Division of Hospital Medicine. She received her medical degree from the University of Southern California Keck School of Medicine and subsequently completed her training in Internal Medicine at the Georgetown Universty/Washington Hospital Center program in June 2005. She then worked as an Academic Hospitalist at Columbia University in New York City, where she was actively involved in resident education. Subsequently, Sujatha volunteered in sub Saharan Africa.
After returning from Africa, Sujatha switched to primarily providing outpatient medical practice for five years before joining the Division of Hospital Medicine as an Assistant Clinical Professor. During this time, Sujatha started a non-governmental organization aimed at training health workers in the developing world to prevent chronic cardiovascular disease. Her current career interest involves providing high quality and safe care to patients in under-resourced regions, both domestically and globally. In 2015, Sujatha was awarded a Fulbright scholarship to study mechanisms for cardiovascular disease.
Preface
1. Introduction
2. Race in hospital medicine:
· Race based medicine
· how racism impacts care
· strategies for proving race-conscious care
3. Limited English proficiency in hospital medicine
· how language proficiency impacts care
· ways to overcome language barriers· patterns of language proficiency
4. Immigration and hospital care
· barriers immigrants face in inpatient care
· cultural discordance issues
· undocumented immigrants
5. Social determinants of health and hospital care:
· how homelessness, food insecurity, and poverty affect care· ways systems are using to mitigate these effects
6. Gender identity and hospital care:
· how hospital care is impacted by gender and gender identity
· issues that arise for transgender patients
· issues that arise for cisgender women
7. Substance use and hospital care
· how patients with substance use disorders face barriers
· how stigma affects care
· how to mitigate these effects
8. Religion and hospital care
· how religious practices and beliefs impact care
9. Quality and safety and health equity
· how principles if equity can and should be incorporated into hospital-based care
10. Hospital policies and equity
· the role that hospital policies can impact the delivery of equitable care
· the use of security and de-escalation teams in hospital care
11. Advocacy in hospital medicine
· advocating for patients· helping patients retain their voices and advocate for themselves
12. Pain management in hospital medicine
· pain management and equity
· end of life care and equity
13. Patient centered care in hospitalized patients
· how to center patients and who they truly are into the hospital care we provide
14. Conclusions
| Erscheinungsdatum | 18.11.2023 |
|---|---|
| Zusatzinfo | X, 148 p. 11 illus., 8 illus. in color. |
| Verlagsort | Cham |
| Sprache | englisch |
| Maße | 155 x 235 mm |
| Gewicht | 425 g |
| Themenwelt | Medizin / Pharmazie ► Allgemeines / Lexika |
| Schlagworte | Cardiology • clinical medicine • endocrinology • Internal Medicine • Practice and Hospital Management |
| ISBN-10 | 3-031-44998-3 / 3031449983 |
| ISBN-13 | 978-3-031-44998-7 / 9783031449987 |
| Zustand | Neuware |
| Haben Sie eine Frage zum Produkt? |
aus dem Bereich
