Michigan Medicine slide reading "The Healthcare Equity Consult Service, Grand Rounds, March 24, 2023" is on a zoom screen with attendees on the side.
Photo courtesy of Nadia Taeckens

Michigan Medicine hosted a Grand Rounds meeting on March 24 centered around its new Healthcare Equity Consult Service, which launched in 2022. According to Dr. Okeoma Mmeje, who led the Grand Rounds, the event was part of Michigan Medicine’s celebration of Healthcare Equity Month, which started March 20.

At the beginning of the event, Mmeje said the Healthcare Equity Consult Service aims to provide support in cases where patients or their family members believe their healthcare at Michigan Medicine has been impacted by discrimination, bias or inequity.

“The theme of (University of Michigan’s) Healthcare Equity Month is focusing on intersectionalities of healthcare inequities that we see play out in our society as well as our health systems,” Mmeje said.“The objectives of the Healthcare Equity Consult Service were first to address inequity in healthcare access and delivery at Michigan Medicine and to build upon our BASE (Belonging, Access, Safety, and Experience).”

According to Mmeje, the death of Dr. Susan Moore, a U-M Medical School alumnus, helped inspire the creation of the service. Moore died of COVID-19 in an Indiana hospital after posting a video alleging she was receiving racist treatment.

“Although (Moore) was not here at Michigan Medicine (when) she experienced those things she talked about, I do want to highlight that this is not an experience that Michigan Medicine is exempt from,” Mmeje said. “Just looking at a snapshot from 2020 to 2021, there was (an) increase in reported cases amongst patients where they felt as though there was bias or some type of racism affecting the care and outcomes that they may have experienced here.”

Mmeje went on to explain that the new consult service is currently available for both adult and pediatric patients, though they plan to expand to patients who receive ambulatory care in the near future. The service can be requested by a patient, their family or any staff member involved in their care. Mmeje said once a consult service is requested, a service member will complete an initial investigation and update the patient and care team on what they find before making a final recommendation and conducting a debrief to identify potential health system and policy changes. 

“Anyone who’s part of the patient’s care team, whether it be a medical student, social worker, complex care coordinator, faculty, nurse at the bedside (or) spiritual care provider, anyone who’s involved in the patient’s care including a family member can request a consult,” Mmeje said. “There’s also an anonymous option for requesting a consult, meaning that there would be limited documentation in the medical record.”

She said a total of 51 consults have been requested since the service was first piloted in August. The team is still working to gather feedback on the public reception to the program, Mmeje said.

“At this time we’re preparing for an evaluation that is currently underway to interview patients and family members who have had an engagement with the consult service so that we can understand how the service helped and supported their care and also if there are opportunities for growth and improvement,” Mmeje said. “We’ve also used the lessons we’ve learned to … to identify policies and procedures that are happening or that are in place in our institution that may be affecting equitable access or health care experiences for the patient.”

In an email to The Michigan Daily, Mmeje said the program was approved as a permanent service in January, and will officially transition to its permanent structure on April 3.

Following the presentation, the event moved into a brief moderated discussion with Kamau Ayubbi, Prianka Shakil-Brown and Samantha Guyah, some of the case managers for the consulting service. Shakil-Brown, a medical social worker at Michigan Medicine, said the pilot phase of the program has helped the team understand how to work with other staff members across the medical campus to promote equitable experiences for patients.

“I think one of the most valuable things for me has been learning about the perspectives and viewpoints of my colleagues in other disciplines, not just, you know, the discipline that I am in as a social worker, and learning all the different ways in which people think, all the experiences that they’ve had, and how they bring those to work,” Shakil-Brown said.

According to Ayubbi, an imam on the U-M Spiritual Care Team, the Health Equity Consult Service is intended to be a way of addressing unjust social and legal constructs that have historically affected patient care.

“(This service) is uplifting this human dignity that we see in patients and we see in staff who want to make a change, who want to create a good culture, a safe culture, a just culture, but it’s also hopefully reducing human suffering,” Ayubbi said.

Public Health junior Andrew Hoover, vice president of the Public Health Association, said he thinks the program will help address disparities in health care and he hopes to see more work done to advance health equity at Michigan Medicine.

“My initial reaction was that I think this service will be super beneficial, but I also think there is still a lot more that needs to be done,” Hoover said. “Really, I think it’s a good first step, but there will definitely need to be future work going forward.”

Daily Staff Reporter Nadia Taeckens can be reached at taeckens@umich.edu.