Breaking Barriers in Healthcare: The Color of Wellness with Michelle Greene Rhodes

Hi Dr. Amy, thank you for having me. I appreciate the invite.

All right, well thank you again. I appreciate your invite and thank you for your time. This is awesome. Proud of you, of course, all the things you're doing to pour back into us nurses, keep us astute in our leadership skills, and it's so needed. The world is changing right before our eyes, so I feel like I need to stay connected to someone that will keep me sharp. We actually started our brand, it's The Color Wellness Media. We're the first Black wellness media platform by Black nurses. It encompasses quite a few things, but to put it succinctly, our goal is to help increase health equity through health education. We wanted to be that trusted source, that face of relatability, a very laid-back type of media outlet. We didn't want the sterile feel; we wanted a lifestyle feel where it felt like your cousin or aunt was having a conversation with you, or a nurse you know in the neighborhood saying, 'Hey, have you thought about this? Have you considered that? Have you talked to your doctor about that?' That's the feel of the magazine. Through that, the health literacy piece is still new for us, we're still building out some programming. However, it's always been around a 10th grade level of education the way it reads, so that hopefully helps those who may struggle with reading or retaining what they've read. They can take what we read and understand it very easily. The goal is always to have them take our magazine to the doctor with them. We wanted to do our part in the health equity fight. It's a huge fight, but for me, it was what I could do. Before The Color Wellness, as you mentioned, I was coaching and pivoted through the pandemic because I wanted to help the Black community a little more. I was like, 'What can I do to help?' The numbers and data throughout the pandemic were just astounding. Through my writing skills and communication, which was a strong point for me, that's why we started with the magazine, and we've grown from there.

That's right. If your parents talk to you about it, absolutely. Sometimes it's too late, which was really what I saw as a case manager, disease management nurse, and then my last position was population health. I got to see the broader aspect regarding population and geography. That's when my eyes were opened to see the percentage who took advantage of mammography or certain screenings. It was really bad, or if they did get those screenings, it was stage four. So it was like, 'Okay, what can I do?' Because most people, especially in some of our rural communities where access isn't easy, don't go until they feel bad. Sometimes feeling bad has been so progressive that they don't realize how bad it is until they go, and as you said, now the disease is down the road where if we had caught it much earlier, it might have been more preventable or minimized those symptoms.

Yes, thank you for this. I get excited because I had to step back and take a look at where we are with this platform. It was nice to have magazines, but what impact are you making? As I began to dig into that, I ended up looking at the whole spectrum of where Color of Wellness fit in on the prevention spectrum. If I were an average patient coming into my doctor's office, where would that come in? When would I even learn about Color of Wellness? Or if I was being discharged from the hospital, what was my typical client going to see, hear, and feel? That's when I saw that Color of Wellness is really the entry point for someone just learning about what we do, but there's so much more that comes after that. However, there's something that needs to happen before they even need to learn about Color of Wellness. If we're just creating the magazine, the podcast, the videos, there are two pieces to that. We need nurses and other healthcare providers to know that we're a resource. How do we let them know we're here and available to share these resources? That was the first thing I had to tackle. I knew I needed to get connected to more PCPs or hospitals. But once we connect, what is it? They're just going to tell us about a magazine? What does that look like? That's when I decided we need to include my peers because they play a part in this. They may not realize it, but before they can even say, 'Hey, think about this resource,' there's a whole hospital stay this patient has just completed. How would they treat it? Are they going to come back? Are they going to recommend this hospital? Are they going to speak positively of the nurses? What was their experience? What was the safety? I saw that piece was missing. I said, in order for my counterparts or my profession to speak well of us, they have to speak well to the patients. Likewise, the patients feeling that rapport, comfort, and inclusion. It really came down to an inclusive communication piece where we go above and beyond, surpassing the standards. Now it's easy to say, 'Hey, you might want to take a look at this type of resource to keep you informed, or talk to your doctor about this resource.' Then we have some other things that come after that, not just the magazine. The magazine is an entry point, but there's hopefully a coaching and support group that comes after that. That's the next piece we'll be working on, so they can further work on healthy habits for 12 weeks. We're a preventive program, not stage disease management or case management. It's about healthy habits for Black families. That's where the programming piece will come in, and then we can show the impact at the end. There's a whole spectrum of things that needed to happen to really get this where it needs to be. Inclusion was a big piece of this transformation. I opened it up a little bit more to include others so that healthcare could see there's a different type of resource available. Yes, we have health education here, but we're a little bit different, powered by nurses, specifically Black nurses. We have the desire for relatability, that missing piece that can help bring in those patients, make them feel connected to your brand. We're here to support your brand as the hospital, and then they go out and speak well of you. It's a win-win for everybody.

Absolutely. It's so important, and I'm so glad you mentioned an example of what it could look like. Sometimes we don't even think about some of these things until we're in the hospital. Those who are not in healthcare have an even harder time because they don't know what they don't know. They don't know what to ask, sometimes they can't remember most things that we're asking. Some of the things we've created and put into our program are not just for patient relatability, but we do put a little bit of the culture in there. We have questions that we put into the assessment that the nurse can ask. They're very optional, but at least they know what type of questions they could add to their assessment. Let me ask a few of these questions about culture, about spirituality. You wouldn't believe how big a part that plays in a patient's belief system. A lot of what they say yes or no to, or understand, or will take, is because of their belief system. So we tackle belief, we put a little bit of mindset in there, we talk about history, and then we go more into a cultural piece. It's a little more in-depth than your general assessment, giving them a pool of questions they can ask based on the situation, which gives them more information to give better care. That's what it's all about. That's just an example of how we support what they do. Also, which is really huge, we've gotten this request from the nurse side, of course training the nurses to speak more inclusively and ask those questions. But I mentioned to you before the show that even leaders are wanting to get more information on how they can be more inclusive in what they do. So we're looking at how we can support leaders. Also, for all of them, we do as part of our train-the-trainer implicit bias assessments, so everyone leads with that knowledge. Sometimes as a caregiver, we don't know, or we have some things we don't want to talk about, ways that we believe or perceive people, biases, stereotypes. How does that affect the care we're giving as a nurse? I want to make sure I'm getting the best care without withholding. Studies have shown this, which is why I'm so excited about this program. I pull the studies where same exact diagnosis, Black patients got poorer care because they were offered less for certain things in certain situations, where a white person got all that they needed and had a much better outcome. There are so many studies I pulled regarding that. Lastly, worst case scenario, we've seen horror stories about racism in hospitals where patients either got the care they felt they needed or there was some discriminatory practice that occurred. That's where the big dollars come in. We want to avoid that type of cost that can really be a detriment to the hospital.

Very interesting approach to have to take. I remember I had a patient one time, I use this example a lot because it's such a unique and clean example of a specific cultural difference. I had a patient who was Korean. I was the nurse manager at the time of a postpartum unit. My nurses came to me very frustrated because the patient wasn't engaging with them, wasn't talking to them a whole lot, was starting to run a fever, they couldn't get her to drink water, they couldn't get her to shower. The auntie and the grandma were in the room doing everything for the baby, and we couldn't get them out of the way. I said, 'Well, hang on, let's go to our resources and look up what their specific background needs and beliefs are.' The beliefs were that you don't bathe for the first couple of weeks. So I said, 'Well, how about let's focus on perineal care and handwashing?' She was supposed to just breastfeed and rest, and mommy and auntie were supposed to do everything for her. So instead of saying she has to learn all of this, clearly they're going to be providing the care for the next couple of weeks. Teach them the cord care, teach them what to look for with the baby. Instead of forcing them to have our perspective, how do we go to their perspective? We were giving her ice water, and she was in a hot state, she wasn't going to drink it. You have to give them lukewarm or warm fluids. Once we got her drinking and engaged, and reset our expectations to that care, we had a successful delivery and discharge. But until we reset our approach to meet their needs versus expecting them to adjust to ours, we had a huge disconnect that could have been quite damaging to that patient.

Yes, and that's what it's all about. That's a wonderful example. You took the time to ask 'why' and 'tell me more' as opposed to 'why' which is more like 'share with me, I'd love to hear more, I'd love to learn more, can you tell me more?' Those types of questions. I didn't mean to say 'why' all the time, that's kind of one that makes you cringe. So yes, worst case scenario, that's why. But 'share more with me, you mind sharing that with me? I'd love to learn more about where you're coming from.' That's one of the five parts of communication. The inquisitive piece, in order to get good answers, we need good questions. I was just thinking, let me know how I'm doing on time. Am I okay?

I didn't know about how a little bit about how this started as well. You mentioned case management and we briefly talked about this before the show. Again, one of the reasons this is so important for us to create programming to help with this is because we've seen data. Data is always the driver, research is a driver, we want evidence-based information. When I started to dig into this, I thought, 'Wow, I didn't realize how many for instance, we were called in to do support with a mammography campaign where mammography was totally free with this particular campaign for a hospital. But for some reason, Spanish women came out in droves, but Black women were not showing up. The hospital was very concerned. 'It's free, what are we missing? Why the low attendance?' Money was sitting there to pay for these tests. It's an example of communication. How do we overcome social determinants? Transportation was a big thing. That's a determinant, it was a big concern. Those who work hours, that's a concern. Making sure they put in some after-hours and weekend hours helped as well. Color of Wellness was able to be a bridge to communicate the importance of it. This goes back to belief because a lot of the women felt like, 'I don't need it, it doesn't run in my family, those things hurt, I don't have time, I'm okay, I feel fine, I check myself.' Although that's important, we still need to get screened. This is an example of why we do what we do. Let us be a bridge to push that message forward.

Absolutely, very important. So what would the two things you would tell the leaders that are listening to the podcast? What are two pieces of advice you'd give or resources you'd like people to know about?

Absolutely. So there are resources there to support that change. I think the thing was that she just didn't have either the resources or support to help make that happen, so we're happy to support her. And then there was a second part to that question. Do you have any other resources that you would recommend people go look at if they're thinking about implementing something?

No, I haven't yet.

Right, right. Excellent. Yeah, that'll be huge, especially as places really do try to buy into those centers of excellence that the Joint Commission does and pull that together. That's really one of those pieces that they can stamp on the website in the front of the hospital and say, 'Hey, you want to come to us because we're committed to doing this. We've been through this process and we're committed to that excellence.' So yeah, that's awesome. And strictly Health Equity, I don't know if I said that. I believe that's what the certification is for, to say you're fully embracing health equity and equitable care. I just personally love it. Let's start systemic change.

Absolutely, for sure. Yeah, well, a couple of fun questions as we end the day. What is a book that you're reading right now that you wish everyone would read?

Yeah, yeah, which leads me to probably the other great question I had. What is your biggest piece of wellness advice you're giving people right now? How to improve?

Yeah, you know, so many of us don't concentrate on the self-care. We concentrate on a skill or another thing or a certification or the next thing. We don't really think about, 'I can level up also by just making sure I am well, I am ready, and I am whole.'

That's awesome. Well, I love it. Well, as always, it's great talking with you and catching up. We're going to have some resources in the show notes. There's a resource website from the HRSA as well as a Color of Wellness that you guys will be able to get to. Have some references and reach out to Michelle and the team, or see the magazine as well and access the podcast. So great to talk with you, Michelle. Thank you so much for your time today.