I would like to nominate Gaby Diaz for the DAISY Health Equity Award as her work on advancing health equity has benefited the Cardiac ICU within BCH-SF as well as UCSF as a whole. When Gaby recognized that our unit was under-utilizing interpreter services when caring for patients with limited English proficiency, she started a project to fix this problem. Gaby taught nurses and support staff how to utilize interpreter services and why this was essential to addressing health equity and mitigating health disparities. She created learning materials and then collaborated with nursing management and the Department of Nursing Excellence to create an educational module that is now available to all of UCSF to improve our use of interpreter services (including translation and interpretation) as an institution. Gaby is insightful and passionate and has dedicated so much time and labor to this project. Her work addressing the language needs of our diverse patient populations has left a profound impact on our unit and has opened the door for continued conversations and improvement projects. Gaby was able to integrate her immense compassion and her dedication to our patients and families into a highly effective improvement project that not only improved the hospital for patients and families but also furthered the larger conversations about health equity and inclusion. Gaby encourages everyone to work harder to address injustice without compromise. Her hard work and passion are so deserving of this award. Thank you for all that you do, Gaby!

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It is my pleasure to nominate Gabriela Diaz for the 2022 DAISY Health Equity Award. Gabriela “Gaby” Diaz has been a nurse in the Pediatric Cardiac ICU since October of 2015. She started as a new graduate nurse and quickly became a leader on the unit. Currently, she is a charge nurse, resource nurse, remodulin, heart transplant and failure, and ECLS nurse. Basically, she can care for all of our patients. Being in these roles has allowed her to see first-hand the lack of equitable communication and involvement in care and decision-making for families who have limited English proficiency (LEP). When compared to English-speaking patients, LEP patients have longer hospital stays, greater risk of surgical site infections, line infections, falls, pressure injuries, delays in surgical procedures, and greater chances of readmission.

In 2021 she applied for the UCSF Evidenced Based Fellowship Program, with her focus being health equity. Her EB project was to ensure that families with limited English proficiency receive updates on the plan of care with a medical interpreter after daily rounds in the CICU. Since rounds are in English, families with LEP can’t participate in crucial discussions made about their child’s care. Her goal was to create a rounding tool and to educate staff on the importance of and proper use of interpreter services. She called the rounding tool Bedside Updates for Family Integration (BUFFI) rounding tool. The tool helps to assess whether LEP families are updated and remind the care team to advocate for the updates. She also created a BUFFI resource binder with background information on why equitable communication is important, why it is important to use a medical interpreter, how to best work with medical interpreters when speaking with patients, how to find interpreters on voalte and on the computer, how to make outbound calls and connect with an interpreter when a family member calls, and how to preschedule interpreter requests. She collaborated with other nurses called BUFFI unit champions and taught them how to identify LEP patients, ensure the BUFFI tool is at the bedside, help educate providers and nurses on the importance of the project, and help staff navigate available interpreter services and properly document its use. She presented at the November 2021 Nursing Grand Rounds to discuss her project and equitable communication in the PCICU.

She created a committee on the unit with members from all disciplines: social work, physicians, management, and our CNS to discuss these disparities and find ways to increase equitable communication. Through this committee, she developed a letter of intent for the Caring Wisely Contest, a contest that awards $50,000 to three projects each year. Her letter of intent was titled “Investing in Available Technology to Reduce Language Barriers for Patients with Limited English Proficiency- A call to action”. Through this letter, she asked for more investment in technology to increase visibility, ease of access, increased use, and success of professional medical interpreter services in inpatient settings. Though she did not win the contest, she appealed to our upper management: CNO and Nursing Director, and was awarded 10 tablets on mobile hospital-grade stands for the CICU.

She also constantly encourages staff to continually educate themselves on health disparities/race relations, examples of this include reminding people to attend UCSF sponsored events including the Schwartz rounds on communication when caring for patients and families with LEP and hosting a CICU debrief during COVID following UCSF town halls on race, loss, and grief. Every year she also holds a Christmas fundraiser to support those in need. In 2020 she raised $1200 for USF’s Immigration and Deportation Clinic and in 2021 she collected sweaters and blankets to donate to California farmworkers. She is currently on the hospital-wide DEI committee and in the process of establishing a CICU specific DEI committee.

I can’t think of anyone more deserving of this award and more passionate about health equity. 

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I am nominating Gabriela Diaz for the DAISY Health Equity Award for her dedication to our Limited English Proficiency (LEP) families in the CICU. Gaby has been a bedside nurse in our unit for years and her leadership, dedication, knowledge, and compassion have been an integral part in changing the culture of our unit to one that is inclusive and sensitive to the needs of our patients and families coming from marginalized communities. She has consistently gone above and beyond to support the lower socioeconomic and BIPOC communities that our unit cares for by implementing projects that support LEP families and bring cultural/social awareness to the providers who are making critical health care decisions.

Over the summer, Gaby implemented a project with the sole focus of “ensuring that families with Limited English Proficiency (LEP) receive an update on the daily plan of care after rounds using a medical interpreter.” The project provided efficient and easy-to-use bedside resources for the nurses and providers to reference when communicating with families. Since the implementation, our LEP families have been consistently updated in their native language and at a level that is appropriate for their health literacy. Gaby continually reinforces the importance of identifying and addressing the health literacy of our families in our staff meetings, in her role as charge and resource nurse, and when precepting new hires. Her passion and dedication for providing appropriate education and updates to our families have increased awareness and compassion in all our staff. Additionally, she constantly provides ongoing education for staff by forwarding hospital-wide projects or championing initiatives that support diversity and equity in our unit. After encouraging participation in the “Colliding Pandemics: Loss, Grief, & Race During COVID-19" series, she facilitated a unit meeting dedicated to discussing “social issues that have plagued this country, at disproportionally higher rates for our Black community members” and what we as a unit could do about it. She continues to facilitate those conversations daily when interacting with BIPOC families, championing our unit to be culturally sensitive and eliminating implicit bias in our care. Gaby serves as a leader in our unit and a health equity advocate. She deserves the most recognition for her hard work, passion, and advocacy for our marginalized patients, families, and colleagues.

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I have been a nurse in the Cardiac ICU for three and a half years and I have had the privilege of watching Gaby make a meaningful change in our unit and inspire her colleagues to be the best nurses possible. She recognizes issues we encounter daily and through data collection, a successful grant application, and a policy change has improved the lives of our patients, their families, and the staff at UCSF. In the CICU we have patients come from all over the world. We were lacking in opportunities and knowledge on translator use with families. Gaby recognized the need for patients and their guardians to be consistently updated by the nursing staff and providers. She trained nurses on the use of video translators, taught our unit secretaries how to transfer phone calls from parents with an interpreter already dialed in, and updated the way we chart these interactions. In addition to this practice change, Gaby worked tirelessly to become a medical translator and improve the signage on our unit. Gaby is a nurse I look up to for her dedication to patients as well as her peers.
She is our CNA union liaison and fearlessly advocates for all of her nursing colleagues, especially during the past two years during the Covid-19 pandemic. We have all been impacted by the ongoing health crisis but none more so than our at-risk families who became so vulnerable as resources were pulled from hospitals. Gaby truly goes above and beyond to advance health equity in our unit and ensure that those fighting health disparities are listened to and advocated for. She is compassionate, capable, and dedicated and deserves to be celebrated for her commitment to our staff, our patients, and their families.