Equity of Care Award Winner Monument Health: A Commitment to Inclusion

00:00:00:28 - 00:00:38:25
Tom Haederle
Sometimes it takes a controversy to light the way forward. In 2015, insensitive language used regarding a Native American patient triggered some soul searching at Monument Health, a rural system based in western South Dakota, serving patients in a five state region. Monument vowed to do better, and they made it stick. Eight years later, their progress in the health equity space has won a national award.

00:00:38:28 - 00:01:09:25
Tom Haederle
Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. Monument Health was recognized in the category of rural and small hospital excellence and equity to earn the American Hospital Association's 2023 Carolyn Boone Lewis Equity of Care Award. This award honors outstanding efforts among hospitals and health care systems to advance equity of care to all patients and spread lessons learned and progress towards diversity, inclusion and health equity.

00:01:09:27 - 00:01:35:11
Tom Haederle
In this podcast, hosted by Dr. Leon Caldwell, senior director of Health Equity Strategies and Innovation with AHA; Paulette Davidson, president and CEO of Monument Health, and Dr. Sandra Ogunremi, vice president of Diversity, Inclusion and Belonging with Monument, discuss the meaning and the journey of the commitment they made, the importance of a trusting relationship between leaders, and how it led the health system to where it is today.

00:01:35:13 - 00:02:06:05
Leon Caldwell
Hello, everyone. This is Dr. Leon Caldwell, senior director for Health Equity Strategy and Innovation at the American Hospital Association's Institute for Diversity and Health Equity. I am pleased beyond, I think, recognition right now to welcome to our podcast two stars of AHA's kind of award season. We are really excited to have two leaders from Monument Health and we'll get more into their work.

00:02:06:06 - 00:02:39:21
Leon Caldwell
We'll also get more into what makes the secret sauce for equity. I wanted to first open up by saying congratulations to you both and this is really a important thing for us to acknowledge that your hospital, Monument Health and your leadership is one of the first winners of the redesign of the Carolyn Boone Lewis Awards, Equity of Care. And this is exciting for us because we've expanded categories to include rural hospitals.

00:02:39:23 - 00:03:04:01
Leon Caldwell
And we think this is important to do, as many rural hospitals are doing the work and we wanted them to have a sense of inclusion in this conversation around equity and our work with making more hospitals and health systems equitable and transforming into more equitable opportunities to serve all. Well, you know, without further ado, I wanted to do an introduction.

00:03:04:04 - 00:03:23:10
Leon Caldwell
First, I'd like to introduce Paulette Davidson. She's the CEO of Monument Health and then Sandra Ogunremi, who is the vice president for Diversity, Inclusion and Belonging at Monument. Welcome to both of you. I'm excited to have you here in the podcast with me.

00:03:23:12 - 00:03:30:10
Paulette Davidson
Thank you, Leon. We appreciate being here with you and we're excited to have a conversation today.

00:03:30:12 - 00:03:31:22
Dr. Sandra Ogunremi
Thank you for having us.

00:03:31:24 - 00:03:56:29
Leon Caldwell
And let's be clear, this is a conversation. These podcasts are not only spreading the good word of your good work, but using these as learning platforms and really helping many of your colleagues around the country understand the work that needs to be done, the work they can get done, the possibilities, no matter what the setting you are, or whether urban academic setting, rural, small town, it doesn't make a difference.

00:03:57:00 - 00:04:18:03
Leon Caldwell
Equity is one of these things that we firmly believe will change health care for the good. So tell me a little bit about your work. I mean, what was the what was the thing that you propose that that your colleagues on AHA's panel award, what was the thing you did?

00:04:18:06 - 00:04:54:20
Paulette Davidson
I'll start. This Paulette. And I would say that we took diversity, inclusion and belonging very seriously several years ago. And it was a moment, I would say, that started with us in 2015. Monument Health is located in western South Dakota. We serve around 450,000 people in a five-state region. And within those areas we have three Indian reservations.

00:04:54:22 - 00:05:38:27
Paulette Davidson
And in 2015 and we had we had several points of friction, racial tension over the years. But in 2015 we had an event that took place. It was an event where a caregiver made an inappropriate comment via social media. She was a young person that worked within Monument Health and it was slanted toward a Native American patient. It was a wake up call in our in our community, especially within our internal community of the work we need to do to educate, to be more inclusive and to be an organization that is trusted in our region.

00:05:39:00 - 00:06:09:21
Paulette Davidson
And I think that was the initial stepping point. And Sandra and I were partners from the very beginning. And Sandra, I don't know if there's more you want to share about that, but it was it was a time of intention and a time of reflection for us. 
00:06:09:21 - 00:06:29:17

Paulette Davidson
Absolutely. And, you know, as we were thinking about making intentional decisions and reflecting upon it, Paulette asked me would I oversee a project and a plan that we had. And that was the American Hospital Association Institute for Diversity Health Equity goal to eliminate health care disparities, The 1, 2, 3 pledge goal in all of our five hospitals signed it. And we had four things that we had to do. We had to increase collection of race, ethnicity and language preference data. We had to increase cultural competency training.

00:06:29:17 - 00:06:50:14
Paulette Davidson
We had to increase diversity in governance and leadership. We had to strengthen and improve community partnerships. And so she gave me this very thick document that she had printed out that she had read, and she says, Let's do this. You can do this. And I'm right here. And that was the beginning of our journey together, working on this and getting the results we have.

00:06:50:16 - 00:07:18:21
Leon Caldwell
So it sounds like the, you know, the resource of the one, two, three, four equity pledge was at least allowed the framing for you all to to move through as you started to reflect and have intention, particularly after that catalytic incident in 2015. The interesting thing about pledges is, you know, people often say that, well, it's just a pledge.

00:07:18:26 - 00:07:36:11
Leon Caldwell
It's like kind of performative equity. It's not you know, you're not really doing it. This is, you know, what's next after the pledge. But it seems as if you all took the pledge seriously and started to actualize the thing you pledged to do. So can you tell me more about that?

00:07:36:13 - 00:08:07:15
Paulette Davidson
What I would tell you is that we took it as a pledge for all of our hospitals, all of our governing boards, all of the trustees for the organization. We took the pledge too and explained why we were signing the pledge and what it meant for our organization. And so it wasn't a step that we took that we kind of buried within our operations, within our hospitals that maybe would be successful, maybe wouldn't be.

00:08:07:15 - 00:08:36:00
Paulette Davidson
No one would really know. We were very forthright and we shared it with our boards and they took the commitment just as strongly as we did, and we made it part of our strategic plan for the organization. That transparency at the board level was necessary. If you're going to educate and improve your culture, it has to start at the board level, at our trustee level.

00:08:36:02 - 00:09:02:08
Leon Caldwell
Yeah, that's very powerful because, you know, our trustee services, led by Sue Ellen Wagner, would be really happy and pleased to hear like the role that boards play. We're now doing a lot of work in our health equity roadmap - its governance and leadership lever to really help boards see how vital they are in the creating culture right around equity.

00:09:02:13 - 00:09:25:09
Leon Caldwell
So it's really you know, Paulette, it's really fascinating to hear with a great example of how important boards are in shaping that. And I'm wondering, Sandra, like when you have a board and a CEO and a leader who is taking the work, right, and saying we're going beyond just a commitment, beyond a pledge, we're putting some some legs on this thing.

00:09:25:11 - 00:09:46:18
Leon Caldwell
And here's the person that's going to like shepherd us as we move forward. But I'm not leaving her. I'm just going to be by her side. And we'll shepard this together. What is that feeling like of knowing you had that level of commitment from not only the board, but your your top senior leader in the CEO?

00:09:46:21 - 00:10:27:06
Dr. Sandra Ogunremi
It's hard to describe the feelings I've had moments where I've gotten teary eyed saying, wow, I'm so blessed. I am so blessed because she's a text away. She is a huge encourager. When I became the vice president for Diversity, Inclusion and Belonging, she helped ensure that it reported to the Corporate Responsibility Committee, a committee that is a part of the board, and she was creating a structure that would last way longer than me or her, such that I report to a corporate responsibility committee while she's right there.

00:10:27:09 - 00:10:48:11
Dr. Sandra Ogunremi
And in that way - and I remember she said to me, I can't tell you what to do. And I looked at her, So you're reporting to a committee. That's how much you need to have the CEO believe in it, to support it, to be a partner with you, to be available such that you're not afraid. What if something goes wrong?

00:10:48:13 - 00:11:12:18
Dr. Sandra Ogunremi
One of the things that hinders people from making progress is the fear of failure. And sometimes the fear of success. If I do well, will more be required? I don't have either of those? Because I have someone who enables me to thrive. And so and to have psychological safety and to have a sense of belonging. So you can't talk about helping people have a sense of belonging

00:11:12:18 - 00:11:36:27
Dr. Sandra Ogunremi
if you don't have a sense of belonging. You have to have that. I would like to encourage anyone who listens to this. The CEO is important and not just important from the endorsement of stuff, but helping to create that psychological safety, diversity, work, inclusion, belonging - can be easy, but it can be hard. It's heart work, and heart work can be hard on occasion, and it can be easy on occasion.

00:11:36:27 - 00:11:42:03
Dr. Sandra Ogunremi
And you need someone who is right there who supports and encourages you.

00:11:42:06 - 00:12:13:07
Leon Caldwell
Your story and your passion, both of your passion around this work dispels a big myth that we're trying to also dispel. And that myth is that rural communities don't really care about equity, diversity, inclusion, belonging or justice. I think there's a a narrative that, you know, rural communities are, you know, this is all this is the conversation for urban spaces, right, where we see racial and ethnic diversity.

00:12:13:14 - 00:12:35:26
Leon Caldwell
But your story in the way you talk about it is not something I would expect to hear out of South Dakota. Right. Having lived in Nebraska, you know, I know there are places where we don't think of diversity in the way diversity is played out in some of these rural places. Right. It's not just race and ethnicity. It's ability, right?

00:12:35:26 - 00:13:05:08
Leon Caldwell
It's it's what we call sogi sexual orientation, gender identity. There's all kinds of human dimensions of human diversity that live everywhere. But when we think about, like rural communities and this is why I think that, you know, are really positioning the Equity of Care Award as also inclusive of and belonging, right for rural communities. These stories are really important for us to hear.

00:13:05:15 - 00:13:15:07
Leon Caldwell
So tell me more about what does it mean when you think about this award and your work in this area from a rural community?

00:13:15:09 - 00:14:02:05
Paulette Davidson
You know, we started this work early on with the data collection component. We wanted to make sure that the initial work was based on facts, was based on real data. And, you know, within a first few years we were collecting more than 90% of our patients real data, which then we were able to bring that information to our physicians and our clinicians, and we could actually look at where we had health disparities, where patients maybe we were discharged from one of our hospitals and potentially a certain group of patients were coming back sooner than other patients within a 30 day readmission rate.

00:14:02:07 - 00:14:31:00
Paulette Davidson
So it's really this data has helped us address quality as it pertains to outcomes. And specifically if we see a group that has a disparity in what we're seeing with other groups, we've been able to operationalize efforts to intervene and improve those outcomes. So I think for us, this work is our mission. Our mission is to make a difference every day.

00:14:31:03 - 00:14:58:10
Paulette Davidson
And by having the data and looking at the data carefully and understanding what is driving some of the challenges and creating those barriers, we can create those interventions. So for our patients and our families, I think it's been impactful. On any one day in one of our largest hospitals, which is our tertiary level hospital, it's licensed for 417 beds.

00:14:58:13 - 00:15:26:21
Paulette Davidson
Any one day, approximately 30% of the patients, adult patients in that hospital are Native American. And their backgrounds are different, their experiences are different. The historical trauma is different. We're better today at caring for those families and those patients than we were when we started this work. And our patient experience scores demonstrate that work. Our top scores have improved.

00:15:26:23 - 00:15:59:11
Paulette Davidson
Our ability to recruit and retain caregivers and physicians has improved. We start every new caregiver in our organization and they attend an orientation. And our orientation is like other health hospital and health system orientation. You learn about safety, you learn about the electronic health record. But we do something special, and they learn about diversity and inclusivity and belonging, and it is their favorite part of orientation.

00:15:59:17 - 00:16:22:03
Paulette Davidson
And every month they're invited to attend a culture diversity talk. And it's a different speaker from a different background with a different perspective. And it is a sharing opportunity. It's a culture where we want to hear about your differences, we want to hear about you and we want to respect those differences. And so part of that is also our daily huddles.

00:16:22:06 - 00:16:42:25
Paulette Davidson
Every caregiver in our organization participates in a daily huddle where they talk about what's happening, what are the safety issues and their voice is heard. And so I think for us, it's been this inclusive environment has really led to a culture where people feel like they can belong based on their differences.

00:16:42:27 - 00:16:44:04
Dr. Sandra Ogunremi
I want to add something to that.

00:16:44:04 - 00:17:05:15
Dr. Sandra Ogunremi
Paulette talked about our cultural diversity gatherings that we have. You know, we started those in 2017. And 2020 COVID happened. And we were having large gatherings and we would provide a lunch that people could spend the hour with those 12 to 1, have your lunch, learn and have a great time. And then COVID happened and we had to stop, right?

00:17:05:17 - 00:17:26:25
Dr. Sandra Ogunremi
I remember her saying to me right about May or June of 2020, what if we did this virtually? And I didn't want to. And that's the fear of failure. I was like, What if no one shows up? And I said, okay, great idea. And I kind of left it alone. And she came back several months later again and said, So what about the cultural diversity gathering?

00:17:26:28 - 00:17:45:03
Dr. Sandra Ogunremi
And I talk about this because sometimes that's what people need. You can be a successful leader and still say, what about what if this feels what if no one shows up? I mean, it's COVID, everyone's, you know, going through stuff. And she asked me several times and eventually we started a virtual cultural diversity gathering in the midst of COVID.

00:17:45:05 - 00:18:06:27
Dr. Sandra Ogunremi
And you know what? Now we have the virtual and in-person. If you can't make it in-person, you can join virtually.  People join. So we actually improved on what we already had in place. We're across our entire markets, people can watch our cultural diversity gatherings, we record them. So all of our five markets, they can look, they can go back and look at our archived records and watch a cultural diversity gathering.

00:18:07:04 - 00:18:27:29
Dr. Sandra Ogunremi
And those are the things that I want to really share, is you need that. I try to encourage all those who report to me. You need from the top down and with Paulette even sharing how many CEOs can actually talk about what's going on in their organization with their DIE efforts, VIP efforts, you know how many people can talk about it?

00:18:27:29 - 00:18:50:17
Dr. Sandra Ogunremi
How many people understand it? If you don't understand it, you cannot support it. You cannot advocate for it. You cannot speak up for it. You cannot provide the funding for it in the budget and the opportunities for it to succeed. So it is so important that the president and CEO and that the board of trustees that they understand this, the governing boards, whatever, or boards people have, they need to understand it so that they can support it.

00:18:50:20 - 00:19:07:01
Dr. Sandra Ogunremi
And as you mentioned before, you know, you think about diversity. There are so many aspects to it. And we're addressing the various aspects within Monument Health to ensure that all of our caregivers, 5000 plus have that sense of belonging and our patients have that sense of belonging.

00:19:07:04 - 00:19:47:19
Leon Caldwell
You know, when we think about transformation of systems, any system or particularly a hospital system, we know that there's policies that either have to be dismantled because they compromise the very thing we're going after equity or we know there's some that need to be proliferated because they help us to really anchor our climate culture on equity. Can you think of any policies that you all had to really look at and ask that question is, does it help us or does it hurt us?

00:19:47:21 - 00:19:50:29
Leon Caldwell
I see you both smiling. So there's a story in there I’m sure.

00:19:52:02 - 00:20:24:28
Paulette Davidson
I would say one of the first things we had to look at was our dress and appearance policy. I think it was a bit old school. In a rural setting and we're a growing health care organization, we have many open positions. And as everyone's recruiting, we are too. But we we also recognize that maybe our our dress and appearance policy was a bit old school, a bit outdated, and we had to take a hard look at it.

00:20:25:00 - 00:21:02:15
Paulette Davidson
We didn't allow tattoos or at least you couldn't you couldn't have them visible. And we actually brought focus groups of our patients and our caregivers together. And we asked them: what is professionalism in health care and how does our current policy not work anymore? And they gave us plenty of feedback. We listened and we adopted many of their recommendations, and I think that's allowed us to recruit more people than we had in the past.

00:21:02:21 - 00:21:23:23
Paulette Davidson
For example, where the second largest employer of Native Americans in our region, the first, the largest employer, is a Native American clinic in our community that we collaborate with, but we are the second largest employer. We're proud that we can attract our Native Americans to our organization to be part of our mission.

00:21:23:25 - 00:21:34:07
Dr. Sandra Ogunremi
So she talked about the tattoos and you can imagine that there's another aspect of our dress and appearance policy, which was the color of the hair.

00:21:34:09 - 00:22:02:04
Dr. Sandra Ogunremi
You know, can you have green hair? Can you have yellow hair? Can you have purple hair? Think about those colors. We determined that our caregivers can be their authentic self in the way that they deem it to be the best. So you might have someone who has some tattoos and may have a or a sleeve and they might not have what we consider the conventional hair color.

00:22:02:06 - 00:22:20:12
Dr. Sandra Ogunremi
Does that stop them from being an exceptional nurse? Does that stop them from being an exceptional physician? Does that stop them from being an exceptional respiratory therapist? Absolutely not. We have to look at body piercing. You know, how many piercings can you have on your face? You know, it used to be just one. Now you can have two.

00:22:20:12 - 00:22:49:02
Dr. Sandra Ogunremi
And again, we think about to protect the caregivers, two, right? When they're going into certain environments, you don't want to have too many facial piercings. What we're talking about on the face now. So we've come up with how do we help everyone have that sense of belonging that they don't have to put, you know, cover up, put some makeup over their hand or put makeup over their their arms because they have a shorter sleeve top on and it's summer.

00:22:49:05 - 00:23:03:28
Dr. Sandra Ogunremi
Those were huge. And it's been a huge win for our caregivers and even for our patients who have family members that have those piercings, can they see their family members working in our hospitals across our system, in our clinics? The answer is yes.

00:23:04:00 - 00:23:31:13
Leon Caldwell
Great. That's a really good example. The thing I like most about it is your really your openness to talk to and listen right to community members, to the end user, if you will, and get their feedback and then send you your last part of a belonging. Like really seeing can a community member or anyone see themselves as part of your community because it's all one kind of big community.

00:23:31:13 - 00:24:02:03
Leon Caldwell
When you think about the hospital system and where it anchors. So one of the things that arm's been really interesting, you know, as we talk about this work and really the strategy around it. From where you sit as a CEO, like what's kind of the message to other CEOs who are grappling with understanding equity, finding a place for it in the organization, maybe hearing about it, but not quite knowing what to do, how to accept it?

00:24:02:05 - 00:24:15:10
Leon Caldwell
Can you know, my VP have green hair if she wants to? Like like this is these are all things that I'm sure most CEOs are kind of wondering. What's with some words you have for the CEOs?

00:24:15:12 - 00:24:42:17
Paulette Davidson
Well, you know, I I'm fortunate. I have many CEO colleagues across the country where where we do talk about this issue. And sometimes the first thing you hear from others are we don't have the budget, we don't have the funding to really get into this work in a meaningful way. And margins are thin today. We're all in that same space.

00:24:42:17 - 00:25:10:09
Paulette Davidson
We share those challenges. But have a plan. Start with what is your data look like? Everyone's collecting data. What are how can you collect better data? Because that can at least tell you where you have some places to start. And it could be working with your cardiovascular team and saying, look at this certain group of patients. How can we connect with these patients to ensure they get their medications?

00:25:10:12 - 00:25:33:21
Paulette Davidson
And so you don't have to boil the ocean. This is just a process where you start identifying what are meaningful things for your organization, for your community. Every three years we do a community health assessment for all of our communities, and that work really informs us. What are those kind of low hanging fruit that you can partner with others in the community to address?

00:25:33:23 - 00:26:04:04
Paulette Davidson
This all doesn't have to be on you. We've partnered with probably dozens and dozens of organizations in our communities to help improve health and reduce disparities. Every time we begin a new relationship with either an opioid center or a the mission or a detox center, I think we just get more partnerships and more momentum so you don't feel like you're doing it yourself.

00:26:04:06 - 00:26:27:19
Paulette Davidson
And I would just say, don't be afraid. Just start doing some things and then you'll learn what you're good at and what you need more help with. I think I've learned when I think we've accomplished quite a bit, I realize we have a lot more to do and it does fuel me, but it at times it's a bit daunting and I think you just take it day by day.

00:26:27:21 - 00:26:56:03
Leon Caldwell
Thank you. That's very helpful. You know, one of the things you lead with is like data to help you chart your course and make your plan. So we designed the health equity roadmap, it was really important that we start with like a hospital's assessment of itself, right? Not benchmarking, no. Data is all your data. And those six levers can tell you something.

00:26:56:05 - 00:27:16:20
Leon Caldwell
Those six levers can give you at least a place to start. So even if it feels daunting, you know, you have a transformation action plan that can help you start to chart your course. So it's part of the journey I think we're all on. And that's one of our favorite words in IFDHE, is that we're all in this journey.

00:27:16:23 - 00:27:50:02
Leon Caldwell
We see everyone in this journey together. And I really can think of to greater leaders to actually be in this journey with. And I want to give you kind of a closing statement as we all go and still try to advance equity, even with its, you know, thin margins and and political climates and the agility that's needed, emotional agility that's needed to actually lead in some of the places where we just don't know the answers and we're moving forward really trying to figure it out.

00:27:50:03 - 00:27:59:02
Leon Caldwell
That's the beauty of the journey. So as you think of your other journey, folks, right, what kind of words of encouragement would you like to give them, Sandra?

00:27:59:02 - 00:28:26:09
Dr. Sandra Ogunremi
Everything that we do starts with heart, and that's part of our vision statement. It starts with heart. Our vision is to be one team, to be inclusive, to listen, to show that we care to do the right thing every single time. We have been on this journey, and when you think about the heart aspect, if something goes wrong or something needs improvement, if something needs to be adjusted, if new things need to be done, we do it, we do it.

00:28:26:09 - 00:28:54:18
Dr. Sandra Ogunremi
We check the pulse. When we had the situation where George Floyd was murdered and there was just this emotion, you know, you could feel the palpable emotions across the country. You could see the protests and everything. And I remember Paulette and I kind of looked at each other and said, we're going to do a lot recording for our caregivers, for them to be able to watch for us to talk about, check in on each other, because it wasn't about race anymore.

00:28:54:18 - 00:29:14:05
Dr. Sandra Ogunremi
It was about every single person who may have felt, you know, something going on in their soul with what they witnessed, with what they saw and all of that. And we said, let's check on each other. We did a 30 minute unedited recording, and we released it for our caregivers because it was a heart decision. And many people emailed saying, Thank you.

00:29:14:05 - 00:29:32:05
Dr. Sandra Ogunremi
We need it to hear. We need it to know that you knew how we were feeling. When you think about diversity, inclusion and belonging, there are things that happen that you have to say, am I going to ignore this or am I going to address it? Am I going to hope that it goes away or am I going to face it?

00:29:32:07 - 00:29:52:21
Dr. Sandra Ogunremi
Even if it did not happen in Rapid City, it affected people here. And we did that and we do that all the time where if something comes up, we do a heart check, is this what's the right thing to do? And that's what we do. We do the right thing all the time, and that's my encouragement to people is pause and say, what's the right thing to do and then do it.

00:29:52:24 - 00:30:24:15
Paulette Davidson
I would just encourage all the health care leaders out there. I've been a health care leader for over 35 years. This work is hard work, but the more you step in and lean into inclusivity, diversity and belonging, the more energized you will feel, the more joy you will find in your work and the more meaningful it will feel at the end of the day.

00:30:24:18 - 00:30:47:11
Paulette Davidson
Because you create a culture in your organization that you as a leader...it really takes a light, a good life of its own, and it just it raises the bar in your outcomes, in your patient experience, in your ability to recruit. It gives back and it gives back to you so you can continue to do the work that you do.

00:30:47:11 - 00:30:53:05
Paulette Davidson
So lean in. It just raises the bar for the organization.

00:30:53:07 - 00:31:30:03
Leon Caldwell
Awesome. So to two of our greatest leaders in this health equity space, I want to thank you both, Paulette Davidson, CEO of Monument Health, and Sandra Ogunremi, vice president of Diversity, Inclusion and Belonging. Congrats on being recognized as the Carolyn Boone Equity of Award winner for rural and small hospitals. It's quite a feat and we welcome more of your thoughts and your brilliance and your passion and your heart and your love for this work and for your community.

00:31:30:05 - 00:31:40:15
Leon Caldwell
And on behalf of the Institute for Diversity and Health Equity, congratulations again and we look forward to hearing more from you. Thank you so much.

00:31:40:17 - 00:31:41:11
Paulette Davidson
Thank you.

00:31:41:13 - 00:31:42:12
Dr. Sandra Ogunremi
Thank you so much.