NNACoE Strategic Plan
Introduction and Welcome
The Northwest Native American Center of Excellence (NNACoE) at Oregon Health & Science University (OHSU) works to sustainably address the health care needs of all people by increasing the number of American Indians and Alaska Natives (AI/ANs) in the health professions workforce. We accomplish this through a continuum of health professions initiatives from high school through early faculty level. NNACoE is Native-led, and grounded in Indigenous values that strengthen our programmatic approaches to recruit, train, and retain future AI/AN healthcare leaders.
Figure 1. The Path
While AI/AN people in the US constitute at least 2% of the population, AI/AN physicians comprise just 0.56% of all active physicians, and AI/AN full-time faculty represent 0.48% of all faculty at MD-granting institutions. Since NNACoE was established in 2017, we have made tremendous strides in supporting future and current AI/AN medical students at OHSU. In a nationwide climate where many medical schools cannot count a single AI/AN person as a member of their student body, AI/AN medical students currently make up 6% of the OHSU School of Medicine Class of 2024. When NNACoE was established, there were 10 AI/AN Medical Students at OHSU; now there are nearly 40.
Figure 2. AI/AN Medical Students at OHSU
We are at an inflection point in our growth, where many factors of our success that were previously implicit now need to be considered and preserved by telling our story in different ways. In the Spring of 2023 we were fortunate to engage with Project Mosaic, LLC, a group of skilled facilitators and consultants highly experienced in helping tribes, nonprofit organizations and community groups with strategic planning, economic development, communications strategies, evaluation and community engagement. Over the course of several meeting sessions in collaboration with Project Mosaic we entered into deep reflection together as a team, and developed the strategic plan that follows. We hope that this document will serve as an introduction to our center and our priorities, and a welcome to engage in transforming the health professions, wherever you may be.
Mission
The Northwest Native American Center of Excellence (NNACoE) works to sustainably address the health care needs of all people by increasing the number of AI/ANs in the U.S. health professions workforce.
Vision
There are many artists, poets, and gardeners on the NNACoE team. Our vision statement is crafted in the spirit of an invocation, poem, or prayer.
We envision:
Indigenous leadership and healing
that extends more widely into the community;
Unapologetically doing things in a different way,
while holding kindness and humility;
Providing education rooted in Indigenous values that removes barriers to learners knowing themselves in order to better heal and be healers;
Embodying this way of being while traversing old and new ways on a new path;
Transforming medicine to better serve all people.
Values
EXCELLENCE
The north star that guides our long-range journey. We walk this path with honor and distinction, always with our people in our hearts. North, our guiding direction.
TENACITY
We approach our work with boldness, resolve and urgency because we know that health and education are critical to the well-being of our people, the continuation of our culture and the sovereignty of our nations. East, where we start each day and the intention we bring to it.
HEALING
Our work is rooted in Indigenous traditions of community-centered nurturing, reciprocity, balance and rejuvenation. We are called to this work to ensure the health of our people. South, our purpose throughout the day.
KINSHIP
Our connections to each other, our lands and our people provide love, strength, resilience, belonging and identity. We honor our responsibility to care for each other, our communities, our children, our culture and our lands on behalf of future generations. West, where we end each day at home with our relatives and community.
History
NNACoE, housed within the OHSU Department of Family Medicine, began in July 2017, with a 5-year award from the Health Resources and Services Administration (HRSA). This award funded the creation of NNACoE’s core initiatives to recruit, train, and retain Native Americans in the health professions. Subsequent funding from the Indian Health Service Indians Into Medicine Program, foundation grants, and state-legislated funds supported expansion of partnerships with University of California-Davis and Washington State University and greater resourcing of initiatives for high school students.
In July 2022, NNACoE was awarded a renewal of the initial 5-year grant from HRSA, which will guide the day-to-day activities and goals of the center through 2027. With some initiatives well-established and others in a planning phase, there was a need to step back and consider our current landscape of activities while simultaneously looking to the North Star of innovation and excellence that drives our future.
The Landscape: Mapping Current Initiatives and Values
As a Center, we are most proud of the meaningful relationships we’ve developed, student engagement, and serving the AI/AN community. We fulfill unique needs for students including:
Advocacy
Individualized academic and social support
Consistency
Navigation in an academic medical center
Cultural intelligence
Simultaneously, we provide a workspace and set of team relationships that encourages:
Creative freedom
Equity
Close alignment with our shared mission
Flexibility and autonomy
Innovation
The integrity with which we run student services and internal team processes was deliberate and requires deliberate effort to maintain. We know that to have a deep impact we need to be able to scale and share our work in a way that maintains the integrity and values inherent in our approach.
To make that inherent approach clear we considered our existing initiatives, mapping them to the values we identified in the planning process. By assessing existing initiatives, we created space to consider the ways we spend our time as a center and how those initiatives bring us closer to our vision. All current initiatives were strongly associated by the team with our values of Excellence, Tenacity, Healing, and Kinship. Our culture as a center has ensured that these values were woven in organically as each initiative grew over the past 5 years. Now, we can ensure that NNACoE’s values carry on for the next 5 years and beyond.
Through review and discussion, we reinforced and recommitted to continuing support at key points along the health professions path. We know that what we have built is all too rare among academic medical centers and continuity of our existing programming will amplify our impact. Our programs for Pre-College, Application Phase, Medical Training, and Professional/Faculty Development are all fully developed and active. Health Pathway Coaching is our most robust initiative for College-level and other prospective AI/AN health professions students, however opportunity remains for expanded programming at College-level. We are also embarking on translating our knowledge to other health professions pathways and initiatives including Nursing, Dentistry, Pharmacy, and Public Health. The health professions students we support and train will go on to have a positive impact on the health of all people in our communities, becoming future health leaders.
The Constellations: Imagined Futures and Directions
As we imagine a network of multiple Native American Centers of Excellence and scaling health workforce recruitment, retention, and training we considered our priorities and who we are accountable to in this work. For greatest mutual impact and accountability, we will prioritize relationships and collaborations with:
Students or learners across many academic levels
Tribal people
Tribal clinics and Urban Indian Health Centers
When we consider the future of NNACoE we see a center that is equipped to innovate. This means that much of our resources are devoted to ensuring sustainable staffing so that the team has space for the creativity needed to design and implement improvements to existing initiatives. We also are committed to ensuring that health professions student support in the form of stipends, testing resources, travel and emergency funds are scaled to grow.
NNACoE innovation and sustainability over the next decade will be concentrated in the following priority areas:
Gratitude
We gratefully acknowledge the following relationships and elements that made this strategic plan possible:
the waters, lands, plants, and animals in this region;
the dedication of the NNACoE team;
the innovation and brilliance of Tribal nations and people;
the guidance and expertise of Project Mosaic;
the love and hope we carry for generations past, present, and future