The events of 2020 shined a glaring light on racial disparities and inequities in our country and healthcare that persist as we begin 2021. Racism has been declared a public health crisis. Social unrest has been the impetus for initiating purposeful conversations about racism in some healthcare systems. Executives recognized that these events were the topic of conversations in communities and the people in those communities are their staff, patients and families they serve. Leaders had to decide whether to remain silent or use these events as a catalyst for change.
Terry Shaw, president and CEO, Advent Health, Altamonte Springs, Fla., sent a statement on June 2, 2020, to all employees in the health system. He stated, “We cannot remain bystanders. While there is breath in us, silence is not an option.” Shaw convened an Advent Health Executive Roundtable meeting, comprised of the most senior leaders in the health system, to listen to some of the organization’s African American leaders.
Top leaders, such as Shaw, recognized that if the recent events were not openly discussed, racism and implicit bias could become covert processes that would undermine good intentions to achieve health equity and social impact goals.
Here are two additional examples.
RWJBarnabas Health, West Orange, N.J.
The largest integrated academic healthcare delivery system in New Jersey, the system is a member of the Healthcare Anchor Network.
Michellene Davis, JD, executive vice president and chief corporate affairs officer, shared how the health system initiated conversations about racism.
She told how Barry H. Ostrowsky, FACHE, president and CEO, gathered the top five Black leaders in the health system, including Davis, for an active listening session about the events surrounding the death of George Floyd and other Blacks in police custody. Davis described the meeting as a candid discussion of the group’s feelings about the events. Specifically, they shared what it is like to be Black in the community witnessing racial injustice and unrest. And they discussed what it is like to be Black in the health system. Ostrowsky listened empathically as they told their stories. He then shared what he was feeling and thinking. At the end of the meeting, he asked, “What would it take to become a racial justice healthcare system? What would that look like?”
As a result of this meeting, a series of conversations and open dialogues about racism and the events that put it in the headlines have been taking place across the health system. They are facilitated by the diversity and inclusion leadership team led by Trina Parks, FACHE, senior vice president, chief diversity and inclusion officer. People have been forthcoming and honest about their feelings and experiences, according to Davis. She believes what the workforce needed was for the organization to create a safe space.
She indicated the goal of the conversations is to ensure individuals understand that “We cannot have the best of them if we do not welcome all of them.” For some people it is the first time they are realizing racism is real and what that means as people share their stories. These conversations are informing the organization about what strategy and initiatives they are going to co-orchestrate and implement to ensure that individuals understand that “Black Lives Matter” in the health system.
The conversations have not been easy because, as Davis acknowledged, “We have been taught that race is undiscussable in organizations and viewed as controversial.” She believes success lies in equipping leaders to talk about things they have been taught not to talk about. The health system is doing that by helping leaders on all levels of the organization to learn about racism and implicit bias from system, team and individual perspectives. The health system corporate board of trustees is taking a leadership role and has created a subcommittee dedicated to the dismantling racism effort.
These purposeful conversations are providing important insights for the health system. Davis stated, “We hope that the discussions are instrumental in informing all of our practices, protocols, policies and processes in operational, clinical and administrative areas.” The results are helping to determine the systems change required to achieve health and racial equity for all in both the communities they serve and the health system.
Atrium Health, Charlotte, N.C.
Atrium Health is a not-for-profit integrated health system network, providing services in North Carolina, South Carolina and Georgia.
Fernando G. Little, vice president and chief diversity officer, spoke on behalf of Eugene (Gene) A. Woods, FACHE, president and CEO, about the health system’s position on racial justice and how it aligns with the organization’s mission and social impact strategy.
The tipping point, he said, for conversations to be held about race and racism was the incidents related to the death of George Floyd and other Black men and women in police custody. Woods and Atrium Health’s senior leaders, with the guidance of Little, recognized that the repeated imagery of Floyd’s death on social media and news reports of other deaths of Black citizens in police custody was affecting their teammates at the health system. Woods and Little, working with the organization’s chief people and culture officer, wanted to be proactive in addressing concerns by creating a safe space for teammates to share their feelings about these events.
Woods initiated the process by sending a message to the entire workforce with the theme, “Whatever Affects One of Us, Affects All of Us.” In this note, he shared his story and the reality he experiences as a multiracial man. He set an expectation for all leaders to be at the forefront of facilitating conversations that reinforced the organization’s stance, “We do not uphold racial injustice at Atrium Health” and that reminded everyone of the mission, “To improve health, elevate hope and advance healing—for all.”
The key goal of the conversations was to offer communities support that would channel emotions into productive purpose. In addition, they wanted people to accept and be educated on the different realities for how diverse people experienced the recent events in the organization. Woods suggested that they should seek help and support from Atrium Health’s Office of Diversity and Inclusion for facilitating these conversations.
In recognizing that some leaders would struggle with the expectation to facilitate these courageous conversations, the Office of Diversity and Inclusion provided a Courageous Conversations Guide and a Racial Justice Toolkit. To initiate the process, organizationwide virtual conversations were coordinated and facilitated by Little. They included “What’s Going On?” with the Men’s Diversity Leadership Network and two “fishbowl” panel discussions:
“Alone Together—Community, Violence, and Unrest,” one with Black men and another with Black women. The purpose was to share the personal impact, coping mechanisms and to provide a community of support during this difficult time. These discussions were followed by an executive fishbowl, “Alone Together—What’s Next?” in which teammates listened to senior executives share their perspectives on racial injustice and suggestions for moving forward in a productive way.
These conversations are informing Atrium Health’s social impact strategy and how they will continue addressing the social determinants of health to achieve health equity for all. Atrium Health’s leadership believes it is essential to assess how systemic and institutional racism are barriers to attaining measurable progress. Leadership accountability is essential for executing their social impact strategy.
Closing Thoughts
In this unprecedented time in our country, racial justice and health equity are imperative for health systems to achieve their missions and commitment to the diverse communities they serve. Purposeful conversations about racism, along with other efforts to address health equity, can help leaders to examine underlying barriers. With this understanding, leaders increase the opportunity to eliminate disparities and attain sustainable systems change.
Diane L. Dixon, EdD, is managing principal, D. Dixon & Associates LLC, and Adjunct Lecturer, Health Policy and Management, University of Maryland School of Public Health, Columbia, Md., and an ACHE Member. She is the author of Diversity on the Executive Path.