Just like we’re fighting COVID-19, we must inoculate ourselves against bias

Jeffrey Flaks

Jeffrey Flaks, president and CEO, Hartford HealthCare.

“Breaking Bias” is a provocative name for this regular column. Like much of our work in healthcare—especially efforts against the COVID-19 pandemic—dismantling bias is both an everyday challenge and a long-term aspiration. For the last 19 months, the dual diseases of coronavirus and systemic racism have been intertwined. We have seen unassailable evidence of healthcare disparities, confronted our industry’s failure to reach many of its most vulnerable communities, and acknowledged that our boasts of “access” have for decades left many people unsupported. At Hartford HealthCare, we have begun to tackle bias in much the same way we confront COVID: Recognize the condition, communicate effectively, and develop interventions that can inoculate (as best we can) our colleagues and communities. Yes, we aim to build antibodies to break bias.

Recognition: We have known for years that disparities in care—along predominantly racial and socioeconomic lines—are real. But the pandemic forced us to measure our effectiveness: not only those we are serving, but what communities we are leaving behind. Our teams developed equity dashboards using data visualization to show, daily, how we were caring for underserved populations. The early results were disappointing, but not surprising. The data did, however, help us adjust our approach and measure progress. Hartford HealthCare expanded outreach via vans for testing and vaccines; we solidified or established new relationships with community organizations; and we expanded this concept of access beyond COVID-19 to other forms of care—emotional and physical—by staffing and equipping a new Neighborhood Care initiative. We have more to do, but I am confident our eyes have been opened as never before.

Communication: Too often, healthcare organizations couch discussions of diversity, equity, inclusion and belonging in jargon-filled language. I decided that we needed straight talk. In June 2020, I called for a systemwide “Time-Out for Racial Equity.” There, I unveiled a 10-point plan for Hartford HealthCare—concrete, visible and measurable objectives to advance a culture of inclusion and belonging. We shared the goals on our intranet, messages in our all-colleague newsletters and in videos and podcasts.  A year later, we added a fifth value, equity, to our long-standing core values of caring, excellence, integrity and safety. And we embedded health and racial equity, diversity, inclusion and belonging in our system’s balanced scorecard to ensure broad awareness, adoption and accountability.Intervention: Racism, bias (implicit and otherwise) and inequity are stubborn things. Breaking them down requires intervention. So we created Colleague Resource Groups to support the advancement of staff members from underrepresented backgrounds. We expanded our Health Equity Department to better identify and address racial and ethnic health disparities. We enhanced recruitment and career development programs for individuals from underrepresented backgrounds. We established a system-wide Supplier Diversity Council. We launched bias awareness and education for all colleagues. Significantly, we began to work with Duane Elliott Reynolds, CEO and founder of Just Health Collective. Mr. Reynolds and the JHC team bring a wealth of knowledge about healthcare operations, expertise in change management and a passion to transform healthcare. The team has conducted an enterprise health equity and belonging assessment and developed a three-year road map. Hartford HealthCare intends to lead the field in this space and the work of JHC has catapulted our journey.  Can we break bias? Yes, but it will take hard work—just like beating back a pandemic. We’re used to hard work, and we are ready.