How does a culture combat an entity that cannot be seen? Start with awareness of the issue. “As humans, we all have bias,” says Dr. Rebecca Bernstein of Mission Health. “It doesn’t make us bad people, but when that bias affects how we make decisions, it can have adverse effects on our patients.”
“We hope to help providers communicate better with patients and be more aware of patients’ perceptions, wishes and fears.”
To build awareness, Mission Health has created a Diversity Committee, which Bernstein chairs. “The [committee] goals … are to educate our employees and care providers in ‘cultural competency,’ to identify and eliminate health care disparities and to partner Mission Health with community events and organizations,” Bernstein says. She also points out the lack of minorities who work in the health care field and suggests that patients prefer to be cared for by providers of the same ethnicity.
One way that Mission works to increase minority representation is by partnering with MAHEC, WCMS, and ABIPA to participate in the Minority Medical Mentorship program. This program provides internships to minority high school students interested in the healthcare, matching them with nurses, physicians and administrators to expose the students to various career opportunities.
Recently, the Diversity Committee initiated a cultural competency training program. “The education is focused on raising awareness: awareness of our own beliefs and how they contribute to decision-making, and the awareness that health care disparities exist,” Bernstein says.
Mission Health offers the cultural competency training course to all of its employees, with the goal of helping them meet the needs of patients who come from diverse backgrounds. “Our course objectives are to explore how personal and cultural beliefs affect our decision-making and how we interact with our patients; to understand the nature of assumptions and biases; to raise awareness around the existence of health care disparities; to recognize the right and wrong ways to work with an interpreter; and to begin to use certain communication tools to improve the health care of all patients,” Bernstein says.
The training is one part of a multifaceted effort — Mission’s “Achieve the BIG(GER) Aim” initiative “to get each patient to the desired outcome, first without harm, also without waste and with an exceptional experience for the patient and family,” Bernstein says.
She also points out that disparities in health care are a national, not a regional, problem. “When we talk about all patients and families, we need to be aware that there is [an] overwhelming body of evidence that shows existence of health care disparities,” Bernstein says, mentioning an Institute of Medicine report — Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.
Bernstein also explains that the cultural competency education addresses the way that an unconscious bias can affect decision-making. “Unconscious bias is more prominent when we are busy or stressed and can be more likely to affect our decisions if we have to make those decisions quickly,” she says. “Our course addresses the existence of unconscious bias and helps providers be more aware that bias can affect how they treat a patient or decisions they make.”
Mission Health collaborates with other organizations, such as the Center for Diversity Education, Minority Enterprise Development week, and the YWCA. An underlying goal of these programs, Bernstein says, is to build a stronger community.
“We are building partnerships with community organizations with the hopes of improving the health of our communities,” she says.
Recognizing and combating bias in health care is really about helping patients. “Disparities exist in every community,” Bernstein says. “At Mission Health, we look at our outcomes by race and ethnicity. If a disparity is found, we share that with the leadership of the department it affects so that we can think about ways to address the disparity.”