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RWJBarnabas Health Exec: How We End Racism Together

Analysis  |  By Melanie Blackman  
   March 18, 2021

DeAnna Minus-Vincent, MPA, chief social integration and health equity strategist at RWJBarnabas Health, details how the New Jersey-based health system is creating an antiracism culture change across its enterprise.

Hospitals and health systems have recently taken larger steps to address the social determinants of health (SDOH) in the communities they serve while also promoting diversity, equity, and inclusion (DEI) efforts within their own organizations.

These strategies were important prior to the pandemic but have been prioritized due to the significant health inequities exposed by COVID-19, which has killed more than 500,000 Americans, as well as the public unrest last summer against racism and police brutality.

In February, the Catholic Health Association of the United States along with 23 Catholic provider organizations signed the Confronting Racism by Achieving Health Equity pledge, marking a public attempt to tackle systemic racism.

Related: Committed to Confronting Racism: Catholic Healthcare Systems Join the Cause

During a recent HealthLeaders CEO Ideas Exchange, Luminis Health CEO Tori Bayless shared how the Maryland-based health system put together a Health Equity and Anti-Racism Task Force to focus on DEI initiatives in the organization and foster more diverse leadership.

New Jersey-based RWJBarnabas Health has made similar steps by announcing an antiracism commitment at the end of 2020 to address racism among the health system and in the communities it serves. Ending Racism Together seeks to change the culture of RWJBarnabas Health across the enterprise.

DeAnna Minus-Vincent, MPA, senior vice president and chief social integration and health equity strategist for RWJBarnabas, spoke with HealthLeaders about how the health system is rolling out Ending Racism Together, why the work is important for healthcare leaders, and how the organization will measure the success of the initiative.

This transcript has been edited for clarity and brevity.

HealthLeaders: Why is it important for hospitals and health systems to focus on racism and ensuring healthcare equity for all?

DeAnna Minus-Vincent: Racism is an SDOH [and] it produces health disparities. We've seen it for years; it manifests itself as food insecurity, as housing insecurity, and as stress. As we know, those all manifest as chronic illness, and then ultimately, in premature death.

HL: What sparked RWJ Barnabas Health’s Ending Racism, Together initiative?

Minus-Vincent: For the past several years, RWJBarnabas Health has been immersed in addressing social determinants of health, advancing health equity and improving our hiring practices to create a more diverse workforce.

After the pandemic began and the social unrest magnified, we realized that we needed to accelerate our efforts across our enterprise. We had been on this journey for the past three or four years, but we realized we needed a direct focus on racism. We are looking at all our policies, processes, practices, and behaviors, and are intent on dismantling racism in a very intentional and highly focused way.

HL: The initiative has four primary focus areas: patient care, workforce, community, and system operations. How will each of these areas be affected by the initiative?

Minus-Vincent: Patient care will focus heavily on our clinical practices. [We'll look] at our internal and regional data to develop priority initiatives. [We'll look] at evidence-based practices to look at things such as black infant mortality, black maternal mortality, emergency room wait time, [factors] such as the use of pain medications, the use of different clinical machines and AI, and how that's employed across the spectrum. [We'll also examine] things in the clinical realm that have been racist and have led to poor outcomes for people of color.

As far as our workforce, [we'll look] at [factors] such as parity in pay, disciplinary actions and how discipline is meted out for black and brown individuals compared to their white counterparts, how we hire, and whether our organization is diverse across the spectrum. [We'll examine how to] attract, recruit, and retain individuals of color across all areas of the organization, our HR policy, and our board composition.

In the community area, [we'll look at] the SDOH. Everything from language to housing, to food insecurity, and how [to] ensure that it's integrated directly into critical care.

And then for operations, [we'll examine] other areas that bolster the first three [including] IT, marketing and communications, and procurement.

Related: How to Address Vaccine Hesitancy Among Black Americans

HL: What steps have the health system already taken to fulfill the mission?

Minus-Vincent: We have done quite a bit of work to date and a lot has been in building out our infrastructure.

We have a steering committee that is led by our president and CEO [Barry Ostrowsky] [with] people from across the system. It is diverse in its disciplines, its levels of authority, and its racial and ethnic composition.

We have initiated a process requiring that [when hiring] for all leadership positions higher than the vice president [level,] if the finalists are not diverse or female, it requires some justification to ensure that we're moving in that direction.

We've looked at integrating SDOH screenings into the clinical setting through our Health Beyond the Hospital program. We've also looked at making translation and interpretation services more readily available for those individuals who need them because we know that people who have limited English proficiency have poor health outcomes.

We are completing a five-part provider education series that's virtual and self-led, designed to increase knowledge about bias, racism, and SDOH. We've also included a racial equity assessment so that we are methodically creating policies, programs, and procedures to ensure that we are not harming communities of color.

We are making some true strides in this area; figuring out ways where we can identify racism and allow our providers and patients to record it because we need to move in this direction.

Related: Opinion: I'm a black nurse on the pandemic's frontlines. Yes, black healthcare workers experience racism

HL: How will you measure the success of the initiative?

Minus-Vincent: We are actively working with a consulting firm, and we are also looking at detailed metrics. We want both our internal and external stakeholders to hold us accountable. We will have dashboards that will have cascading goals from individuals up to the priority initiatives, where each goal will cascade all the way down to tactics, and they will be measured.

So, for instance, if in fact, our goal is to ensure that individuals are screened for their social determinants, then one of the priority initiatives is to ensure that individuals who have limited English proficiency are provided with interpreters. We will ensure that our intake workers understand that when someone is checked in, they are assessed for race, ethnicity, preferred language and their need for an interpreter.

Right now, as with many healthcare systems, that may not always happen on the upfront, but if it does not, because, as we know language and race contribute to health outcomes and by not asking we are contributing to racist practices, intentionally or unintentionally It will be a full goals cascade from social determinants, all the way down to asking a question about race, ethnicity, and language preference, and modality.

HL: How can other hospitals and health systems join the fight to end racism and create racial, ethnic, and cultural equity in the communities they serve?

Minus-Vincent: Other healthcare systems can join the fight by first looking at themselves and their readiness to do so.

We are fortunate in the fact that we have leadership that believes in this—our president and CEO, as well as our board. They are committed to this effort and they were ready to take a progressive step.

[Health systems should] identify the needs in their system and be prepared to roll up their sleeves and do the hard work.

It is not something that will be solved overnight. Racism has been around for centuries and it's also not something that only people of color can solve. It's about everyone deciding that it's a priority and everyone willing to put in the work.

Related: How to Build a Comprehensive Social Determinants of Health Initiative

Editor's note: This story was updated on March 24 to clarify RWJBarnabas Health's culture change.

“Other healthcare systems can join the fight by first looking at themselves and their readiness to do so.”

Melanie Blackman is a contributing editor for strategy, marketing, and human resources at HealthLeaders, an HCPro brand.

Photo credit: RWJBarnabas Health corporate offices located in West Orange, New Jersey. Photo courtesy of RWJBarnabas Health.

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