The Equitable Patient Experience

As health care providers look back on 2020, they cannot unsee what they have seen: A sweeping pandemic that disproportionately upended the lives of people of color, compounded by inequities that cast a light on institutional racism across the globe.

Over the past year, the Mount Sinai Health System has taken concrete steps to integrate equity into organization-wide Patient Experience efforts. The Health System has reprioritized how it cares for patients and communities of color by changing the way it responds to complaints and grievances, ensuring equity in interpreter services, creating a policy to support staff when issues of racism, discrimination, and inequity appear, and transforming patient experience data strategy to elevate voices of color, says Pamela Abner, MPA, CPXP, Vice President and Chief Diversity Operations Officer for Mount Sinai Hospital Groups, Office for Diversity and Inclusion (ODI), Mount Sinai Health System.

“One of the first steps was to engage in courageous conversations with our staff and patients about issues related to equity,” Ms. Abner says. “We heard, and the data validated, the disparities our staff brought up. When examining patient survey data, we were alarmed to see that voices from our patients of color were significantly underrepresented.”

These findings prompted a journey to design and implement strategies that addressed the critical need to hear from patients of color and to commit to shifts in health equity that lift health for all.

In 2020, Mount Sinai committed to listening to staff members to propel the journey toward an equitable patient experience. Patient Experience Coaches facilitated staff listening sessions around themes of racism, using a guide written by the Office of Patient Experience and ODI, with anonymous pipelines for leaders to act on the feedback. Thus far, coaches have held more than 20 sessions, engaging more than 500 staff members, and accruing 1,500 unique responses, which illuminated barriers as well as suggestions for overcoming them.

“We should have open forums about racism—discuss it regularly—that’s the only way to address racism,” one staff member at The Mount Sinai Hospital said in a session.

“Our staff’s honest feedback led to open conversations with leadership, action plans with a foundation in transparency, communication, and commitment to equity,“ says Erica Rubinstein, MS, LCSW, CPXP, Vice President, Service Excellence and Patient Experience, Mount Sinai Health System. “We have already seen improvement in how our staff perceive the system’s commitment to creating an equitable experience for both staff and patients.”

Ms. Rubinstein and Ms. Abner say their offices work closely together toward shared goals because equity and the patient experience are inseparably linked. In 2020, they conducted a webinar on the Press Ganey site that outlined how Mount Sinai is building a foundation for health equity through the collection of meaningful patient data.

In response to staff concerns, a multidisciplinary team of experts across MSHS is developing policies to respond to racism and discrimination. The new “Responding to Racist and Discriminatory Patient Behavior” policy provides guidance to staff and learners of MSHS who encounter racist or discriminatory behavior of any kind from a patient or family member. The policy says, “We are committed to creating a safe environment free from all forms of racism, bias, and discrimination for all who enter our doors both virtually as well as physically. Any behaviors that undermine this commitment will not be tolerated. This policy will be enforced based on the impact of the discriminatory behavior or speech, not the intention.”

The policy prioritizes anti-racist behavior, says Ms. Rubinstein, “And it shifts the understanding that racism and discrimination happen, and we, as health care providers, must endure it. This policy will not only support our staff but empower and care for them so they feel safe giving care to our patients.”

“At a difficult moment in our city’s history, I was very impressed, even inspired, by the
sincere commitment and human decency of everyone I dealt with.”

– Mount Sinai Morningside Inpatient