Putting Anti-Racism Into Action: Partnering With Staff and Patients to Advance Equity

As the Mount Sinai community looks back on recent times, no one can unsee what they have seen: A sweeping pandemic that disproportionately upended the lives of people of color, compounded by brutal inequities that cast a light on institutional racism across the globe. It was this suffering that accelerated the Mount Sinai Health System’s journey toward anti-racism. In 2020, Mount Sinai added equity to its core values of safety, agility, creativity, empathy, and teamwork. And the equity foundation that was laid out before this addition quickly grew into an organization-wide strategic priority. The Office of Patient Experience was determined to carry the torch forward in its own work.

In 2020, Erica Rubinstein, MS, LCSW, CPXP, Vice President of Service Excellence and Patient Experience, and Pamela Abner, MPA, CPXP, Vice President of Diversity Equity and Inclusion for Mount Sinai Health System, brought together a workgroup whose mission is to ensure that care is provided in a safe environment, free from all forms of racism, bias, and discrimination for all who enter the doors of Mount Sinai. The workgroup knew one of their first critical steps was to create an equity-advancing policy that aimed to protect and support staff members who experienced racism and discrimination from patients and visitors. In 2021, the “Responding to Racist and Discriminatory Patient Behavior" policy was created, published, and put into effect. This is the statement at its core:

At the Mount Sinai Health System, we strive to provide care that is safe, compassionate and equitable. All individuals within our organization are entitled to safety, courtesy, and respect. 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’s scope consists of any patient, family member, or visitor who displays racist, biased, or discriminatory behavior in any way toward any member of the Health System’s workforce, or learning community, or another patient, family member, or visitor. The policy’s goals are to:

• Shift understanding of what ordinary patient behavior is.

• Ensure that leaders and staff understand the partnerships the policy encourages.

• Guide leaders and staff in managing such patient interactions, prioritizing anti-racist behavior.

• Demonstrate how reporting should take place, depending on the nature of the incident.

• Encourage that communication during and after such incidents occurs with the affected staff and team.

Any behaviors that undermine this commitment will not be tolerated, and the workgroup created measures to support this policy so it would not live solely on paper. The Mount Sinai Talent Development and Learning team played a crucial role in the roll-out of this policy by providing education on how to put it into practice. The team worked together to create instructor-led training and web-based training to help facilitate the practice of the policy.

Workgroup member Tamiesha Frempong, MD, MPH, Assistant Professor of Ophthalmology, Pediatrics, and Medical Education, feels strongly that this policy points Mount Sinai in the right direction—but that efforts should not stop there.

To accompany this policy, the Office of Patient Experience partnered with Marketing to create anti-racism and discrimination signs and banners to be placed on doors, to be viewed by both patients and staff, as a reminder to all that Mount Sinai does not accept racist or discriminatory behavior and will stand against it.

In addition to the policy, the Office of Patient Experience has provided opportunities for diverse patients to share their experiences, breaking down the barriers that can prevent health care workers from hearing from all their patients, regardless of background or status. The Patient Experience Forums, system-wide webinars led by the Office of Patient Experience, have been a successful avenue in broadcasting not only stories of patients from diverse backgrounds and with unique needs, but Mount Sinai staff as well. This has made the experiences of Mount Sinai’s diverse patients and staff accessible to leaders and staff of various service lines, departments, and sites.

In addition, the Office of Patient Experience transformed their data strategy to analyze, interpret, and act on data by demographics such as race and ethnicity. Tara Villon, Director of Patient Experience Strategy, Data, and Improvement, recalls one of their first analyses performed to uncover disparities in respondents:

“We look at our patient feedback every day—it’s the heart of our organization’s strategy. We wanted to be able to understand more about who was giving us this feedback, and were there disparities in who responds. We were alarmed to see voices from our patients of color were significantly underrepresented. This is simply not representative of the communities we serve, and we knew in our commitment to be actively anti-racist, we had do better,” Tara says.

“It became even more of an imperative when we saw this same insight in our own employee survey data. And furthermore, employees told us the more they feel a commitment to equity at Mount Sinai, the more engaged they are at work.” Patient experience reporting now includes demographic variables to enable the organization to uncover and act on disparities of care.

In November 2021, Erica Rubinstein and Tara Villon spoke on behalf of the Office of Patient Experience to share the plan to create a more equitable and sustainable experience for both patients and staff. This presentation was shared during the Press Ganey National Client Conference in February 2022.