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Strategies for Addressing Healthcare Inequities and Bias in the Hospital Setting

Strategies for Addressing Healthcare Inequities and Bias in the Hospital Setting

By Christine Ijiomah, BSN, RN; and Tara Lerew, BSN, RN, NE-BC

Do you want to address healthcare inequities and bias in your institution? Do you provide EDI (Equity, Diversity, and Inclusion) training to your employees but aren't sure it is really making an impact? Healthcare has a long history of bias and inequities systemically entrenched in the culture, and it will take more than classroom learning to move us collectively forward.

In 2020, our inpatient acute care unit leaders reached out to our EDI hospital leadership, requesting assistance in combatting witnessed inequities in real time. With our EDI partners, the unit set up monthly forums called Equity in the Moment™ (EIM™) to improve our ability to recognize bias, provide structural empowerment, and initiate action. These monthly conversations led to a greater engagement and awareness around microaggressions, both witnessed and experienced on and off the unit. In addition, there have been meaningful and measurable cultural shifts in the team members' willingness and ability to recognize and engage in these often-hard conversations.

EIM™ monthly forums have led to actionable change within the unit and the broader institution. Two of these changes include adding Black, Indigenous, and people of color (BIPOC) hygiene products to unit supply rooms and increased engagement with our interpreter services department to ensure all patients have an interpreter if needed. It also has led to the creation of pantry menus with dietary options such as halal, kosher, and gluten-free, delineated and in multiple languages.

Unit leadership realized that they needed tools to help the team recognize microaggressions and address them in the moment. The unit partnered with the university’s School of Nursing to implement HEALS (halt, engage, allow, learn, and synthesize) in a hospital setting. HEALS is a tool created by the University of California San Francisco to call people into conversations when a microaggression occurs.

EIM™ and the HEALS model create an environment for bias recognition, individual growth, and collective action. Implementing EIM™ and the HEALS tool has improved the unit's ability to address microaggressions and inequities in real time by creating an environment for bias recognition, individual growth, and collective action. This empowers staff to make positive systemic changes that benefit patients, staff, and the hospital. EIM™ and HEALS may be a template for others to pursue equity and justice. To learn more about this important topic, please attend our AMSN Annual Convention presentation, entitled “Collaborative Conversations on Equity, Inclusion, and Justice.”  We look forward to seeing you there!

Visit the AMSN website to register for the 2024 AMSN Annual Convention, and for more information about “Collaborate Conversations on Equity, Inclusion, and Justice” and other sessions, view the preliminary program.

Content published on the Medical-Surgical Monitor represents the views, thoughts, and opinions of the authors and may not necessarily reflect the views, thoughts, and opinions of the Academy of Medical-Surgical Nurses.

Christine Ijiomah, BSN, RN

Christine Ijiomah, BSN, RN, is an assistant nurse manager on the Burns, Plastics and Pediatrics trauma acute care unit at Harborview Medical Center (HMC) in Seattle. She has been a nurse since 2008 and an assistant nurse manager since 2016. HMC is the only level one trauma center in four states, and its mission is to provide care for underserved individuals. Christine has served on multiple hospitalwide Equity, Diversity, and Inclusion committees, including serving as a white anti-racist workgroup facilitator for the multi-hospital organization. She has facilitated her unit’s Equity in the Moment™ meetings since its initiation in December 2020. Christine has previously presented this work at the Seattle Nursing Research Consortium and to multiple workgroups hospitalwide.

Tara Lerew, BSN, RN, NE-BC

Tara Lerew, BSN, RN, NE-BC, is a nurse manager on the Burns, Plastics and Pediatrics Trauma acute care unit at Harborview Medical Center (HMC) in Seattle. She has been a nurse since 2002 at HMC, whose mission is to serve the most vulnerable populations. Tara has been a nurse manager for 10 years. She graduated from the AONL Nurse Manager fellowship in 2021. Tara is the nurse manager of the unit where Equity in the Moment™ initiated and continues today. She provides education on HEALS to unit staff and to other areas interested in utilizing HEALS as a tool. Tara provides Equity, Diversity, and Inclusion education annually at the hospital Leadership Development Program.

AMSN Annual Convention | Professional Concepts | Healthcare Inequities

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