Diversity, Equity, and Inclusion: Focus on Antiracism

Key Domains

1. Leadership: Develops strategies in recruitment, retention, support, and promotion

• Objectives:
  • Increase under-represented in medicine (URiM) representation in each department among trainees and faculty
  • Augment the diversity of our non-physician staff
  • Revise exclusionary job description and deliberately recruit from our surrounding majority-minority communities
  • Enhance career support for URiM, including enhancing faculty leadership by URiM
  • Ensure diversity and inclusion training for all faculty members
  • Develop initiatives for awareness and intervention in the clinical practice environment
  • Inform best practices to empower URiM communities to receive equitable healthcare in our system
  • Engage with community leaders in the greater Boston area to focus on specific healthcare initiatives
  • Develop mechanisms of accountability in our faculty culture designed to foster an inclusive culture, such as safe culture reporting structure

2. Education and Faculty Engagement: The sub-committee on Education and Faculty Engagement works to facilitate open forums to discuss racial inequalities, to promote awareness of systematic racial hierarchy, to recognize white advantage, to understand how racism affects health outcomes, and to take action in deconstructing racism.

3. Clinical Equity Practice: Quality Improvement Projects

• Nursery:
  • Goal: To identify and reduce racial disparities in the postpartum maternal and newborn care that families receive at BWH and improve related health outcomes.The Well Mother-Baby Team examine differences in postpartum health outcomes and breastfeeding success by race and ethnicity.They gather direct feedback from mothers and stakeholders from under-served communities to guide the development of interventions to address health disparities in women/families from these communities.
• NICU:
  • Goal: To examine racial and ethnic disparities in the quality of care delivered in SCN/NICU and to develop innovative processes to eliminate disparities by improving parental satisfaction and clinical outcomes.
  • The NeoQIC Family Engagement Project focuses on:
    • Communication between NICU/SCN staff and parents
    • Care Delivery and Support Services in NICU/SCN
    • Parent engagement in hands-on care in the NICU/SCN
    • Parent discharge readiness
    • Parent perceived NICU/SCN-related stress

4. Advocacy and Community Outreach Initiatives

• Goal: To improve BWH provision of equitable access to optimal health care for infants born to families at risk of racial bias and/or who live in under-resourced settings by identifying gaps in care for target population and implement programs that most effectively address their needs.
• Projects:
  • Bridges to Moms Program (Sponsored by Health Care Without Walls): Joins BWH Center for Women and Newborns to assist vulnerable new mothers who are experiencing housing and food insecurity and ability to access medical care. Bridges to Moms Program supports throughout pregnancy and for up to 1 year postpartum, working to secure: housing, safety, food/nutrition, baby supplies, transportation, health care.
  • Center for Community Wellness Program: Provides pregnant women in the Blue Hill Corridor support and power through knowledge for their pregnancy, delivery, and first months of their newborn infant’s life, with the goal of optimizing health and social outcomes for both mother and baby.
    • The program seeks to build a community of women to learn and share their experiences together and provides education over 30 weeks, with weekly 1-1.5-hour sessions.
      • Trimester 1 – Healthy Pregnancy
      • Trimester 2 – Delivery and Welcoming New Baby
      • Trimester 3 – Postpartum and Newborn Care
    • The program focus will employ the following metrics:
      • Pregnancy Risk Assessment Monitoring System (PRAMS) data comparators
      • Breastfeeding initiation, exclusivity, and length of breast feeding
      • PRAMS survey for women in program
      • Use of medical care during programming, including primary care and emergent care
      • Survey of emotional and mental wellbeing pre/during/post program
      • Uptake of community services by participants

American Academy of Pediatrics:

• Racial Disparity Repository

Articles:

• African American Inequality in the United States (2020)
• Countering Stereotypes about Asian Americans (2019)
• The Anxiety of Being an Asian American: Hate Crimes and Negative Biases During the COVID-19 Pandemic (2020)
• The Long History of US Racism Against Asian Americans from 'Yellow Peril' to 'Model Minority' to 'Chinese Virus' (2020)
• To Dismantle Anti-Asian Racism, We Must Understand Its Roots (2021)

Books:

• Aiiieeeee! An Anthology of Asian-American Writers, by Frank Chin
• Between the World and Me, by Ta-Nehisi Coates
• How to Be an Antiracist, by Ibram X. Kendi
• Me and White Supremacy, by Layla Saad
• The Bluest Eye, by Tony Morrison
• The Fire Next Time, by James Baldwin
• White Fragility, by Robin DiAngelo

Documentary/Video:

• Race: The Power of an Illusion
  • Panel Discussion (Episode 1)
  • Summary of Episode 1: The Difference Between Us
• White Fragility, Robin DiAngelo

Health disparities and initiatives to promote improve maternal and neonatal outcomes:

• National Institute of Children’s Health Quality
• Betsy Lehman Center for Patient Safety
• Harvard University Diversity Inclusion and Belonging
• Bad Robot's Guide to Dismantling White Supremacy at Work

Interpreter Services:

• Brigham and Women's Hospital is committed to clearly and thoroughly communicating with all patients and their families about the care we provide. Interpreter services for non-English speaking and hearing impaired patients are important to quality health care.
• Please let your doctor know in advance about your language or hearing needs. If you need an interpreter while in the hospital, please contact your nurse or doctor.
• Spanish interpreters are available 24 hours a day by appointment only; interpreters for 29 other languages are available as needed.
• Sign Language interpreters are available Monday-Friday, 9:00 a.m. to 5:00 p.m. If you need an interpreter while in the hospital, please contact the patient’s nurse.

MGB/Brigham Resources:

• Toolkit for Conversations on Race
• Anti-Racism Resources - BWH Center for Diversity & Inclusion

Movies:

• 13th (2016)
• I Am Not Your Negro (2016)
• Just Mercy (2019)
• Selma (2014)
• When They See Us (2019)

• Code Switch (NPR): Fearless Conversation About Race

Workshops:

• Racial Equity Institute: Groundwater Presentation
• Brigham and Women's Hospital-DEI: Implicit Bias Training, Microaggression, Up-standing Training
• Brigham and Women's Hospital: Toolkit for Conversation on Race

Director: Silvia Patrizi, MD

Domains:

• Leadership: Terrie Inder, MBChB, Mandy Belfort, MD, Richard Parad, MD, John McGillivray, MBA
• Education and Faculty Engagement: Tanzeema Hossain, MBChB and Silvia Patrizi, MD
• Clinical Equity:
  • Well Baby Nursery: Anne (CC) Lee MD, MPH, Ann Velie, MD, Carolyn Rundquist, MD
  • NICU: Carmen-Monthe-Dreze, MD, Maggie Everett, MD, Carmina Erdei, MD, Sujatha Ramadurai, MD, Franchyeska Silfa-Mazara, MD, Lisa Pizzi
• Advocacy and Community Engagement: Linda Van Marter MD, MPH, Terri Gorman, MD, Ann Velie, MD, Kenia Gomez, PhD, Yasmin Almonte, BA

• Silvia Patrizi, MD, Director DEI, spatrizi@bwh.harvard.edu
• Tanzeema Hossain, MBChB, Director of Education thossain@bwh.harvard.edu

The Aspen Institute Glossary

Underrepresented Minorities (URM): Representation of a subset of population in professions and education that is disproportionally less than their proportion in the general population.

NIH Definition of Minorities: Black, Hispanic, Native American or Alaskan native, Asian, Pacific Islander

Impact on Health Indicators: URM experience a disproportionate burden of preventable diseases, death and disability compared to the general population.