Selected Podcast
Recognizing and Managing Bias in Healthcare
In this conversation, we explore the definitions and impact of unconscious and implicit biases on healthcare delivery and patient safety, centering specific biases including: relation, race, gender identity and expression, sexual orientation, age, and mental health. This discussion, an adjunct to the Whitepaper series on Recognizing and Managing Bias in Healthcare, facilitates evaluation of current healthcare environments and identification of strategies, tools, and interventions to address conscious or implicit bias in healthcare.
Featuring:
Benjamin (Ben) Wilburn is the Senior Inclusion and Diversity Specialist at the Institute for Diversity in Health Equity (IFDHE). In his role at IFDHE, Ben oversees the Summer and Fall Enrichment Programs, and the Certificate in Diversity Management (CDM). Additionally, he works closely with team members on resources related to diversity and inclusion. Prior to joining IFDHE Ben served as the Director of Advocacy for a non-profit in Central Illinois working with survivors of sexual violence. Ben has served as a content expert, consultant, and trainer on transgender and gender variant communities for almost a decade. He earned his BA in Sociology ‘14 and MS in Family and Consumer Science ‘16 both from Eastern Illinois University.
Doris Fischer-Sanchez, DNP, APN-BC, CPHRM | Benjamin Wilburn, BA, MS
Doris has more than 30 years’ experience in healthcare. As a dually board certified psychiatric and family nurse practitioner, Doris has practiced in both the in and outpatient settings including: critical care, psychiatry, private practice, ambulatory and long- term care. Transitioning to risk management 15 years ago, she was the director of risk management at a large academic system. She holds a Doctorate in Nursing Practice, Systems Leadership from Rush University in Chicago. Prior to joining WTW, Doris provided organizationally specific consultation services and education as a content expert and resource on matters of clinical enterprise risk management, risk assessment, selection, and mitigation for internal and external clients at a global insurance company. Doris has published on various risk management topics and speaks with audiences nationally on matters of clinical and enterprise risk management. Doris is a certified professional in healthcare risk management (CPHRM).Benjamin (Ben) Wilburn is the Senior Inclusion and Diversity Specialist at the Institute for Diversity in Health Equity (IFDHE). In his role at IFDHE, Ben oversees the Summer and Fall Enrichment Programs, and the Certificate in Diversity Management (CDM). Additionally, he works closely with team members on resources related to diversity and inclusion. Prior to joining IFDHE Ben served as the Director of Advocacy for a non-profit in Central Illinois working with survivors of sexual violence. Ben has served as a content expert, consultant, and trainer on transgender and gender variant communities for almost a decade. He earned his BA in Sociology ‘14 and MS in Family and Consumer Science ‘16 both from Eastern Illinois University.
Transcription:
Michael Carrese: Welcome to the ASHRM Podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management.
Visit ASHRM.org/membership to learn more and become an ASHRM member. I'm Michael Carrese. And the events of 2020 raised awareness of prejudice and bias in the United States to a level not seen in decades. And as a result, many organizations have been scrutinizing their policies, procedures, and workplace cultures to determine how they might be contributing to inequity and disparities.
Important part of that work is recognizing and managing unconscious and implicit biases. And that's what we'll be discussing today with two experts. We have Doris Fischer-Sanchez with us. She's a Senior Clinical and Enterprise Risk Management Consultant at Willis Towers Watson. And Benjamin Wilburn is with us as well. He's a Senior Inclusion and Diversity Specialist at the Institute for Diversity in Health Equity, which is an affiliate of the American Hospital Association. Thanks to you both for being with us today.
Doris Fischer-Sanchez: Thank you, Michael.
Benjamin Wilburn: Thanks, Michael.
Michael Carrese: So I'd like to start with both of you sharing some background on your credentials and careers. You've got an impressive amount of experience in this area. So I want our listeners to be able to understand what you're bringing to the table today. And Doris, would you like to start?
Doris Fischer-Sanchez: Sure thing. My background is that I'm a psychiatric and family nurse practitioner by training and practice. And I have my doctorate in nursing practice and healthcare systems. My focus in my career was largely clinical. And a few years ago, I went into the area of risk management. And that led me also then to a path into global insurance. And then now working at the brokerage at Willis Towers Watson. The idea for this again, came out, yes, of the pandemic, but also realizing that biases and their influence on the way we practice has been around for quite some time.
Michael Carrese: To be sure. And Ben, what should folks know about your career path and highlights?
Benjamin Wilburn: I think my career up to this point has really been focused on providing guidance and education on topics such as this implicit bias, but also with cultural competencies and specifically with LGBTQ populations, which fits perfectly with my role at the institute as the Senior Inclusion and Diversity Specialist. And in that role, I worked closely on issues related to diversity and inclusion ranging from internship programs and targeted towards students from diverse backgrounds, down to our certificate in diversity management, which is an in-depth and immersive program for diversity inclusion and health equity practitioners. So it all fits together in a perfect puzzle.
Michael Carrese: So Doris, let's dive into this and I think a good jumping off point is having you explain what implicit bias is and provide us with some examples.
Doris Fischer-Sanchez: So my coauthors and I of this white paper series that we're doing for the American Hospital Association and ASHRM, we tried to take a look around and find what was out there in terms of the perfect definition. And as you can imagine, there are many, but what we've agreed upon and what we found to resonate was that we look at biases as a series of influencing beliefs that are either unconscious or they're implicit, and they really do exist outside of how we consciously are aware.
So they're difficult to control and they're kind of automatically activated within us because it's what we're used to and it's what we've learned and it's what we've grown up with. And those biases lead to how we behave and how we make decisions and how they influence our decisions. And within healthcare, we're human and that happens there as well. So there is some element obviously of stereotyping and prejudice and potentially discrimination. But again, you may feel very strongly that you don't have these biases, but within all of us, they're kind of there. They're an undercurrent.
Michael Carrese: And just to stick with that for a second, you know, there's been a lot of training activity around implicit bias, and I'm wondering what you think some of the key techniques are for helping people understand what they are maybe for the first time.
Doris Fischer-Sanchez: I think that taking a look at your own self internally and, in healthcare, we're always asked how do we feel about things, how do we believe that impacted us as opposed to just the people that we're working with or trying to help, but taking a look at what do we feel drove us to a particular decision or how did the situation make us feel? And we can talk a little bit more about this, but naturally the pandemic has brought to light different situations that maybe we were not necessarily taking a look at before, like how COVID-19 affects various populations as opposed to others and so on. And so I think that plays a large role in how to begin uncovering what some of these particular issues are.
Michael Carrese: So, Ben, what would you add to how Doris has outlined things?
Benjamin Wilburn: I think it's a great outline. If I added anything. I think it would be that just remember this can be found everywhere, patient interactions, down to treatment decisions that were made, and whether they choose to move forward with those decisions, are individuals satisfied with their care. This impacts a lot of what we look at.
Michael Carrese: And speaking of impact, so what are some consequences of implicit bias in a healthcare context, if you particularly think about patient safety and outcomes?
Doris Fischer-Sanchez: I think that if we're looking at how we listen to people when they present their concerns or complaints, how we assess them and the diagnoses or the interventions that we come up with impact what's going to happen with respect to whether or not the person actually decides to follow through with our suggestions. If they're so off the charts and so beyond their ability to even access them, let's say medications because of the price or, you know, certain cultural beliefs feel that certain types of medications, et cetera, are not appropriate or certain interventions or opportunities for even some types of therapy may not be culturally appropriate. They may not be gender appropriate. We may have a true just unfamiliar or unaware way of looking at things, because we just believe that we're going down a list of remedies. And, you know, for lack of creativity or empathy or whatever the issue is, we're just not hitting the mark.
Michael Carrese: Right. And, you know, I was reading something recently about one consequence that people might not always think about which is they might just not come back for care. And you wouldn't know that they are doing that or have a problem with patient who feels like they've been disrespected or misunderstood or have felt some bias in some way. They just will take themselves right out of the system. Which is really tragic when you think about it.
Doris Fischer-Sanchez: It's true. And also with the idea of value-based purchasing and bundled care and more onus being placed on providers and organizations, hoping to get people to a level of health. This is a huge issue and it does impact patients and harm. And also potentially liability issues. Yes, if a patient isn't returning, that's a diabetic and truly requires care, what's the inception of that and how do we address it if we've lost them because we don't even know how to approach them respectfully, empathically, appropriately.
Michael Carrese: Right. So Ben, race obviously I think floats to mind first when we were talking about bias, but Doris mentioned gender there, and I know this is an issue you have a particular expertise in. So in terms of gender identity, gender expression, what are some of the key blind spots that you're aware of and that you talked to people about?
Benjamin Wilburn: When I think about this, I really think about it from the ground up, if you will, what comes to mind are moments of just respect, of blatant respect. So often for people within the transgender or gender nonconforming communities, a name might be incorrect on their chart or an assumption might be made about their gender identity based off of their expression or what they're wearing or their presentation. And so you can imagine being referred to as the wrong name or the wrong pronoun or the wrong identity could be very unsettling for a patient and might impact if they return or how that visit went for them. So understanding that we have to break away from just assumptions to build that trust from the ground up, starting with those items, which may seem minor, really makes a lasting impact on building those trusting relationships over time. And therefore, positively impacts that person's care over time.
Michael Carrese: And talk a little bit about how this should be documented, so as they go from provider to provider, the mistake is not repeated.
Doris Fischer-Sanchez: I think in terms of documentation and the need for that to be the patient's record and their obviously medical legal record and following them, in the era of the electronic health record, I think you have the opportunity and the option to take a look at the social history and other types of important information that follows the patient at a true patient level, as opposed to just a specific encounter.
So I think making sure that the information is accurate and taking the time within your assessment to make sure that you're addressing and updating items of importance is paramount to creating an appropriate and a pertinent record for the particular patient.
From a risk perspective, I think when you discuss documentation and health record, I think it's appropriate and very important for risk managers to be aware that there are specific guidelines and regs that need to be followed in terms of people's health history. And, for example, SOGI documentation and, Ben, can you help me talk a little bit more about that?
Michael Carrese: So SOGI, to jump in sexual orientation and gender identity. So, Ben, what do you think?
Benjamin Wilburn: Yeah, I think that's a really good point and a really great starting point for good conversations around this, because when I think about even my own experiences moving through the system, it can be really hard to find providers who are welcoming and inclusive that can come from different reasons and for different reasons. But I certainly agree with Doris and think the importance of continuing to document and the accuracy of that document and also asking questions is very important. Not working off of the assumptions if somebody is presenting in your office and you perceive them to be one way. Ask them what name they prefer to go by, ask them what their pronouns are. There is no problem in asking. It's sometimes when we run into trouble, when we don't ask.
Michael Carrese: Very good point. So Doris along the same lines, I think people don't always think about mental health status when they're thinking about biases. So you're a certified psychiatric nurse practitioner, what's important for people to understand about that?
Doris Fischer-Sanchez: Michael, I think that part of the reason that myself and Maura Wertheimer, and Ben think this is such an important series to help folks deal with bias in healthcare is to also touch on the topic of mental health and mental health status within society. And I think we all appreciate and understand that there are variety of biases and mental health has always kind of been the kind of stepchild, if you will, in terms of jokes and how people are perceived and flipped statements like, “Oh, that's just crazy or you're crazy."
But really that impact has a lot of weight. And I think if we can just appreciate and empathize and understand that people struggle with a variety of issues, including mental health and particularly in this time period where we've had the pandemic and we've begun to understand more personally maybe from the perspective of what a post-traumatic stress event may feel like based on some unexpected losses, whether it was job or family or income or things of that nature, depression, feelings of suicidality, all of these things that impact our mental health and then in turn our physical health as well focuses on how important it is to understand where you and how you feel about these types of situations, mental health included, because let's face it, we're all human. We all are patients at one time or another. How would you like to be treated?
Michael Carrese: Right. So let's turn our attention toward what people could be doing about this, an organization should be doing about it. Ben, you run programs on diversity management and health equity and so forth. What do you advise organizations to do maybe as a first or second step?
Benjamin Wilburn: I think there's a few things and Doris and I have talked about this at length that one of the first things I think is really having an open and honest communication with ourselves within the hospital or the health system. Because at some point we have to look at ourselves, at the structures and the systems in place and say, "Okay, how do we improve this? What are people giving us in feedback? And what are the realistic steps we can take to improve?"
And in that same accord, you know, training for staff is a really great place to start. Many people don't receive this information in their formal education. So taking that first step, committing to learning about this topic and not just today, but as a commitment to lifelong learning is a really great first step. And also just acknowledge that this is a journey. Making these changes and learning about this cannot be accomplished in one day or one week or one month. It really is a continuation over time.
Michael Carrese: And Doris, I'm thinking from an organizational standpoint, maybe more procedural or policy kind of work, help us understand what needs to be done there.
Doris Fischer-Sanchez: I think policy and procedure is important. I think we all approach healthcare in a very systemized, highly educated perspective. I think you can policy and procedure many things, but if you don't really understand how people are thinking, what they're feeling, what's happening, one of the things Ben and I had also discussed is bias is a possible way of having more of a defense mechanism as you approach the day, because you're so overwhelmed and overworked. It may very well be, but as organizations, we need to start talking to people about other better ways of maybe handling things. And here are some examples of that. People like Ben who come into organizations and help uncover those biases and kind of make us look in the mirror, which is very important sometimes.
And then even though you don't like to bring things down to the question of finance and such, because we're in the business of helping people, but the truth of the matter is healthcare is a very large business. And so when we think about liability, litigation claims that are brought, one of the primary reasons people do that is because of a lack of communication or feeling like they weren't heard or feeling like they were just passed over.
And so I think for the bottom line of organizations, it would behoove them to kind of take a look at these things and see what else it is that they can do aside from just having the best and the brightest and the latest technologies. But going back to the basics, which is communication, understanding what drives satisfaction and how do you best address that?
Michael Carrese: So as we wrap up here, I wanted to help our listeners understand where they can turn to for help and guidance. And Ben, in terms of the Institute for Diversity and Health Equity, what's the best way for them to reach you guys?
Benjamin Wilburn: I absolutely encourage taking a look at our website at IFDHE.AHA.org. There are countless resources related to diversity inclusion and health equity, and it's a really great place to start with a lot of resources packed into one page.
Doris Fischer-Sanchez: And the other is in this year of 2021, as I mentioned before, we do have this three-part white paper series coming out this year, where we're going to look at bias and risk management and addressing that with resources in the areas of ambulatory, inpatient and telehealth medicine.
Michael Carrese: Great. And ASHRM of course is always a good resource for people to turn to as well. So I'm afraid to say we have to leave it there, but I want to thank you both for being with us today and sharing such good guidance with everybody. You've been listening to Doris Fischer-Sanchez, a Senior Clinical and Enterprise Risk Management Consultant at Willis Towers Watson and Ben Wilburn, a Senior Inclusion and Diversity Specialist at the Institute for Diversity in Health Equity, which is an affiliate of the American Hospital Association.
Thanks very much to both of you.
Doris Fischer-Sanchez: Thank you.
Benjamin Wilburn: Thanks, Michael.
Michael Carrese: This podcast is made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ASHRM.org/membership to learn more and become a national member.
Michael Carrese: Welcome to the ASHRM Podcast made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management.
Visit ASHRM.org/membership to learn more and become an ASHRM member. I'm Michael Carrese. And the events of 2020 raised awareness of prejudice and bias in the United States to a level not seen in decades. And as a result, many organizations have been scrutinizing their policies, procedures, and workplace cultures to determine how they might be contributing to inequity and disparities.
Important part of that work is recognizing and managing unconscious and implicit biases. And that's what we'll be discussing today with two experts. We have Doris Fischer-Sanchez with us. She's a Senior Clinical and Enterprise Risk Management Consultant at Willis Towers Watson. And Benjamin Wilburn is with us as well. He's a Senior Inclusion and Diversity Specialist at the Institute for Diversity in Health Equity, which is an affiliate of the American Hospital Association. Thanks to you both for being with us today.
Doris Fischer-Sanchez: Thank you, Michael.
Benjamin Wilburn: Thanks, Michael.
Michael Carrese: So I'd like to start with both of you sharing some background on your credentials and careers. You've got an impressive amount of experience in this area. So I want our listeners to be able to understand what you're bringing to the table today. And Doris, would you like to start?
Doris Fischer-Sanchez: Sure thing. My background is that I'm a psychiatric and family nurse practitioner by training and practice. And I have my doctorate in nursing practice and healthcare systems. My focus in my career was largely clinical. And a few years ago, I went into the area of risk management. And that led me also then to a path into global insurance. And then now working at the brokerage at Willis Towers Watson. The idea for this again, came out, yes, of the pandemic, but also realizing that biases and their influence on the way we practice has been around for quite some time.
Michael Carrese: To be sure. And Ben, what should folks know about your career path and highlights?
Benjamin Wilburn: I think my career up to this point has really been focused on providing guidance and education on topics such as this implicit bias, but also with cultural competencies and specifically with LGBTQ populations, which fits perfectly with my role at the institute as the Senior Inclusion and Diversity Specialist. And in that role, I worked closely on issues related to diversity and inclusion ranging from internship programs and targeted towards students from diverse backgrounds, down to our certificate in diversity management, which is an in-depth and immersive program for diversity inclusion and health equity practitioners. So it all fits together in a perfect puzzle.
Michael Carrese: So Doris, let's dive into this and I think a good jumping off point is having you explain what implicit bias is and provide us with some examples.
Doris Fischer-Sanchez: So my coauthors and I of this white paper series that we're doing for the American Hospital Association and ASHRM, we tried to take a look around and find what was out there in terms of the perfect definition. And as you can imagine, there are many, but what we've agreed upon and what we found to resonate was that we look at biases as a series of influencing beliefs that are either unconscious or they're implicit, and they really do exist outside of how we consciously are aware.
So they're difficult to control and they're kind of automatically activated within us because it's what we're used to and it's what we've learned and it's what we've grown up with. And those biases lead to how we behave and how we make decisions and how they influence our decisions. And within healthcare, we're human and that happens there as well. So there is some element obviously of stereotyping and prejudice and potentially discrimination. But again, you may feel very strongly that you don't have these biases, but within all of us, they're kind of there. They're an undercurrent.
Michael Carrese: And just to stick with that for a second, you know, there's been a lot of training activity around implicit bias, and I'm wondering what you think some of the key techniques are for helping people understand what they are maybe for the first time.
Doris Fischer-Sanchez: I think that taking a look at your own self internally and, in healthcare, we're always asked how do we feel about things, how do we believe that impacted us as opposed to just the people that we're working with or trying to help, but taking a look at what do we feel drove us to a particular decision or how did the situation make us feel? And we can talk a little bit more about this, but naturally the pandemic has brought to light different situations that maybe we were not necessarily taking a look at before, like how COVID-19 affects various populations as opposed to others and so on. And so I think that plays a large role in how to begin uncovering what some of these particular issues are.
Michael Carrese: So, Ben, what would you add to how Doris has outlined things?
Benjamin Wilburn: I think it's a great outline. If I added anything. I think it would be that just remember this can be found everywhere, patient interactions, down to treatment decisions that were made, and whether they choose to move forward with those decisions, are individuals satisfied with their care. This impacts a lot of what we look at.
Michael Carrese: And speaking of impact, so what are some consequences of implicit bias in a healthcare context, if you particularly think about patient safety and outcomes?
Doris Fischer-Sanchez: I think that if we're looking at how we listen to people when they present their concerns or complaints, how we assess them and the diagnoses or the interventions that we come up with impact what's going to happen with respect to whether or not the person actually decides to follow through with our suggestions. If they're so off the charts and so beyond their ability to even access them, let's say medications because of the price or, you know, certain cultural beliefs feel that certain types of medications, et cetera, are not appropriate or certain interventions or opportunities for even some types of therapy may not be culturally appropriate. They may not be gender appropriate. We may have a true just unfamiliar or unaware way of looking at things, because we just believe that we're going down a list of remedies. And, you know, for lack of creativity or empathy or whatever the issue is, we're just not hitting the mark.
Michael Carrese: Right. And, you know, I was reading something recently about one consequence that people might not always think about which is they might just not come back for care. And you wouldn't know that they are doing that or have a problem with patient who feels like they've been disrespected or misunderstood or have felt some bias in some way. They just will take themselves right out of the system. Which is really tragic when you think about it.
Doris Fischer-Sanchez: It's true. And also with the idea of value-based purchasing and bundled care and more onus being placed on providers and organizations, hoping to get people to a level of health. This is a huge issue and it does impact patients and harm. And also potentially liability issues. Yes, if a patient isn't returning, that's a diabetic and truly requires care, what's the inception of that and how do we address it if we've lost them because we don't even know how to approach them respectfully, empathically, appropriately.
Michael Carrese: Right. So Ben, race obviously I think floats to mind first when we were talking about bias, but Doris mentioned gender there, and I know this is an issue you have a particular expertise in. So in terms of gender identity, gender expression, what are some of the key blind spots that you're aware of and that you talked to people about?
Benjamin Wilburn: When I think about this, I really think about it from the ground up, if you will, what comes to mind are moments of just respect, of blatant respect. So often for people within the transgender or gender nonconforming communities, a name might be incorrect on their chart or an assumption might be made about their gender identity based off of their expression or what they're wearing or their presentation. And so you can imagine being referred to as the wrong name or the wrong pronoun or the wrong identity could be very unsettling for a patient and might impact if they return or how that visit went for them. So understanding that we have to break away from just assumptions to build that trust from the ground up, starting with those items, which may seem minor, really makes a lasting impact on building those trusting relationships over time. And therefore, positively impacts that person's care over time.
Michael Carrese: And talk a little bit about how this should be documented, so as they go from provider to provider, the mistake is not repeated.
Doris Fischer-Sanchez: I think in terms of documentation and the need for that to be the patient's record and their obviously medical legal record and following them, in the era of the electronic health record, I think you have the opportunity and the option to take a look at the social history and other types of important information that follows the patient at a true patient level, as opposed to just a specific encounter.
So I think making sure that the information is accurate and taking the time within your assessment to make sure that you're addressing and updating items of importance is paramount to creating an appropriate and a pertinent record for the particular patient.
From a risk perspective, I think when you discuss documentation and health record, I think it's appropriate and very important for risk managers to be aware that there are specific guidelines and regs that need to be followed in terms of people's health history. And, for example, SOGI documentation and, Ben, can you help me talk a little bit more about that?
Michael Carrese: So SOGI, to jump in sexual orientation and gender identity. So, Ben, what do you think?
Benjamin Wilburn: Yeah, I think that's a really good point and a really great starting point for good conversations around this, because when I think about even my own experiences moving through the system, it can be really hard to find providers who are welcoming and inclusive that can come from different reasons and for different reasons. But I certainly agree with Doris and think the importance of continuing to document and the accuracy of that document and also asking questions is very important. Not working off of the assumptions if somebody is presenting in your office and you perceive them to be one way. Ask them what name they prefer to go by, ask them what their pronouns are. There is no problem in asking. It's sometimes when we run into trouble, when we don't ask.
Michael Carrese: Very good point. So Doris along the same lines, I think people don't always think about mental health status when they're thinking about biases. So you're a certified psychiatric nurse practitioner, what's important for people to understand about that?
Doris Fischer-Sanchez: Michael, I think that part of the reason that myself and Maura Wertheimer, and Ben think this is such an important series to help folks deal with bias in healthcare is to also touch on the topic of mental health and mental health status within society. And I think we all appreciate and understand that there are variety of biases and mental health has always kind of been the kind of stepchild, if you will, in terms of jokes and how people are perceived and flipped statements like, “Oh, that's just crazy or you're crazy."
But really that impact has a lot of weight. And I think if we can just appreciate and empathize and understand that people struggle with a variety of issues, including mental health and particularly in this time period where we've had the pandemic and we've begun to understand more personally maybe from the perspective of what a post-traumatic stress event may feel like based on some unexpected losses, whether it was job or family or income or things of that nature, depression, feelings of suicidality, all of these things that impact our mental health and then in turn our physical health as well focuses on how important it is to understand where you and how you feel about these types of situations, mental health included, because let's face it, we're all human. We all are patients at one time or another. How would you like to be treated?
Michael Carrese: Right. So let's turn our attention toward what people could be doing about this, an organization should be doing about it. Ben, you run programs on diversity management and health equity and so forth. What do you advise organizations to do maybe as a first or second step?
Benjamin Wilburn: I think there's a few things and Doris and I have talked about this at length that one of the first things I think is really having an open and honest communication with ourselves within the hospital or the health system. Because at some point we have to look at ourselves, at the structures and the systems in place and say, "Okay, how do we improve this? What are people giving us in feedback? And what are the realistic steps we can take to improve?"
And in that same accord, you know, training for staff is a really great place to start. Many people don't receive this information in their formal education. So taking that first step, committing to learning about this topic and not just today, but as a commitment to lifelong learning is a really great first step. And also just acknowledge that this is a journey. Making these changes and learning about this cannot be accomplished in one day or one week or one month. It really is a continuation over time.
Michael Carrese: And Doris, I'm thinking from an organizational standpoint, maybe more procedural or policy kind of work, help us understand what needs to be done there.
Doris Fischer-Sanchez: I think policy and procedure is important. I think we all approach healthcare in a very systemized, highly educated perspective. I think you can policy and procedure many things, but if you don't really understand how people are thinking, what they're feeling, what's happening, one of the things Ben and I had also discussed is bias is a possible way of having more of a defense mechanism as you approach the day, because you're so overwhelmed and overworked. It may very well be, but as organizations, we need to start talking to people about other better ways of maybe handling things. And here are some examples of that. People like Ben who come into organizations and help uncover those biases and kind of make us look in the mirror, which is very important sometimes.
And then even though you don't like to bring things down to the question of finance and such, because we're in the business of helping people, but the truth of the matter is healthcare is a very large business. And so when we think about liability, litigation claims that are brought, one of the primary reasons people do that is because of a lack of communication or feeling like they weren't heard or feeling like they were just passed over.
And so I think for the bottom line of organizations, it would behoove them to kind of take a look at these things and see what else it is that they can do aside from just having the best and the brightest and the latest technologies. But going back to the basics, which is communication, understanding what drives satisfaction and how do you best address that?
Michael Carrese: So as we wrap up here, I wanted to help our listeners understand where they can turn to for help and guidance. And Ben, in terms of the Institute for Diversity and Health Equity, what's the best way for them to reach you guys?
Benjamin Wilburn: I absolutely encourage taking a look at our website at IFDHE.AHA.org. There are countless resources related to diversity inclusion and health equity, and it's a really great place to start with a lot of resources packed into one page.
Doris Fischer-Sanchez: And the other is in this year of 2021, as I mentioned before, we do have this three-part white paper series coming out this year, where we're going to look at bias and risk management and addressing that with resources in the areas of ambulatory, inpatient and telehealth medicine.
Michael Carrese: Great. And ASHRM of course is always a good resource for people to turn to as well. So I'm afraid to say we have to leave it there, but I want to thank you both for being with us today and sharing such good guidance with everybody. You've been listening to Doris Fischer-Sanchez, a Senior Clinical and Enterprise Risk Management Consultant at Willis Towers Watson and Ben Wilburn, a Senior Inclusion and Diversity Specialist at the Institute for Diversity in Health Equity, which is an affiliate of the American Hospital Association.
Thanks very much to both of you.
Doris Fischer-Sanchez: Thank you.
Benjamin Wilburn: Thanks, Michael.
Michael Carrese: This podcast is made possible by the American Society for Healthcare Risk Management to support efforts to advance safe and trusted healthcare through enterprise risk management. You can visit ASHRM.org/membership to learn more and become a national member.