Case Study: Spotlight on Winners and Honorees of AHA’s 2022 Carolyn Boone Lewis Awards
2022 Carolyn Boone Lewis Equity of Care Award Winner: Mount Sinai Health System | New York
Mount Sinai Health System’s exemplary display of leadership through its health equity, diversity and inclusion initiatives resulted in winning the AHA’s 2022 Carolyn Boone Lewis Equity of Care Award. The award, presented annually by AHA and its Institute for Diversity and Health Equity, recognizes hospitals and health systems that demonstrate a high level of success in advancing health equity, diversity and equitable health care through data, leadership, governance, cultural humility and community partnerships.
Mount Sinai Health System consists of eight campuses within the New York metropolitan area, in addition to the Icahn School of Medicine at Mount Sinai. The health system employs more than 43,000 individuals, including approximately 7,400 physicians.
Mount Sinai launched its Road Map for Action framework in 2021 to help drive change in addressing medical racism and eliminating health disparities. The Road Map was first conceptualized in 2020 in the aftermath of George Floyd’s murder, when Mount Sinai established a task force on racism to evaluate and address issues within the organization and surrounding community related to racism and health inequities. The task force consists of 51 community members including front-line staff, students, hospital presidents and board members, ensuring a mix of perspectives and solutions.
Its educational program includes content about anti-racism, data and disparities, administrative talent pipeline and unconscious bias.
The health system took other actions to address inequities during the COVID-19 pandemic, such as administering COVID-19 testing at more than 400 community events across New York City. And with its “Vaxmobile,” Mount Sinai has administered more than 8,000 vaccinations throughout Nassau County.
Much of Mount Sinai’s health equity work is embedded in improving its data collection of different patient demographics. Race, ethnicity and language (REaL) data are used to identify differences or gaps in care, as well as how people are being treated. Through this effort, staff were able to find focus areas for improvements and were encouraged to hone in on the factors that contributed to those differences and outcomes. The data are used for the development of educational modules for clinical and patient-intake staff. Staff/patient focus groups were conducted to develop a REaL data rate-capture dashboard. A 4% reduction in the number of unknown patient identities was achieved as a result of these system enhancements, along with a greater understanding of the data collection process.
Mount Sinai first began the push to overhaul its data collection practices approximately seven years ago, but amplified these efforts following two landmark events: the onset of the COVID-19 pandemic and the subsequent calls for social justice that resulted in the spring of 2020 following several high-profile cases of police brutality against Black Americans. These efforts were followed by the creation of its task force to address racism. The organization consistently proved their commitment to health equity by utilizing an analytical approach to understand systemic racism and identify how and why it becomes perpetuated.
In March 2021, Mount Sinai created a two-part course titled “Creating a Brave Space for Conversations About Race,” as well as a committee to address anti-Asian bias and racism. To help improve diversity in leadership, Mount Sinai created an Executive Diversity Leadership Dashboard, which monitors the racial/ethnic and gender diversity of executive and senior leaders at the top three levels of the organization. The creation of the dashboard resulted in an increased percentage of women and underrepresented minorities within leadership ranks, particularly those who self-identified as Black/African American and Hispanic/Latinx.
There were two important lessons Mount Sinai learned along their journey, according to Shana Dacon-Pereira, the health system’s senior director for the office of diversity and inclusion. Dacon-Pereira shared her insights on those lessons during an episode of the AHA’s special podcast series, #JustLead. The first lesson learned is the importance of gaining support from leadership. Mount Sinai has an executive diversity leadership board, which establishes the diversity, equity and inclusion strategy for the health system.
“The expertise and experience of our leaders in both setting the strategy and leading by example, I think, has been crucial to that success,” said Dacon-Pereira. “For any hospital or health system really looking to get into this work, having that commitment from the top is important. And then having those leaders demonstrate those behaviors that they really want to instill in the health system is important as well.”
The second significant takeaway from their experience is the importance of both understanding and trusting the community the organization serves. “If we don’t understand the communities that we serve, then how are we supposed to be able to meet their needs?” Dacon-Pereira asked.
To help learn more about its community and residents, Mount Sinai’s community and governance department became regular attendees at community board meetings. They also met with local businesses to find ways they could work together on equity initiatives.
The health system’s Institute for Health Equity Research led sessions with community leaders and other stakeholders through town halls and other events, sharing with them how they could do their own research about disparities.
Mount Sinai’s work in the community isn’t a one-off project. Its goal is to continue making gains in health equity for generations to come. Staff are taught the importance of collecting patient data and identifying trends to create innovative solutions that address disparities.
“For it to be ‘forever work,’ we need forever change in our hearts and in our minds to really push this forward,” Dacon-Pereira said.
Mount Sinai will continue to use data stratification to help address disparities, which could influence future efforts such as policy shifts or new practices developed as a result of the data collection. They would then monitor how any new initiatives changed outcomes for certain groups.
“I think that there’s so much to be done in that space, that we don’t even know how great it’s going to be,” said Pamela Abner, MPA, CPXP, vice president and chief diversity operations officer for Mount Sinai Hospital Groups. “There are little things that we’ve done along the way that have been helpful. Everything to me is kind of incremental – you have to get to one place, to another place, and another and you can’t do it all at once. But we’re on such a wonderful path.”
To learn more about Mount Sinai’s work, check out its Road Map Conversations Toolkit. The toolkit features resources about the task force to address racism, videos and documents further explaining the Road Map for Action, and more.
2022 Carolyn Boone Lewis Equity of Care Award Honorees
Novant Health | Winston Salem, N.C.
The AHA recognized Novant Health, based in Winston-Salem, N.C., as an honoree in 2022. Last year, Novant Health established an annual goal to ensure underrepresented communities received a proportionate distribution of COVID-19 vaccines. The hospital set a goal of 25.3%, which aligned with the demographics of historically marginalized communities in the state. Novant Health exceeded its goal and achieved a rate of 31.6%, with the support of community pillars such as places of worship, schools and local businesses.
In addition to its vaccine equity effort, Novant Health established notable equity initiatives within its workforce and the LGBTQ+ community. The hospital has a 10-week, paid internship for undergraduate students and it was also recognized as one of the “Best Places to Work for People with Disabilities” by Disability:IN, scoring 100 on its Disability Equality Index. Novant Health also created a campaign through data collection with the goal of increasing trust and understanding with LGBTQ+ patients and community members. Patients were asked to share their sexual orientation and gender identity information during registration in the patient’s room or via MyChart.
Thomas Jefferson University Health | Philadelphia
Thomas Jefferson University/Jefferson Health of Philadelphia was also recognized as a 2022 Equity of Care Award honoree by the AHA. Jefferson Health has made significant strides in increasing diversity within its leadership ranks during the past three years. Executives hired from underrepresented groups increased from 20% in 2019 to 40% in 2021. The health system has taken other actions to improve diversity and inclusion strategies in its community, such as sponsoring high school students for recruitment through the Cristo Rey Program and working more closely with college programs.
It also recently renamed and expanded its health equity program, which is now named the Jefferson Collaborative for Health Equity. The program focuses on health and wellness, health equity-focused interventions and addressing systemic issues such as food access by collaborating broadly. In partnership with Jefferson’s Office of Institutional Advancement, the Collaborative received funding to support multiple initiatives that address the drivers of stroke and cardiovascular disease, which specifically focus on five targeted high risk/underserved areas in North and South Philadelphia. Some of its first projects focus on mental health access, teen resilience, urban blight and home repair.