Voices from The Front Lines: Diversity, Equity, and Inclusion (DEI) Experiences of Staff in a Safety-Net Healthcare System

Description

Damaging DEI-related dynamics including explicit bias, implicit bias, microaggressions, and macroaggressions are ubiquitous in society. Healthcare settings, including institutions that dedicate services to marginalized populations, are no exception. In fact, the traditional medical hierarchy amplifies these phenomena. That is, those at the “top” (e.g., physicians) are more likely to be members of a majority group (e.g., White, male, and high socioeconomic status), whereas those at the “bottom” (e.g., medical assistants) are more likely to be members of a minority group (e.g., Persons of Color, female, and low socioeconomic status).

Psychological safety is the foundation of strong team functioning and high-quality patient care. When left unaddressed, DEI-related experiences erode this, putting both patient care and team member well-being in jeopardy, especially for individuals with low power.

We will share research results from individual interviews with 60 frontline workers in a safety-net healthcare system in Denver, Colo., about their DEI-related experiences. We intentionally sought out and prioritized voices often uninvited: about 70% identify as BIPOC (30% White), and about 70% staff in low-power positions such as front-desk staff or medical assistants (30% in high-power positions, such as medical providers or leadership). We will share the complexities and barriers identified in addressing DEI-related issues, as well as the impact of power on trust, safety, and value.

Learning Outcomes:

• Understand power and privilege in the medical hierarchy, including discrimination and invisible burden on BIPOC and staff with low power.
• Identify corrective and protective factors in a safety-net healthcare system, as well as barriers to further change toward trust, safety, and value.
• Name systemic needs identified as opportunities for improvement in the experience of BIPOC and staff with low power in the clinic space.