Racial health disparities exist and because they are associated with worse outcomes, they are unacceptable. This was one of the initial findings from a study commissioned by the Institute of Medicine over 15 years ago. Since then additional research confirms the role of a healthcare provider’s own implicit bias as a contribution to these disparities. Not only do providers have an implicit bias, as does everyone else, but they are more likely to have a pro-white bias (Zeidan, Khatri, et al, 2018). Healthcare disparities among people of color continue to worsen. Racism is a public health crisis, and implicit bias plays a role in the quality care we deliver to communities. Implicit bias and systemic racism affect the patient experience, per capita costs, and health outcomes; which are all part of IHI’s Triple AIM to improve the quality of care to Americans. Sherman and colleagues said, “For enduring change, there is a need for approaches that act as a catalyst for systemic change.” This change can start with healthcare accrediting bodies by holding healthcare institutions to quality standards including those that address implicit bias and systemic racism.
Since that initial study by the Institute of Medicine, much research on implicit bias training and its effect on healthcare professionals is available. One study found that after a simple implicit bias training intervention, healthcare professionals became more aware of their implicit bias by over 33% and the awareness of how that bias affects how they deliver care increase by 9%. These results and the hundreds of other articles should push organizations such as these accreditation organizations to create strong training standards.
My goal is to lobby the biggest (URAC, NCQA, The Joint Commission, CARF, and COA) accrediting healthcare organizations to add standards that require organizations seeking accreditation to utilize an evidence based framework for development and implementation of implicit bias and racism as a public health crisis training. These organizations provide accreditation for close to 100,000 different healthcare organizations amongst a range of specialties and disciplines. While many of them may have cultural competency training, this is not the same as implicit bias training and does not begin to address the systemic racism within American healthcare. A mandatory standard from accrediting bodies would allow us to reach a vast amount of healthcare professionals across many disciplines.
Over the next few months with your help I will
· Research and share information on accreditation requirements related to cultural competence and racism.
· Develop factsheets on evidence-based frameworks for implicit racial bias training and resources
· Develop partnerships and support from organizations
· Solicit signatures from healthcare executives and organizations in support of this standard
· Create and disseminate a petition for support of this policy change.
Together we can work together to bring about a change that helps us begin to address the bias and racism within the healthcare field.
 Sherman, M. D., Ricco, J., Nelson, S. C., Nezhad, S. J., & Prasad, S. (2019). Implicit Bias Training in Residency Program: Aiming for Enduring Effects. Family Medicine, 51(8), 677-681. doi:10.22454/fammed.2019.947255  Zeidan, A. J., Khatri, U. G., Aysola, J., Shofer, F. S., Mamtani, M., Scott, K. R., . . . Lopez, B. L. (2018). Implicit Bias Education and Emergency Medicine Training: Step One? Awareness. AEM Education and Training, 3(1), 81-85. doi:10.1002/aet2.10124