Being the Change: Mount Sinai Health System’s Legacy of Diversity, Equity, and Inclusion

Being the Change

Mount Sinai Health System’s Legacy of Diversity, Equity, and Inclusion

Introduction

The Mount Sinai Health System, a renowned academic medical institution, has become a leader in diversity, equity, and inclusion. This is the story of that continuing journey.

COMMITMENT • UNDERSTANDING • THE LOOK OF SUCCESS • PART OF OUR

DNA • A BEDROCK PRINCIPLE • EARLY DAYS • GIFT OF LEADING AHC • HOPE AND

MOTIVATION • RAISING AWARENESS • UNDER HER WINGS • WOMEN MOVING UP

• ELEVATING EQUITY • THE POWER OF DATA • ISSUES OF INCLUSION • HE, SHE, AND THEY • A MOVING SPEECH • A WAKE-UP CALL • STUDENTS TAKE A STAND

• OBSTETRICS AND EQUITY • AAPI BIAS • DIWALI AND PRIDE • COVID-19 AND

COMMUNITY • CHANGING THE ROOM • NURSING AND EQUITY • NURTURING

LEADERS • A LEADER WHO LISTENS • BILLING, WITH AWARENESS • DEFINING

DEI • A COMMITMENT • UNDERSTANDING • THE LOOK OF SUCCESS • PART OF OUR DNA • A BEDROCK PRINCIPLE • EARLY DAYS • GIFT OF LEADING AHC • HOPE AND MOTIVATION • RAISING AWARENESS • UNDER HER WINGS • WOMEN MOVING

Throughout the report are

MOMENTS OF CHANGE

short first-person accounts from Mount Sinai community members. Each person was asked:

UP • ELEVATING EQUITY • THE POWER OF DATA • ISSUES OF INCLUSION • HE, SHE, AND THEY • A MOVING SPEECH • A WAKE-UP CALL • STUDENTS TAKE STAND • OBSTETRICS AND EQUITY • AAPI BIAS • DIWALI AND PRIDE • COVID-19 AND COMMUNITY • CHANGING THE ROOM • NURSING AND EQUITY • NURTURING

LEADERS • A LEADER WHO LISTENS • BILLING, WITH AWARENESS • DEFINING

“When did you experience a change in diversity, equity, and inclusion at Mount Sinai—or realize that a change was needed?”

DEI • A COMMITMENT • UNDERSTANDING • THE LOOK OF SUCCESS • PART OF OUR DNA • A BEDROCK PRINCIPLE • EARLY DAYS • GIFT OF LEADING AHC • HOPE AND MOTIVATION • RAISING AWARENESS • UNDER HER WINGS • WOMEN MOVING UP • ELEVATING EQUITY • THE POWER OF DATA • ISSUES OF INCLUSION • HE, SHE, AND THEY • A MOVING SPEECH • A WAKE-UP CALL • STUDENTS TAKE STAND • OBSTETRICS AND EQUITY • AAPI BIAS • DIWALI AND PRIDE • COVID-19 AND COMMUNITY • CHANGING THE ROOM • NURSING AND EQUITY • NURTURING

Their answers paint a vivid and personal portrait of this important work at Mount Sinai.

LEADERS • A LEADER WHO LISTENS • BILLING, WITH AWARENESS • DEFINING DEI • A COMMITMENT • UNDERSTANDING • THE LOOK OF SUCCESS • PART OF OUR DNA

A BEDROCK PRINCIPLE • EARLY DAYS • GIFT OF LEADING AHC • HOPE AND MOTIVATION • RAISING AWARENESS • UNDER HER WINGS • WOMEN MOVING UP • ELEVATING EQUITY • THE POWER OF DATA • ISSUES OF INCLUSION • HE, SHE, AND THEY • A MOVING SPEECH • A WAKE-UP CALL • STUDENTS TAKE STAND • OBSTETRICS AND EQUITY • AAPI BIAS • DIWALI AND PRIDE • COVID-19 AND COMMUNITY • CHANGING THE ROOM • NURSING AND EQUITY • NURTURING

LEADERS • A LEADER WHO LISTENS • BILLING, WITH AWARENESS • DEFINING

The Mount Sinai Health System stands at the national and global forefront of health care providers that understand and acknowledge the value of diversity, equity, and inclusion (DEI). But Mount Sinai—one of the largest academic medical systems in the New York metro area—could not have taken this important stance without consistent work done by thousands of staff members and leaders at all levels.

The spirit of equity is embedded in the origin of Mount Sinai, and achieving this, with intention, is the work of many years. It is a story worth telling, and is the subject of this report.

“The story of what it took to get to this point is important, so that people appreciate the breadth and depth of the work done over the years,” says Shana Dacon-Pereira, MPH, MBA, CPXP, Assistant Vice President, Corporate Health System Affairs, Office for Diversity and Inclusion (ODI), Mount Sinai Health System.

“In our current sociopolitical climate—with laws being passed to eliminate diversity, equity, and inclusion programs—people are asking about the purpose of such initiatives. So, it is imperative, now more than ever, that we look at where we've been, what's changed, and what we have accomplished to ensure that at Mount Sinai, we are providing equitable care that meets the needs of all the communities we serve, especially those that are marginalized and racially minoritized. We all need to understand the importance of this work.”

Health care equity—defined as providing fair and appropriate care based on each person’s need so that they may thrive—is pursued throughout the Mount Sinai Health System, which encompasses eight hospitals, more than 400 physician practices, the renowned Icahn School of Medicine at Mount Sinai, and the Mount Sinai Phillips School of Nursing. Mount Sinai recognizes the need to ensure that leadership, faculty, staff, trainees, and students represent the diverse communities they serve.

“It’s hard work, make no mistake. But the change in health outcomes we have witnessed for staff and patients over the past decade has been magical,” says Gary C. Butts, MD, Executive Vice President, Diversity, Equity, and Inclusion, Chief Diversity and Inclusion Officer, and Director, Office for Diversity and Inclusion, Mount Sinai Health System, and Dean for Diversity Programs, Policy,

and Community Affairs, Icahn Mount Sinai. “We have been doing this work long enough now to know what we are doing and still see how much there is yet to be done.”

For more than 150 years, Mount Sinai’s goal had been to serve all communities, especially those ignored, oppressed, or facing bias. In time, its leaders discovered that the most efficient way to make great differences within any system is with a road map that challenges in every possible way the effects of this country’s history of social and systemic racism. This is work that requires focus and intentionality.

“If you don’t have these structures in place, people can die as a result,” says Pamela Abner, MPA, CPXP, Senior Vice President and Health Equity Officer, Mount Sinai Health System, and Chief Diversity Operations Officer, Office for Diversity and Inclusion. “DEI is necessary for the organization to thrive and to provide people the care they need and to give our staff opportunities to thrive as well.” An essential part of this structure is the Office for Diversity and Inclusion, which guides and supports Mount Sinai’s present-day commitment to equity.

The Office for Diversity and Inclusion: Guiding Best Practices

Established in 2014, ODI guides and serves the Health System as organizational consultants on best practices in DEI management. The overarching strategy to advance DEI across the Health System is guided by the Executive Diversity Leadership Board, which is chaired by Brendan G. Carr, MD, MA, MS, Chief Executive Officer. Members include hospital presidents, senior leadership, and trustees. With support from ODI, all are aligned with Mount Sinai’s commitment to become an anti-racist health care and learning institution. A systemwide entity, ODI consists of three units and a portfolio of special initiatives, which will be described in great detail in coming chapters:

MOMENTS OF CHANGE › CRISIS AND COMMITMENT

CHANGE ›

Brendan G. Carr, MD, MA, MS Chief Executive Officer

Professor

and Kenneth L. Davis, MD, Distinguished Chair

Mount

Sinai Health System

I joined Mount Sinai right before the COVID-19 pandemic started. We watched poor, marginalized, and Black and Brown people die disproportionately from COVID-19. George Floyd had just been murdered, and it felt like a moment for our hospitals and our society to engage in the difficult conversations about how structural and cultural racism impact the health and health outcomes of the communities that trust us to care for them.

This confluence of events brought into focus what we knew to be true: we had to lead by example. We had to create a safe place for hard conversations about race. And we needed to address the clinical realities that were within our control. We started an open and honest dialogue across our vast health system about the issues—and the solutions.

Mount Sinai leadership created programs to help educate our faculty and staff on the reality of structural racism, and we worked hard to create opportunities to have conversations about health disparities and our role in eliminating them. We read books together, invited key guest speakers (virtually, as it was 2020/2021), and held small group meetings where we could have complex discussions about our personal experiences and hear about those of our peers and our patients. The dialogues were not easy or comfortable, but they allowed for us to grow individually and to plan intentionally.

This work changed me. I’ve worked in urban academic emergency departments my entire professional career. I’ve cared for marginalized populations at the front door of the health system’s safety net. I’ve witnessed health disparities directly, and I have tried to do my part to advocate for equity. But I had too often avoided direct conversations about race and racism. I’m grateful that the health system’s leadership not only gave us permission to have conversations about race but reminded us that it was our job as leaders to have these conversations and to create a safe space for others to talk candidly about race and inequality in America.

I’m proud to be part of this extraordinarily brave institution. As CEO, I will do my part to ensure that Mount Sinai retains its leadership role in advancing diversity, equity, and inclusion in health care and beyond. This mission is connected to our core values, and I'm proud to do my part both in my professional role and in my personal example to create change that will impact the lives of our staff, our patients, and our communities.

Corporate Health System Affairs (CHSA)

Based at Mount Sinai’s Corporate Services Center, CHSA recommends and establishes best practices in diversity, equity, and inclusion management to engage the organization in cultural effectiveness, promote antiracist practices, eliminate disparities, and enhance the patient experience for all. The CHSA team manages, promotes, and partners with Health System leadership on dedicated programs in key DEI areas of focus.

The CHSA team partners with Health System leadership and staff at all levels to employ best practices and include broad perspectives in diversity management. Together, they have established initiatives and dedicated programs in these areas: disparities and data analytics; diversity councils and employee resource groups; education and training; lesbian, gay, bisexual, transgender, and gendernonbinary health; people with disabilities; recruitment, development, and advancement; and supplier diversity.

Patricia S. Levinson Center for Multicultural and Community Affairs (CMCA)

Based at Icahn Mount Sinai, CMCA supports students and faculty from backgrounds underserved in science and medicine to advance diversity at all levels within

the medical and graduate schools. CMCA staff direct innovative and coordinated approaches through educational pipeline programs, diversity affairs, school-wide diversity initiatives, and training and education programs focused on the intersection of medicine, science, and social justice through an urban health lens.

Center for Excellence in Youth Education (CEYE)

Based at Icahn Mount Sinai, CEYE operates a range of school-year and summer programs geared to youth belonging to groups that are underserved in science and medicine. CEYE staff develop and maintain exclusive partnerships with surrounding schools and departments to help more than 200 students each year, from grade seven through college, prepare for careers in science and health care.

The work of diversity, equity, and inclusion is never finished. The leadership of Mount Sinai—like those at all health care institutions—can see failures all around: for instance, a dearth of women and people of color in leadership roles. Nevertheless, Mount Sinai offers a model of consistent, impactful work, and this very report is an expression of that commitment.

Participants in the Center for Excellence in Youth Education at an event in 2023.

MOMENTS OF CHANGE › UNDERSTANDING

A lot of what I do, and my team does, is to further the understanding that when we talk about diversity, we're talking about all people—not just one group, one segment, we're talking about the dimensions of individuals and assuring that we're representing and caring for individuals based on their own personal identities.

When we think about inclusion, we're thinking about making sure that all people feel that they belong here, that they're recognized, that they are able to express themselves, and that they are valued in the organization.

And last, when we think about equity, it's really about being fair. So when we think about how we serve our communities, we note that doing the same thing for everyone is not necessarily going to get people what they need, in terms of health care or education. We have to recognize people who are differently situated in our societies, in our organization.

I use the word understanding a lot. We have to come together in a unified understanding of who we are and how we want to focus on diversity, equity, and inclusion at Mount Sinai.

Pamela Abner, MPA, CPXP

Senior Vice President and Health Equity Officer

Mount Sinai Health System

Chief Diversity Operations Officer

Mount

Sinai

Hospital Groups

Office for Diversity and Inclusion

Introduction MOMENTS OF CHANGE › THE LOOK OF SUCCESS

This work won’t be complete, the finish line won't be truly approachable, until we understand what success looks like for the most invisible among us in the Mount Sinai community. We will have approximated our aspirational 'North Star' when we can ask someone, 'Are we there yet?' And the reply is—even for the most invisible among us—'I think we are; something has happened. There has been noticeable change.'

A quote that many have used regarding the work of diversity, equity, and inclusion: 'Be the change that you wish to see in the world,' is so powerful and appropriate in this space. This phrase has long been attributed to Mahatma Gandhi and was embraced by the Rev. Dr. Martin Luther King Jr. Recalling that phrase now is a way to acknowledge those whose work is still relevant, and clearly important to sustain—now more than ever.

Gary C. Butts, MD

Executive Vice President, Diversity, Equity, and Inclusion

Chief Diversity and Inclusion Officer

Director, Office for Diversity and Inclusion

Dean for Diversity Programs, Policy, and Community Affairs

Icahn School of Medicine at Mount Sinai

ODI Organizational Structure: Three Units

Office for Diversity and Inclusion

Corporate Health System Affairs (CHSA)

Recommends and establishes best practices in diversity, equity, and inclusion management to engage the organization in cultural effectiveness, promote anti-racist practices, eliminate disparities, and enhance the patient experience for all. CHSA staff manage, promote, and partner with health system leadership on dedicated programs in key DEI areas of focus.

Patricia S. Levinson Center for Multicultural and Community Affairs (CMCA)

Supports students and faculty from backgrounds underserved in science and medicine to advance diversity at all levels within the medical and graduate schools. CMCA staff direct innovative and coordinated approaches through educational pipeline programs, diversity affairs, school-wide diversity initiatives, and training and education programs focused on the intersection of medicine, science, and social justice through an urban health lens.

Center for Excellence in Youth Education (CEYE)

Also based at the Icahn School of Medicine at Mount Sinai, CEYE operates a range of school-year and summer programs geared to youth belonging to groups that are underserved in medicine. CEYE staff develop and maintain exclusive partnerships with surrounding schools and departments to help more than 200 students each year from grade seven through college prepare for careers in science and health care.

The Diversity, Equity, and Inclusion Journey at Mount Sinai

This report unfurls, chapter by chapter, the long history of diversity, equity, and inclusion work at Mount Sinai. In “Legacy of Equity,” the Jews’ Hospital becomes The Mount Sinai Hospital, continuing to treat people of all faiths and developing a school of medicine. “Making Strides” features the programs that grew from a consciousness spawned by the demands of the civil rights and women’s rights movements and new laws to advance equality. An important milestone along this path was establishing the Center for Multicultural and Community Affairs in 1998. In “Expanding the Mission,” the Office for Diversity and Inclusion is established, and Continuum Health Partners merges with The Mount Sinai Medical Center, integrating its well-established diversity management programs into the fabric of the Mount Sinai Health System to include the hospital and corporate divisions.

Mount Sinai’s current Road Map for Action to Address Racism, a guiding document for organizational

change, was inspired by the national trauma of the George Floyd killing and is explored in “A Defining Moment.” Finally, a multitude of innovative programs with the goal of fashioning a very different, more diverse future are described in “The Way Forward.”

And positioned throughout the report are “Moments of Change,” first-person narratives from a range of Mount Sinai community members. Each was asked a simple question: When did you experience change in diversity, equity, and inclusion at Mount Sinai—or realize that a change was needed? Their answers and accounts of a wide array of initiatives and programs paint a vivid and personal portrait of the work of diversity, equity, and inclusion at Mount Sinai.

Mount Sinai’s efforts to become an equitable and antiracist organization are not stagnant; the learning is ongoing. What remains constant is the commitment to fostering a health care and learning environment that supports the well-being of every person who walks through the doors of the Mount Sinai Health System—a legacy of the past and a guiding principle for the future.

MOMENTS OF CHANGE › WE BECAME A FAMILY

Ana Rodriguez, LCSW Director of Community Affairs, Patient Relations, and Volunteer Services

Mount Sinai Queens

The Borough of Queens is one of the most diverse places in the world, and Mount Sinai Queens is a wonderful reflection of the communities that we serve.

In 2015, when the Mount Sinai Health System Office for Diversity and Inclusion proposed the idea of starting a diversity council and employee resource groups (ERGs) with us, our first thought was, 'But we are already diverse.' What we did not realize at the time was that in actively promoting diversity and inclusion, we were not only creating a more equitable environment but also enhancing creativity, innovation, and overall performance.

So, we established our diversity council and ERGs, and began educational programs, training sessions, cultural celebrations, mentorship programs, affinity groups, and inclusive leadership workshops. In 2019, we were established as one of the top 20 diversity councils nationally, in recognition of all that we accomplished.

What all of this also accomplished—we became a family here at Mount Sinai Queens.

Milestones at Mount Sinai Health System

• Mount Sinai School of Medicine

• The Adolescent Health Center Center for Excellence in Youth Education Women Faculty Group

Center for Multicultural and Community Affairs The East Harlem Health Outreach Partnership The Northeast Regional Alliance MedPrep Health Careers Opportunity Program

The Office for Diversity and Inclusion

Racism and Bias Initiative

Center for Transgender Medicine and Surgery

• Road Map for Action to Address Racism

• Center for AntiRacism in Practice

• Institute for Health Equity Research

• Task Force to Address Racism

for Asian Equity and Professional Development

• Diversity Innovation Hub

• Office of Gender Equity in Science and Medicine

for Equity and Justice in Health

Legacy of Equity

House Staff physicians at The Mount Sinai Hospital in 1925.

Mount Sinai was built on the principle of equity, established to provide care for those who faced discrimination— people who were turned away from other hospitals.

The men’s ward at The Mount Sinai Hospital in 1891.

The Mount Sinai Hospital in 1878.

With support from their communities, nine Jewish men founded the Jews’ Hospital in New York in 1852, providing free care for indigent Jews, most of them immigrants from Germany. It opened in 1855 with 45 beds on West 28th Street and initially admitted only people of the Jewish faith and accident victims.

Early on, two historical events—the Civil War and the New York City Draft Riots—greatly influenced the hospital’s decision to broaden the pool of patients it served.

The first major shift was in 1861, when the Board of Directors resolved to establish a ward for wounded Union soldiers. In retrospect, this could be seen as a perilous decision because although New York was a northern city, it was quite conservative. At the time, there was even talk of the state seceding from the Union because it was financially interwoven with slavery, and the wealth generated by generations of enslavement.

Then in 1863, the hospital took an even greater step on the path toward social change. For four chaotic days, white residents of the city took to the streets of Manhattan to protest a new federal law that drafted men to fight for the Union. The law included an exemption that enraged working-class whites: A person could hire a substitute to take their place or pay $300 (roughly $5,800 today) to the government.

Initially, angry white residents attacked military and government buildings. But by the second day, what became known as the Draft Riots was a full-fledged race riot, in which white demonstrators beat to death Black residents—who were exempt from the draft—because they were not citizens under the law. Rioters burned their homes and businesses, and lynched a number of Black men, hanging them from city lamp posts.

Much of the violence took place in the area around The Jews’ Hospital. The hospital steadfastly treated injured Black people, as part of its commitment to serving accident victims. This decision also came with risk, because protesters were attacking and burning the properties of white abolitionists and other Black empathizers. Across town, rioters besieged St. Luke’s Hospital for 48 hours, threatening to set the building on fire as it had received three injured policemen. Founder

Reverend William Muhlenberg met an injured rioter who had been brought to the front doors and was able to calm the protesters, who began to disperse.

In The First Hundred Years of The Mount Sinai Hospital of New York, 1852-1952, authors Joseph Hirsh and Beka Doherty write: “The geography of the rioting was such that Jews’ Hospital was frequently the center of its fury, and during the bloody days that ensued, it became the sanctuary of the sick and the wounded.” In the aftermath of the riot, thousands of Black people fled the city for safer communities. Meanwhile, the hospital remained, though changed by its act of compassion. In the months following the riots, archival records of the hospital’s Board of Directors meeting show there was preparation “for the nonsectarian policy which has distinguished the Hospital ever since,” according to The First Hundred Years

In 1864, with the Civil War ongoing, the Executive Committee reported, “The Committee deem it proper to observe that many of those admitted to the Hospital were not of our faith, no distinction ever being made as to either the nationality or the religious belief of the sufferer.”

By now, the hospital was also offering health care to the influx of impoverished immigrants from Europe landing in New York City. Twelve years after its founding, the Board of Directors formally opened the hospital to all, regardless of faith. Then in 1866, to reflect this new policy, the institution changed its name from Jews’ Hospital to The Mount Sinai Hospital.

The authors of The House of Noble Deeds : The Mount Sinai Hospital, 1852-2002 point out that in addition, “the Directors feared that, if they retained the limiting name of Jews’ Hospital, the Hospital would be considered ineligible for State support.”

MOMENTS OF CHANGE › PART OF OUR DNA

Diversity, equity, and inclusion have always been important to Mount Sinai. They are part of our DNA as a school and a health system. We have long been sensitive to how structural racism has been woven into the practice of medicine in this country. However, the George Floyd murder and its aftermath accelerated our commitment and our development of programs related to anti-racism and anti-bias.

At the same time, during the COVID-19 pandemic, it became clear that people of color, and people who were impoverished, were more vulnerable to being exposed to COVID-19 and to getting very sick or dying from the disease. At that point, we knew we had to do something, and we did take action. In just one very significant example, Icahn Mount Sinai formed the new Institute for Health Equity Research, which reflects our commitment to understanding why some groups experienced an increased vulnerability to many diseases, most recently COVID-19. The Institute, and a wide range of other clinical, research, and strategic initiatives at Mount Sinai, are aligned with the mission from our earliest days—to take care of the patients who need us most.

Dennis S. Charney, MD

Anne and Joel Ehrenkranz Dean Icahn School of Medicine at Mount Sinai President for Academic Affairs Mount Sinai Health System

The truth may be that compassion as well as history and economic concerns influenced the decision to provide medical service to everyone. Still, it is worth noting that when many hospitals continued the religious affiliations of their founders, The Jews’ Hospital broke with tradition and became nonsectarian, a hospital for all people.

To accommodate the Union soldiers, the hospital constructed additions to its buildings. By 1881, it was clear that more staff was needed to provide adequate health care, so the Mount Sinai Hospital Training School for Nurses was established. More patients arrived every year, so the hospital continually expanded to meet the needs of its increasing population. First constructing a building at 67th and Lexington with a 110-bed capacity, and then its present location in 1904, which consisted of 10 pavilions with 456 beds.

Meanwhile, as the field of medical science evolved, laboratories were being created by specialists highly skilled in medicine. Many of The Mount Sinai Hospital’s physician staff faced adversity in obtaining medical training because anti-semitism was pervasive in the United States. Most medical schools had quotas to limit

the number of Jewish students they accepted, and hospitals would not even consider hiring them. Many had to travel to Europe to receive education and specialty training. In order to attract the best house staff, Mount Sinai implemented anonymous exams in 1872, and the two highest scores were achieved by women.

In this climate, the culture of Mount Sinai ensured that hospital physicians and staff were simultaneously making clinical discoveries, publishing their work, hosting events that shared the latest discoveries from around the world, collaborating internationally, and rigorously training to offer the most up-to-date education.

After World War II, attitudes about Jews began to shift, as the world witnessed the horrors of the Holocaust and as more than a half-million Jewish men and women returned home from serving their country in World War II. (Yet, there is evidence that quotas remained at some medical schools at least until the 1960s.) Finally, the federal and several state governments passed nondiscrimination in higher

Young patients of Roosevelt Hospital, now Mount Sinai West, around 1900.

MOMENTS OF CHANGE › A BEDROCK PRINCIPLE

education legislation, and this, combined with a change in societal attitudes, meant new opportunities for Jewish physicians and students.

Academic medical centers that combined hospitals and university-affiliated medical schools on one campus became popular with young physicians because these university hospitals could also offer them academic titles. Mount Sinai had thrived in the era of clinical research, when data was collected at the bedside, analyzed in laboratories, and disease descriptions or treatment were read and taken back to the bedside. But medicine was evolving.

Instead of clinical research, the basic sciences of chemistry, molecular biology, and physiology assumed larger roles in exploring the underlying workings of disease. This elevated the importance of biomedical research based on scientific laboratories run by trained scientists and generally located on medical campuses. While it kept apace, ever expanding by opening new buildings dedicated to research, laboratories, and clinical care, Mount Sinai found that increasingly its population of physicians were looking elsewhere for training and better career opportunities.

Mount Sinai was built on the principle of equity. We were established to provide care for those who faced discrimination—Jews and other immigrants—people who were turned away from other hospitals.

That commitment to equity will always remain a bedrock principle of Mount Sinai. And it’s a continual effort, one that is very important to all of us, because we know discrimination still taints our society.

This is why we have invested great time and energy into our Road Map initiatives that promote diversity, equity, and inclusion at Mount Sinai, and why we are proud to be a leader in the fight for health equity in our country.

Kenneth L. Davis, MD Executive Vice Chairman Mount Sinai Health System Boards of Trustees

As the 1950s began, the hospital’s trustees and leaders began discussing how they might compete in this new world of education.

The national decline of anti-semitic policies and attitudes was a double-edged reality for Mount Sinai. It was to be celebrated because it meant more opportunities for Jewish physicians and students, but Mount Sinai lost members of its staff who had once viewed the hospital as their first, and perhaps only, choice for employment.

A century of history had altered the challenges The Mount Sinai Hospital faced. The composition of its house staff, as well as those who received health care, would become even more diverse. What would never change and remains at the core of the Mount Sinai Health System today is the legacy of being birthed from a desire to provide high-quality health care, in the face of anti-semitism, racism, and adversity.

1960s-2010s

Making Strides

1960s-2010s

Angela Diaz, MD, PhD, MPH, at the Mount Sinai Adolescent Health Center in 1984.

The decades of the 1960s and 1970s were years of protests and backlash, and The Mount Sinai Hospital, like other major institutions in the United States, felt the challenges of social change.

Making Strides

On the cusp of a new decade, in 1959, unions arrived at Mount Sinai, and a strike announced a change in the hospital-employee bond, from a patriarchal relationship in which some staff accepted meals and accommodations in lieu of salary to a relationship bound by new rules, regulations, and contracts.

In 1965, the federal government created Medicare and Medicaid to enhance the accessibility of health care for low-income and elderly Americans, bringing a more diverse group of patients but also changing the way hospitals, formally charitable institutions, were to do business.

In parts of the city, minority neighborhoods fought for community control over public schools that were in disrepair and health facilities that were inadequately funded. In April 1968, Martin Luther King, Jr., was assassinated, and while our hospitals held vigils, riots erupted in some urban areas, including in New York City. Nationally, there was widespread protest—including among Mount Sinai staff and students—against the country’s involvement in the Vietnam War, and women marched to demand equal rights. Richard Nixon, a candidate whose campaign for presidency was built around the fears and anxieties of white Americans, was swept into the White House, a sign that a silent majority was worried about the social changes they saw taking place.

Also in 1968, the Mount Sinai School of Medicine held its first classes, with 36 first-year medical students—32 men, and four women, all white. The Board of Trustees had begun laying the groundwork for this moment years

before. When it was chartered in 1963, the Mount Sinai School of Medicine became the first medical school to grow out of a non-university in more than 50 years.

In the late 1960s, the enrollment of Black students in U.S. medical schools was less than 3 percent, and one-third of these students attended three historically Black schools, according to the Association of American Medical Colleges. By the early 1970s, affirmative-action programs were introduced to increase the number of Black and other minority students at medical schools and to improve the medical care resources for these communities.

The Mount Sinai School of Medicine had a strong focus on public health from its earliest days, creating the Department of Community Medicine (now the Division of Community and Preventive Medicine). The Department embodied an important component of what was called the “Mount Sinai Concept,” interest in the health needs of the community at large and the value of seeing the patient as part of a larger context. School founders, particularly Dean George James, MD, former Commissioner of Health for New York City, envisioned the Department of Community Medicine as having equal status with the basic science and clinical faculties and as being the bridge among biological sciences, clinical care, and social sciences.

According to Teaching Tomorrow’s Medicine Today:

The Mount Sinai School of Medicine, 1963–2003, Kurt W. Deuschle, MD, the first Chair of the Department of Community Medicine, “believed that effective social change comes through the actions of those who have the most direct stake in the change. Rather than impose its ideas on the community, the Department has worked to empower community leaders by facilitating their actions to change the social conditions that cause illness.”

Dr. Deuschle, who had experience working with the Navajo Nation and poor people in the Appalachia region of Kentucky, laid a foundational philosophy along with his colleagues that is still a core value at Mount Sinai Health System. In an attempt to take health care to underserved communities and to recruit minority youth to medical

Kurt W. Deuschle, MD, the first Chair of the Department of Community Medicine.

MOMENTS OF CHANGE › EARLY DAYS

The first time I appreciated a need for change as it relates to diversity, equity, and inclusion was many decades ago, when I was an intern in Pediatrics at The Mount Sinai Hospital. As I looked around over the first few days, I realized that I was the only person of color in my internship group in Pediatrics. As I explored further, I was only one of two residents of color in the entire program. That was my introduction to some of the realities of our training program and what we were up against, in addition to continuing to deliver outstanding care for our diverse communities. The good news is that I eventually was positioned to be able to help address that significant issue, among others, over the course of time.

What attracted me to Mount Sinai, by the way, was a very direct message from the department chair at the time, Kurt Hirschhorn, MD. As we were completing my interviews for Pediatrics, he looked across the table and said, “You come here, you work hard, and I guarantee you that things will work out.” That is precisely what happened, and many years later, when I bumped into him in a hallway, Dr. Hirschhorn let me appreciate that I was part of his diversity plan for the Department of Pediatrics, way back then.

I imagine that he has been one of several key mentors and sponsors who, behind the scenes, have helped to pave a pathway to success for me and the work I've been privileged to do for the past decades at Mount Sinai.

Gary C. Butts, MD

Executive Vice President for Diversity, Equity, and Inclusion

Chief Diversity and Inclusion Officer Director, Office for Diversity and Inclusion Mount Sinai Health System

Kurt Hirschhorn, MD

Gary C. Butts, MD, with longtime staff member Carmen Duran-Santos.

Making Strides

professions, the Department of Community Medicine developed various programs, some of which have evolved, yet remain in place today.

The Health Careers Program was developed in 1968 by The Mount Sinai Hospital School of Nursing and the medical school to create interest and training in health careers. Participants were instructed in simple techniques associated with patient care. Boys and girls served in positions such as nurses' aides and inhalation therapy aides. The newly formed Adolescent Clinic, which began in 1968, provided medical supervision. In 1974, the Adolescent Health Center opened at 19 E. 101st Street, housing all adolescent services in one building; it was then the largest comprehensive care facility for adolescents in the country.

The Student Health Opportunity Program (SHOP) was established in 1970 with the goal of helping high school students remain in school and consider pursuing careers in health care. (The Health Careers Program and SHOP were later combined to form the Secondary Education Through Health Program, which later became Mount Sinai’s Center for Excellence in Youth Education in 1975.)

Graduates of the Mount Sinai School of Medicine remember the emphasis faculty put on doing community work and the way it enhanced their education.

“The principle was clearly there: that we live in a community, that we serve the community, and that we need to understand how our background impacts on interactions with patients and how important it is for our institution to serve the community we work in,” says Scott Friedman, MD, Class of 1979, who went on to become Dean for Therapeutic Discovery and Chief of the Division of Liver Diseases at Icahn Mount Sinai.

Students participated in a range of volunteer activities over the years, generally in East Harlem, including counseling at a rape crisis intervention program and starting an AIDS education program for young girls aged 13 to 17. This concern for the community in which patients live and the accessibility of health care would remain one of the pillars of the School, even as the community and the house staff became more diverse. The School, which would change its name to the Icahn School of Medicine at Mount Sinai in 2012, implemented major initiatives focused on educating groups underserved in medicine and underserved in health care.

Some of these initiatives continue today as integral components of the Office for Diversity and Inclusion (ODI); others are separate efforts that exemplify Mount Sinai’s legacy of compassion and equity:

Patricia S. Levinson Center for Multicultural and Community Affairs (CMCA)

This Center is one of the three units of ODI, along with Corporate Health System Affairs and the Center for Excellence in Youth Education. The CMCA was established by the Department of Medical Education in 1998 and serves as the interface for STEM educational pathway programs, student diversity affairs and support services, career development support of faculty from underrepresented backgrounds in medicine and science and institution-wide diversity initiatives.

The CMCA’s mission is to improve community health outcomes and reduce race and ethnic health disparities by increasing health care workforce diversity, encouraging scientific inquiry, and informing health policy. The CMCA focuses on enhancing the academic success, retention, and personal development of students from backgrounds underrepresented in medicine and science, including students who identify as first-generation college graduates and those who are members of the LGBTQ+ community. The CMCA expanded its work during the early 2000s to address underrepresented faculty and house staff.

The CMCA—named after Patricia S. Levinson, a longstanding Trustee and devoted supporter—recruits, develops, and implements programs, activities, and procedures to advance diversity in all levels at Icahn Mount Sinai. Through multifaceted partnerships with local community organizations, CMCA offers a multitude of services, including faculty advising for more than 15 student groups as well as affinity groups; access to faculty mentors for research and career advice and coaching; and mentoring for individuals interested in applying to the School’s MD, PhD, and other academic programs.

CMCA is deeply involved in building the capacity of medical students to appropriately engage and work with New York City’s diverse patient population through its contributions to the Icahn Mount Sinai medical education curriculum. Curriculum-oriented endeavors include the

development and support of Nexus Learning™ elective courses on topics including racism and medicine, nutrition and medicine, the built environment and community health, and LGBTQ+ health, in addition to language proficiency and bilingual certification courses in Medical Spanish and Medical Mandarin. Most important, CMCA is a key partner with the Department of Medical Education’s Racism and Bias Initiative and Office of Curricular Affairs, working together to design curriculum content on topics related to racism and bias in the learning and clinical environment across all four years of medical school.

CMCA also plays a critical role in diversifying the health professions workforce through its own longstanding signature programs, which begin at the college level with pre-med students through to the transition to residency,

as well as in related health professions, such as social work.

The Center for Excellence in Youth Education (CEYE)

The Center for Excellence in Youth Education is one of the three major units of ODI. The center is a consolidation of efforts that began as early as 1968 to help students from grade seven through college prepare for careers in science and health care. The continuing objective has been to provide a range of school-year and summer programs geared to youth belonging to groups that are underserved in medicine and science, through academic enrichment, handson career exploration experience, tutoring, and

Mount Sinai’s Center for Multicultural and Community Affairs is named for Patricia S. Levinson, a Trustee and longstanding supporter. Ms. Levinson, left, at a meeting in 1975 with Helen Rehr, PhD, Director of the Department of Social Work.

Making Strides

counseling—with the goal of bolstering their access to post-secondary education and increasing their motivation to seek careers in medicine, nursing, or allied health.

The Center’s educational philosophy was developed by Lloyd Sherman, EdD, an educational innovator who was a secondary school science teacher in Kenya before coming to Mount Sinai. In Kenya, he determined that people learn best when education is relevant, functional, and carried out in a class arranged in pairs of two, assigned at random. This conviction has shaped all of

the CEYE programming, and continues today. Dr. Sherman served as the director of this program from 1974 until his death in 2012.

Since its inception, CEYE has made a difference in the lives of thousands of students from New York City schools through a wide range of education programming that opens doors for students who are from economically disadvantaged or racially/ ethnically underserved backgrounds. All CEYE programming relies on the real-world classroom of the Mount Sinai Health System, with a range of activities and interactions with faculty and staff.

Each year, nearly 100 members of the faculty, staff, and postgraduate trainees serve as clinical and research mentors to CEYE students. Working with health professionals in laboratories and clinics and on hospital floors gives these students firsthand career awareness. Long-standing mentors and supporters represent more than 25 research areas and departments, including Ambulatory Care, Cardiology, Vascular Surgery, Pediatrics, and Structural and Chemical Biology.

Both CMCA and CEYE have a robust portfolio of pathway programs for students in middle school through medical school. More details are in “The Way Forward” chapter of this report.

Students of the Center for Excellence in Youth Education at The Mount Sinai Hospital in 2001.

Lloyd Sherman, EdD, with a CEYE student in 1989.

Rising to the Challenge

During this challenging period, separate initiatives rose up to fill the needs of patients, students, and staff. Each with a distinct mission, but all grounded in equity and compassion.

Mount Sinai Adolescent Health Center (MSAHC)

The Mount Sinai Adolescent Health Center’s founder, Joan Morgenthau, MD, a Mount Sinai pediatrician, recognized that adolescents needed the privacy and comfort of their own health care space, outside the intimidating façade of a hospital. Today, Dr. Morgenthau’s vision has grown into a space where teenagers find all their health care services under one roof—with all services provided at no cost—and no young person is ever turned away.

The MSAHC model of care for young people has evolved over more than 50 years of experience and innovation.

“We’ve seen first-hand how adolescence presents a spectrum of distinct and consequential health issues, and why adolescent care needs specialized services—and a wholly different approach to young people themselves,” says Angela Diaz, MD, PhD, MPH, who was the longest serving Director of the Mount Sinai Adolescent Health Center, from 1989 to 2024. “The health care system in the United States was created by adults for adults, and then we try to fit young people into that system. When it does not work, we call them noncompliant and hard to reach, when

MOMENTS

OF

MOMENTS OF CHANGE › SERVING YOUTH

Angela Diaz, MD, PhD, MPH

Dean of Global Health, Social Justice, and Human Rights, Jean C. and James W. Crystal Professor in Adolescent Health, and Professor of Pediatrics, Environmental Medicine, and Public Health

When I first came to Mount Sinai, there was not a lot of diversity among faculty and trainees. In fact, I was the only nonwhite physician in my cohort of pediatric residents. While I had a great experience, I saw the need to diversify the workforce and help people of color enter health care and access support as they advanced. Research has shown that diverse teams are more creative, more productive, and have better outcomes. In addition, it is a matter of justice, humanity, and inclusivity. Everyone should have a seat at the table. Everyone should have the opportunity to grow into their true selves. Today, the Mount Sinai Health System is doing a great job with diversity, equity, and inclusion at all levels.

It was a gift to me to work at the Mount Sinai Adolescent Health Center, where the work was about diversity, equity, inclusion, and belonging— long before these terms became commonly used—and where many of the patients are youth of color, low-income, LGBTQ+, or have other marginalized, intersecting identities. It was very important for us to have a diverse staff at all levels of the organization.

Making Strides

what is actually hard to reach are the services, the way they are designed.” Dr. Diaz was succeeded as Director in fall 2024 by Sarah M. Wood, MD, MS, a national leader in research and clinical care in adolescent medicine.

When the Center opened—its initial humble home in the basement of a Mount Sinai Hospital building and soon after in two trailers in East Harlem—it was one of the first in the United States devoted to the special health care needs of teenagers. Dr. Morgenthau eventually passed the reins of directorship to Leslie Jaffe, MD, who continued to expand services to meet the changing needs of adolescents and young adults. The Center initially operated on a sliding fee scale, but early in her time as director, Dr. Diaz shifted the program’s model to ensure no young person ever had to pay for their care. Today, with a staff of more than 100 and a patient roster of 38,000 youth ages 10 to 26, it is one of the largest centers of its kind in the country. Ninety-eight percent of MSAHC’s clients are from low-income families, and 70 percent have no insurance; 44 percent are Hispanic, 32 percent Black, 14 percent mixed race (mostly Hispanic and Black), 4 percent Asian, and 6 percent non-Hispanic white.

The team of specialized professionals is devoted to providing young people with every kind of health and wellness care: Primary, sexual, and reproductive health,

behavioral and mental health, health education, nutrition and fitness, dental, optical, and even legal. Core components are complemented with specialized services for LGBTQ+ and transgender adolescents, parenting teens, young people who have experienced trauma including childhood sexual abuse and human trafficking, and youth living with HIV.

The MSAHC runs six school-based health centers, serving 23 middle and high schools in Manhattan. Its leaders believe that teens must have accurate information about health issues to help them make good decisions about every aspect of their lives. By building relationships, the Center

A patient at the Adolescent Health Center, right, with her mother and siblings.

Joan Morgenthau, MD, founder of the Adolescent Health Center, in 1971.

makes each young person feel safe enough to open up about things as sensitive as their sexuality and innermost feelings or as complex as sexual victimization, including rape and human trafficking.

Another crucial part of the mission of MSAHC is training the next generation of adolescent specialists. The Center offers highly sought-after post-residency fellowships in adolescent medicine, as well as training for psychologists, social workers, and other health professionals, and it conducts clinical research in areas that are vital to the health and welfare of young people.

Clinical practitioners and health policy leaders from around the world have asked the MSAHC to assist in designing programs that provide vulnerable young people with vital health and wellness services. Additionally, the New York State Health Foundation has created a blueprint of the Mount Sinai Adolescent Health Center as a model for the state and the nation. The blueprint includes guidelines to help providers implement key parts of the model or phase it in over time, tailoring the model to their needs and capabilities.

“We see every young person as full of promise rather than full of risk,” Dr. Diaz says. “There are no judgments, no stigmas at our Center. The truth of the matter is that we love the young people. If you ask a young person why they come to the Mount Sinai Adolescent Health Center, they

respond because they feel welcome, respected, connected, safe, and not judged. Each young person is treated with compassion and respect. And then, within that context, we provide them with everything they need to be healthy. We remove all the barriers, and we let them take the lead. And even with our long history, we continue to learn from young people each and every day.”

East Harlem Health Outreach Partnership (EHHOP)

The East Harlem Health Outreach Partnership is a community health service that arose from the concerns and compassion of Mount Sinai’s medical students. It is a student-run, physician-supervised free clinic that provides primary care to uninsured adults in East Harlem. Founded in 2004, the mission of EHHOP is to create a health outreach partnership with the East Harlem community, and provide quality health care, regardless of ability to pay.

Icahn Mount Sinai students carry out all aspects of the operation and administration of the clinic. A steering committee of elected medical students who serve one-year terms runs the day-to-day operations. Under the guidance of EHHOP's medical director and program director, the steering committee continually revises and improves clinic policies and protocols.

Yasmin S. Meah, MD, Director of the East Harlem Health Outreach Partnership, with Colby Parsons, a medical student volunteer.

Making Strides

Staff members of the Peter Krueger Clinic in 2023.

To care comprehensively for patients, EHHOP serves as a bridge to medical and social support resources that it cannot provide. It offers confidential, compassionate care in a safe, respectful environment. EHHOP’s aim is to establish a positive approach to medicine by creating shared goals with patients and by empowering patients to participate actively in their physical and emotional well-being to enhance the effectiveness of services.

The medical students who participate in EHHOP commit themselves to serving patients' health care needs, and, in so doing, also commit to expanding their own knowledge, skills, and ideals. Part of EHHOP’s mission statement says: “We strive to rededicate ourselves continually to our roles as future physicians, strengthening our respect for medicine as students, so that we may maintain our commitment throughout our careers.”

EHHOP has grown substantially since its founding, today serving more than 250 patients annually in more than 1,000 clinic visits across four medical specialties. The Partnership’s clinic space and much of its equipment come from a donation by Mount Sinai's Internal Medicine Associates.

Peter Krueger Clinic

In the early 1980s at the height of the HIV/AIDS epidemic, Beth Israel Medical Center (later Mount Sinai Beth Israel) was one of the first hospitals to identify the symptoms of, and provide specialized care for, patients affected by HIV. Beth

Israel also had a strong clinical trials program for testing HIV treatments and medications. The HIV program started as part of the Adult Medical Services Clinic and in the mid-1980s, it became a separate clinic with HIV care and services for adult and adolescent patients.

With the passing of their son, Peter, due to complications of HIV/AIDS, Harvey and Constance Krueger wanted to honor him by providing support for others affected with HIV/AIDS. In 1989, Beth Israel established the Peter Krueger Clinic through the family’s philanthropy. Since its inception, the Peter Krueger Clinic has been, and will continue to be, a critical component of Mount Sinai's commitment to patient-centered care, training for HIV specialists and infectious disease fellows, and a clinical trial site that has contributed to the development of lifesaving HIV therapies.

The clinic provides compassionate care for patients in need of primary care and infectious disease treatment and management. Since its establishment in 1989, the clinic has been a leader in treating patients affected by HIV with comprehensive programs that include physical, mental, and social care, and clinical trials of advanced treatments. It continues to exist as a crucial part of Mount Sinai's Institute for Advanced Medicine (IAM), led by Michael P. Mullen, MD, who has been a leader in the fight against HIV/AIDS since the 1980s. The Institute reaches out to groups who are underserved or have specialized needs, and provides outstanding, compassionate care—no

MOMENTS OF CHANGE › HOPE AND MOTIVATION

Alessa Ramos Vargas, MBS

Language

Coordinator

Mount Sinai South Nassau

As someone born with paraplegia, it was daunting to join the staff of a hospital—a demanding and high acuity environment. Growing up, I had worries that my wheelchair could be perceived as burdensome or that others would underestimate my capabilities and skills. But as I look back on my time at Mount Sinai South Nassau, I remember a collection of moments that taught me a lot about myself and instilled hope and motivation in me to expand my knowledge in the health care field.

In particular, I recall the COVID-19 pandemic, not only as a period of uncertainty but also as a unique opportunity to work together with my colleagues to navigate unprecedented obstacles and care for those in need. For instance, I was instrumental in providing interpretation for community vaccination sites and integrating translation services into telehealth technology.

I am grateful to be part of an environment that continuously teaches me not to allow my wheelchair to become a barrier to my aspirations. These moments encourage me to raise awareness and share my experience with others so that individuals with disabilities can feel empowered to pursue their interests. It is a gift to provide care for others—the way many cared for me as a young girl.

matter one’s background, ethnicity, or sexual orientation. Some of the groups served include the HIV/AIDS community, the LGBTQ+ community, victims of domestic violence, recently incarcerated men and women who are transitioning to life on their own, and those who cannot afford medical care.

As part of Icahn Mount Sinai, IAM also participates in groundbreaking research across a wide variety of fields, opening the way to revolutionary treatments and drugs. As a result, patients have the opportunity to participate in clinical trials—innovative treatments not available elsewhere.

People With Disabilities

The Americans With Disabilities Act (ADA), passed in 1990, heightened awareness of the challenges faced by many Americans at work, at the office, and in their daily lives. Specifically, it prohibits discrimination against people with disabilities “in such critical areas as employment, housing, public accommodations, education, transportation, communication, recreation,

institutionalization, health services, voting, and access to public services.”

In line with the letter, and the spirit of the law, ODI is dedicated to promoting health equity and cultivating inclusive, accessible environments for people with disabilities. Recognizing that disabilities significantly influence individuals' health care experiences, ODI’s key initiatives include developing cultural awareness and education, enhancing engagement and inclusivity, collecting demographic data, and improving the overall patient experience for people with disabilities. Through these efforts, the Health System has made significant progress in raising awareness and understanding of disability-related issues.

Additionally, the Health System’s ADA Steering Committee continually examines systemwide policies, procedures, education, training, and overall ADA compliance. This includes issues such as physical barriers, accessible medical equipment, assistive technology, safe patient handling, and website accessibility. Through this initiative,

Making Strides

Mount Sinai is taking proactive steps to remediate deficiencies across all facilities, ensuring adherence and compliance with ADA standards.

Cultural awareness and education have been instrumental in the development of inclusive environments for people with disabilities. By leveraging Mount Sinai’s learning management system for in-house training, known as PEAK, and tailored departmental sessions, the Health System creates opportunities for faculty, staff, and students to build a solid understanding of inclusive language, accessible technology, and respectful conduct when engaging with colleagues and patients with disabilities.

To aid in bridging the gap and addressing disparities affecting people with disabilities, the Mount Sinai Health System implemented the mandatory Access for All, People With Disabilities core education for employees. By the end of 2023, approximately 30,000 employees, faculty, and staff had completed the core education. In addition, ODI provides sessions focusing on people with disabilities and best practices to faculty, staff, and

students upon request. The ADAPT (All Differing Abilities Partnering Together) and Caregiver employee resource groups (ERGs) serve as forums to engage staff and generate interest in addressing health equity for people with disabilities. Over the years, these groups have helped develop new connections with departments across the system to serve as resources for the community. Through these employee resource groups, ODI gains valuable insights into the needs of staff and provides materials to implement practical strategies aimed at enhancing the culture and experience for employees, patients, and visitors within the Health System.

In collaboration with the Office for Diversity and Inclusion, the ADAPT ERG organizes in-person events and webinars during Disability Awareness Month in October. The goal is to provide educational opportunities and foster community among employees, faculty, staff, and patients living with disabilities.

ODI has also forged partnerships with external organizations, including the Mayor’s Office for People With Disabilities, the Metropolitan Transit Authority, and the

MOMENTS OF CHANGE › RAISING AWARENESS

MOMENTS

Tiffany Keith, MSW Program Manager II Office for Diversity and Inclusion

Diversity, equity, and inclusion hold both professional and personal significance for me, and I'm grateful to be part of an organization like Mount Sinai that does the necessary work to achieve health equity in New York City—a city known for its 'tale of two cities' and the haves and the have-nots.

I've had the honor of coordinating events that raise awareness and understanding of the lives of people with disabilities, such as “A Conversation with Quemuel Arroyo, Chief Accessibility Officer of the Metropolitan Transit Authority.” Through my ongoing engagement with the Mayor's Office for People With Disabilities, I have witnessed how our leadership and staff are dedicated to understanding and addressing barriers, not only within our Health System, but throughout New York City.

During a recent doctor’s appointment, I was so honored to be a part of the Office for Diversity and Inclusion team, not only because our patients receive dignified and respectful treatment, but also because there was a dedication to embracing all differences and diverse needs. Being an employee of Mount Sinai fills me with pride, especially when I witness our commitment to action.

MOMENTS OF CHANGE › UNDER HER WING

Michelle Sainté Willis Senior Associate Dean for Medical Education Administration

National Multiple Sclerosis Society. These collaborations have enabled Mount Sinai to host fairs, expand educational opportunities, and offer additional resources to staff and students and to the New York City community.

At Icahn Mount Sinai, Disability Services has the goal of providing a physically and educationally accessible environment so that each student is viewed on the basis of ability, not disability. Staff members work with all students in the School of Medicine and the Graduate School to ensure equal access by coordinating reasonable accommodations through a variety of support services. Individually designed accommodation plans and services are determined based on the documented needs of each student, in conjunction with their program requirements, and are created to match the specific disability-related need of each student.

Student Disability Services has evolved as the numbers of students served has grown significantly. As of 2024, the Office served more than 200 students registered in

When I began my leadership role in Medical Education in 1994, Minnie Woodson and I were the only Black women at this level in the School. Minnie was a tour de force, from a generation of Black folk who weathered the storm of Jim Crow, misogyny, and racism in every sector. She had reached the pinnacle in her career, and as a Department Administrator had surpassed even what she thought would be available to her. I was lucky and blessed that she took me under her wing and offered me shelter and what I know now to be inclusion. She knew that in order for me to thrive, I would need to feel as if I belonged; and she made that her mission. I learned from her, and others, and I vowed to them all that I would continue to drive this message of inclusion, an oft-lost next step in this work. I have been fortunate enough to be a partner, thought leader, and contributor to the vast body of work related to diversifying the workforce and student body and the opportunity to work toward creating an environment for all to thrive at Icahn Mount Sinai.

Icahn Mount Sinai’s medical and graduate programs. The Office is staffed by a director and a half-time staff member, who collaborate on projects with offices throughout the School and Health System. These include ongoing training for faculty and staff, coordination with Vocational Rehabilitation in New York City to provide services for students, and collaborative work with Information Technology to improve accessibility in electronic medical records and other systems.

Mount Sinai’s core values include creating a diverse and inclusive environment, free from bias, racism, and favoritism, and fostering optimal care and just opportunities based on individual needs and abilities. To uphold and reinforce these values, ODI has established tools for patients, faculty, and staff to self-identify if they are living with a disability. Patients can self-identify through the MyMountSinai application, while employees can do so through the internal portal, Sinai Cloud. By gathering this data, the system aims to generate data-driven insights to enhance the overall experiences of both patients and employees.

MOMENTS OF CHANGE › WOMEN MOVING UP

Sandra K. Masur, PhD, FASCB Professor of Ophthalmology, and Pharmacological Sciences

Founding Director, Office

for

Women’s Careers Chair, Committee on Special Awards

In the early 1970s, when I was a new junior faculty member at the new Mount Sinai School of Medicine, I knew only one woman in a leadership position, Dorothy Krieger, MD. She was Chief of the Division of Endocrinology in the Department of Medicine and an extraordinary physician-scientist.

Over the years, I became part of a group of women who saw that women who were entering the fields of science and medicine in large numbers—women who were incredibly effective, really smart, superbly trained, and creative—were not moving up into leadership. They weren't even moving up the academic ladder.

So we started gathering together and teaching one another the rules of the road that were hidden from us. We taught one another how to write grants, how to prepare your papers for promotion, and other things like that. As this developed into a formal group, the Women’s Faculty Group, we saw that we were moving up. At the same time, the deans of the Medical School—Nathan Kase, and then Arthur Rubenstein, MD, Kenneth L. Davis, and finally Dennis S. Charney—all supported recruiting women into leadership positions.

Fast-forward to 2024, and I’m now surrounded by a group of more than 40 women who are chairs, institute directors, and deans, forming the Women’s Leadership Group at Icahn Mount Sinai. How did this happen in the intervening 50 years? Self-advocacy and collaboration of women physicians and scientists, support by the deans, and the availability of a pool of outstanding women who travelled from very different beginnings and very different pathways to leadership.

When I received the inaugural Women's Empowerment Influencer Award from the Women’s Leadership Group in November 2023, I was speechless, and I cried. I had been previously recognized for my work for equity and advancement of women in science by the naming of the Senior Leadership Award of the Women in Cell Biology of the American Society for Cell Biology, as the Sandra K. Masur Leadership Award. But to be recognized by Mount Sinai’s extraordinary women, many of whom I have mentored and all of whom I respect, was truly overwhelming.

Women Faculty Group

In 1973, a report titled “The Status of Women at the Mount Sinai School of Medicine of the City University of New York” was issued that examined gender-based discrimination in assignment of faculty rank in 1968 and 1972, when the Medical School was part of the City University of New York. This report was created in response to several federal regulations and laws, mainly the Civil Rights Act and the Equal Pay Act, which had recently been put into place, making it illegal to discriminate based on race, color, religion, sex, or national origin in employment. The findings paint a stark picture.

When the School opened in 1968, there were 28 departments, and 11 of them employed no women faculty. Of the initial 732 full-time faculty members, 88 were women. Of those women, only three were full professors, while 55 men held that rank. Five years later, the trend continued as 108 men and just five women were full professors. An evaluation of the assignment of faculty rank and promotions from 1968 to 1972 showed evidence of discrimination on the basis of sex, the report found. While further study is required to account for the following decades, 20 years later, women faculty themselves formally banded together to face the underlying issues remaining to be rectified.

The year 1993 was a pivotal moment—for the first time, more women than men graduated from the Mount Sinai School of Medicine. While this moment was heralded as a beacon for greater equity in the future of science and medicine, the reality was not so rosy for women who had already dedicated decades to advancing medicine. Twentyfive years after faculty taught the first medical school classes at Mount Sinai, women were still isolated by the old boys' club reality of academia. It seemed that there were unwritten rules of career advancement in men’s favor, and these needed to be learned and then changed. And women faculty members, who experienced the disparity the most, knew that the promise of a brighter future would not change their present condition. They turned to each other, knowing that their common struggle would only change through solidarity, support, and advocacy.

At that time, Angela Diaz, MD, was contributing her expertise in articulating program missions to a Psychiatry program grant application when she learned that several women faculty members were meeting in group therapy. She thought of reaching out to other women on the faculty to gauge their interest in a larger gathering. In May 1993, Drs. Angela Diaz, Diane Meier, and Stephanie Seremetis circulated a memo that stated, “Your response to our recent survey suggests that many of us are interested in forming a group to address a diverse range of issues affecting women faculty at Mount Sinai.”

A gathering in 1997 of an informal group called the “Power Infrastructure.” Front row, from left: Terry Ann Krulwich, PhD, Wendy Goldstein, MPH, Nathan Kase, MD, Jasmin Moshirpur, MD, and Barbara Barasch. Middle row: Lorraine Egan, JD, Karen Zier, PhD, Beth Essig, JD, Diane Meier, MD, Sloane Elman, JD, and Sandra K. Masur, PhD. Back row: Jane Tsambis, MBA, Marie Gibson, PhD, Ruth Abramson, MD, and Stephanie Seremetis, MD.

Making Strides

During the first meeting, the purpose was stated: “To introduce ourselves and the concerns that led to the formation of this group; to establish priorities and a structure that will permit us to get work done and meet the varying needs of the group; and to review specific options for both promoting professional development (gender-leadership issues) and improving our support network within this institution.” The circulated survey received a 25 percent response rate from the 360 fulltime female faculty; their stated priorities:

Mutual support - 65 percent

Networking - 69 percent

Referral pattern advancement - 26 percent

Professional development - 72 percent

Career advancement - 60 percent

Administrative skills - 13 percent

Other issues were raised by respondents, including family and work, and pay equity issues.

A memo sent soon after the first meeting said it “was a standing-room-only success, with participation from nearly all clinical and basic science departments, and a broad range of experiences and concerns expressed. They decided to break down into groups addressing both professional advancement and support network issues. Among the problems and concerns identified were pay equity, promotion, professional isolation, breaking into the ‘old boys network’, balancing family and work, different professional timelines for women and men, ambivalence about power, and others. It is obvious that there was a great deal to discuss and much work to be done.”

The participants drafted bylaws, stating the mission of Mount Sinai School of Medicine Women Faculty Group (WFG) was to “address issues of concern, including pay equity, discrimination, participation by women on decisionmaking bodies at Mount Sinai, limitations on career advancement, parenting and schedule flexibility issues, and the underlying sexism that informs these issues. To fulfill its mission, the Women Faculty Group aimed to provide a platform in which appropriate action may be taken to promote positions endorsed by the membership and will provide a forum for mutual support, networking, education, and discussion.”

The initial memo authors became the steering committee, and members of the group paid dues to fund their planned work, with additional funds from the office of Nathan Kase, MD, Dean of the School of Medicine. The first few

meetings were dedicated to brainstorming a model of job restructuring that would facilitate the promotion of women faculty members to top positions and “other organizational changes that would recognize and support the dual career/ family interests and responsibilities of women and men faculty members.” They arranged lectures by colleagues, such as Jo Ivey Boufford, former President of the New York City Health and Hospitals Corporation. They also began volunteering to treat medical students in their offices at no charge. Several school leaders expressed their support for their undertaking, and Dean Kase approved WFG members working in the Student Health service in lieu of the 10-hour attending service requirements.

In 1994, the first election resulted in Diane Meier, MD, as President and Terry Ann Krulwich, PhD, as Vice President. In short order, they organized several half-day workshops on the themes based on member feedback, first “Negotiation Strategies and Skills,” then “Issues in Academic Advancement for Women.” They were not alone in their concerns.

Susan Kaiser, MD, PhD, FACS, was the second President, and developed events about coordinating child and elder care with professional needs, laboratory management, scheduling flexibility, and issues of sexism in the workplace. Sandra K. Masur, PhD, then served as President from 1998-2004. Of their work during that time, she recalled, “Every month, the room was half-filled with men, because at that point, women were the only ones doing this kind of mentoring. It turns out, when you help women achieve their professional goals, you’re helping the men as well. I went to Dean Kenneth L. Davis, MD, to talk about the problem. His response was to congratulate me and make me Dean for Faculty Development.”

And so, the Women Faculty Group’s work became an officially sanctioned institutional function 10 years after it began, proving that its collective action to publicly acknowledge and address gender disparities led to meaningful progress toward gender equity. While the women faculty who came together in 1993 did not have their concerns adequately addressed in the beginnings of their careers, they worked to make the work environment more equitable for all. In 2008, the Office for Women’s Careers was established by Dean Dennis S. Charney, MD, with Dr. Masur as its director. It carries forward the principles and goals of the pioneering Women Faculty Group and is a branch of the Office of Gender Equity in Science and Medicine.

MOMENTS OF CHANGE › TRANSFORMING TECH

Patti Cuartas DMSc, PA-C, MBA, PMP, FACHE, ACHIP

Executive Director and Associate Chief Medical Information Officer

Working in the technology department at Mount Sinai, a highly diverse organization, I had always considered ourselves open-minded and fair. However, a particular incident during a team meeting several years ago opened my eyes to the need for change in diversity, equity, and inclusion practices.

During that meeting, a colleague who was in the gender minority (female) at the department and from a different cultural background than most at the meeting, suggested an innovative approach to a project. Despite her well-thought-out ideas, I noticed that some team members seemed dismissive and uninterested. I also observed that this colleague struggled to be heard in the conversation, even though her ideas were valuable.

Recognizing the need for change, a few of us decided to take action. We initiated conversations and created a platform with different teams about the importance of diverse viewpoints and equal participation. We worked with some of our leadership to organize groups that were more inclusive and that helped to augment and magnify the ideas of women in particular who felt marginalized in the department and raised awareness to promote respectful communication.

Over time, our efforts led to a significant transformation within the department. Our women colleagues’ ideas gained traction, and the confidence in sharing them grew. The team started to appreciate the richness of diverse perspectives, and inclusivity became a core value in our interactions.

MOMENTS OF CHANGE › A NEW DAY

›

When you walk in the building here, every day is a new day. Because someone is having a baby—it's tears of joy. Someone could be losing a loved one—so it could be tears of sadness and sorrow. But a patient care associate comes in, a housekeeper comes in, a nurse comes in, and a doctor. And they include the family and give the patients hope, every day. Every day a lot of inclusion is going on at Mount Sinai.

Supreme Prescott Environmental Services

Mount Sinai West

Expanding the Mission

Nurse practitioner Miles Harris with a patient at the Center for Transgender Medicine and Surgery.

In 2013, Mount Sinai merged with Continuum Health Partners. In the newly formed Health System, diversity efforts were enriched and extended.

A cultural event sponsored by the Diversity Council at Mount Sinai Queens.

Allen Andrade, MD, is a member of the Faculty Diversity Council, advancing DEI efforts in the Department of Geriatrics and Palliative Medicine.

Expanding the Mission

After the Civil Rights movement of the 1960s, racism was not as acceptable publicly as it had been at the beginning of the 20th century. Laws declared that federal contractors could not discriminate in employment and had to take affirmative action to ensure equal opportunity based on race, color, religion, and national origin.

Nationally, an emphasis was placed on the tolerance of integration in all workplaces, schools, and communities. Affirmative action emerged as the concept aimed at ensuring that marginalized groups, including women and people with disabilities, were not discriminated against, though there was very little accountability. In response to these new expectations, many colleges developed affirmative action activities. But it wasn’t long before there were legal challenges to these practices. Finally, in 1978, a Supreme Court’s ruling prohibited racial quotas but allowed the consideration of race as one of many factors in college admissions.

This decision marked a turning point, and the national conversation turned to diversity, though the language used was different from what is used today. Instead of “diversity,” “equity,” or “inclusion,” the language around affirmative action was about “disproportionate burdens,” “multiculturalism,” “cultural competency,” and “minority affairs.”

At the Mount Sinai School of Medicine, Gary C. Butts, MD, was recruited in 1998 to design, develop, and lead an organizational structure to address a lack of diversity for the School. Dr. Butts already had a long history at Mount Sinai—he completed his clinical training in pediatrics at The Mount Sinai Hospital. The work that Dr. Butts inaugurated focused primarily on the School of Medicine, and this work greatly expanded some years later.

“There was no coherent strategy,” recalls Dr. Butts. “I was hired to pull together existing activities and programs and to lead and oversee the strategy, programs, and activities to advance multiculturalism and diversity. While the initial focus was the diversity of medical students, ultimately, we recognized we couldn’t be effective with medical students without addressing the diversity and climate of the house staff and faculty.”

The Center for Multicultural and Community Affairs (CMCA) is one of three units of the Office for Diversity and Inclusion (ODI) and a major department at the School, with the mission of enhancing the academic success, retention, and personal development of students from racial and ethnic backgrounds underrepresented in medicine. At its inception, CMCA was an initiative operated from one small office. Dr. Butts also discovered a lack of diversity in the people involved in doing affirmative action work; they were generally people of color.

Under his leadership, new programs were started at the School, such as the Visiting Electives Program for Students Underserved in Medicine (VEPSUM), designed to increase diversity in the house staff and subsequently the faculty of the Medical School and its affiliated institutions.

“The program was created to allow underrepresented medical students to enjoy an experience of Mount Sinai and be seen for what they could do, and then ultimately, Mount Sinai program directors and chairs would become more comfortable with these students, perhaps even giving them a chance to do residencies at Mount Sinai,” Dr. Butts says.

It did not take long for him to realize that if real change was going to occur, he needed broader involvement in the planning and discussions around diversity affairs. “It takes more than just people of color,” says Dr. Butts, who is Black. “You need friends and allies to advance and sustain this work, but also at the table to help us plan. It has to be an integrated effort.”

To help further this goal, the Faculty Diversity Council and the Graduate Medical Education (GME) Diversity Council were established to increase representation and advancement of underserved groups. The Faculty Diversity Council is composed of faculty members at all levels. Members participate in planning, implementing, and monitoring work in their departments to promote diversity in recruitment, retention, development, and inclusion. The

GME Diversity Council supports residency and fellowship training program efforts to recruit and guide qualified applicants from diverse backgrounds.

In 2012, the Mount Sinai School of Medicine was renamed the Icahn School of Medicine at Mount Sinai. The next year, in 2013, a new era began when the Mount Sinai Medical Center merged with Continuum Health Partners to form the Mount Sinai Health System, creating the largest private health system in the city. At the time, Continuum had five hospital campuses throughout Manhattan and Brooklyn, and ambulatory health centers and group and private practices throughout the New York metropolitan region. Most important, Continuum had forged ahead of many other hospitals in their diversity work, integrating best practices into the organizational strategy.

“We had had a diversity focus at our five hospitals since 2006. We brought to Mount Sinai the foundation that we established at Continuum—a system-focused, hospital-based diversity management initiative based on industry standards in diversity, equity, and inclusion,” says Pamela Abner, MPA, CPXP, Senior Vice President and Health Equity Officer, Mount Sinai Health System, and Chief Diversity Operations Officer, ODI. “We had a fully articulated 'Destination Diversity' strategy, centered on embedding diversity, equity, and inclusion across our hospitals and corporate divisions.”

With support from senior leadership at Mount Sinai, Dr. Butts and Ms. Abner were able to integrate their work, which meant that diversity efforts extended beyond

Icahn Mount Sinai to all hospitals and the corporate base of the newly formed Mount Sinai Health System. Continuum brought over foundational DEI concepts that remain today—including hospital and corporate diversity councils and employee resource groups that allowed participation by members from every level of the Health System; a strong mentoring program; a supplier diversity program; a focus on recruiting underrepresented staff to leadership roles—including a physicians of color networking group— and awareness of the needs of the LGBTQ+ community and people with disabilities.

“Mount Sinai was open to embracing the work,” says Ms. Abner. “Though we had many bumps in the road, I felt we had the ability to move forward by engaging with our new partners. We initially had support from a small group of key leaders, while today, institutional leadership seeks to embed the lens of equity into all facets of the organization.”

The Founding of ODI: A Watershed Moment

In 2014, the Office for Diversity and Inclusion (ODI) was established to support the Health System in embracing the principles of diversity, equity, and inclusion. The ODI team members serve as consultants and subject matter experts on best practices. ODI expanded the diversity programs of Icahn Mount Sinai, such as the Graduate Medical Education Diversity Council and the Faculty Council, and integrated into the Health System many of the successful practices developed by Continuum.

Sherria McDowell, MPH, at left, leads students in a 2023 orientation session of the Visiting Electives Program for Students Underserved in Medicine (VEPSUM).

Expanding the Mission

Corporate Health System Affairs (CHSA)

Based at Mount Sinai’s Corporate Services Center in midtown Manhattan, CHSA is the third major unit of the Office for Diversity and Inclusion. It recommends and establishes best practices in diversity, equity, and inclusion management to engage the organization in cultural effectiveness, promote anti-racist practices, eliminate disparities, and enhance the patient experience for all. The CHSA staff manages, promotes, and partners with Health System leadership on dedicated programs in areas of focus, including data integrity and equity analytics, diversity councils and employee research groups, people with disabilities, LGBTQ+ and gender nonbinary health, supplier diversity, and environmental, social and governance.

The overarching strategy to advance DEI across the Health System is guided by the Executive Diversity Leadership Board (EDLB), which is chaired by the Chief Executive Officer, until January 2024, Kenneth L. Davis, MD, and now Brendan G. Carr, MD, MA, MS. Members

include hospital presidents, senior leadership, and Trustees. The board meets three to four times a year and is supported by ODI, and it is aligned with Mount Sinai’s commitment to become an anti-racist health care and learning institution. EDLB members are held accountable for leading and developing strategies to address structural and systemic racism; promoting, instilling, and demonstrating anti-racist behaviors; driving equitable practices to enhance quality and outcomes centering on marginalized or oppressed groups, and reporting progress on outcomes and implementing recommendations for further improvement.

EDLB members are expected to lead with equity and support initiatives and teams that advance the Health System’s DEI best practices in the following five domains: cultural effectiveness and education, data integrity and equity analytics, engagement and inclusion, demographic diversity, and community relationships.

The merger and the development of ODI integrated a wide range of programs into the Mount Sinai Health System. Among them are:

MOMENTS OF CHANGE › ELEVATING EQUITY

CHANGE ›

Lyndia Hayden, MS, PMP Senior Director

Data Integrity and Equity Analytics Office for Diversity and Inclusion

In 2021, I experienced a change in diversity, equity, and inclusion at Mount Sinai when 'equity' was added as one of the Mount Sinai Health System’s official core values. This was an epic testament of our brand’s identity. Although the Health System was already engaged in creating a diverse and inclusive environment for our patients, colleagues, and students, the addition of equity as a core value validated Mount Sinai’s commitment to be an organization free from bias, racism, and favoritism in words and deeds. Mount Sinai’s aim to foster optimal care and just opportunities based on one’s individual needs and abilities resonated with me as an employee in the Office for Diversity and Inclusion, because we serve as consultants and subject matter experts in DEI best practices.

The placement of equity—alongside long-standing values such as safety and teamwork—spoke volumes about its monumental importance to the institution. And it made me very proud to be a Mount Sinai employee.

The MSHS Health Equity Data Collection Journey

• Formed Health Disparities Working Group

• Performed Discovery Analysis/Feasibility Study

• Legislative visit to Albany, New York

• Conducted ongoing negotiations among internal key stakeholders

• Began Mandatory Data Collection, pilot and educational programs

• Implemented preferred name, pronoun, sexual orientation and gender identity (SOGI), secondary race/ ethnicity

• Developed OB/GYN Clinical Measures Dashboard with race/ethnicity

• Performed random audit reviews with staff and developed Race/ Ethnicity Capture dashboard to create awareness and reduce ‘unknown’ values

• Conducted focus groups to obtain feedback

• Launched enhancements and marketing campaign for patient education

• Distributing posters and rack cards across Health System

• Improved data integrity and increased identified collection rate to 90-95%

• Continued staff educational programs (including clinical and research)

• Produced research papers, analyzed data for disparities and recommended interventions

• Developed Equity Toolkit

Employee Engagement Diversity Councils and Employee Resource Groups (ERGs) were established to expand the ways employees can engage in and help support diversity efforts. Diversity councils are committees of employees supported and commissioned by executive leadership to champion diversity, equity, and inclusion. Committees exist at Mount Sinai Health System hospitals, the Corporate Services Center, Icahn Mount Sinai, and within departments across the Health System.

Ms. Abner remembers that her work received a major boost because David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens, made himself available to attend and lead The Mount Sinai Hospital site council meetings.

“If we are having a council meeting and the president is there, that is significant in terms of commitment, and staff would come to those sessions,” Ms. Abner says.

• Established Health Equity Data Assessment (HEDA) Hub, data journey road map and consult request form

• Launched Self-Service Patient Demographic Report Dashboard

• Developed a custom Language Dashboard

• Translated intake form to six additional languages

• Launched Best Practices module in PEAK

• Aligned SOGI questions in MyMountSinai and Epic Smartform

• Developed process improvement plan to increase capture rate at ambulatory facilities

• Recommended data collection strategy for social determinants of health

• Developed governance plan and HEDA Hub Portal as a central repository for health equity initiatives

• Developed a custom SOGI Dashboard

• Accomplished a 4% increase in the capture rate for race/ethnicity at ambulatory facilities

• Establish patient data collection policy as a standard operating procedure in Policy Tech guidelines

• Add nonbinary as a gender in registration systems

Diversity councils and ERGs are charged with championing a diverse workforce and fostering an inclusive work and learning environment across the Health System by:

• seeking innovative ways to address the needs of faculty, staff, student, and patient populations to promote belongingness and enhance the patient experience;

• presenting site- or department-specific recommendations to support the strategic goals of the organization; and

• facilitating communication among faculty, staff, and students through educational, cultural, and social activities.

Data and Health Disparities Since 2015, Mount Sinai has built an innovative infrastructure of data collection. The mission of this work is to identify differences in outcomes or processes in order to improve quality and health outcomes for the community through collaborative and

MOMENTS OF CHANGE › THE POWER OF DATA

One day, I was leading an education session with a small group of business associates. They happened to be people of color, and we were talking about health care disparities, and something just clicked. I moved away from the typical presentation and asked them a question:

Why don't you share with me what happens when you're collecting data from patients? Since the whole talk was about using data and information to address disparities, and our front desk staff members are instrumental in collecting information.

What they shared with me was absolutely mind-boggling, but important, and it helped move the Mount Sinai Health System forward: They said they were told to guess the patient’s background and leave it blank if they couldn’t figure it out. In other words, as far as they could tell, it was deemed not important to collect patient demographic information.

I don’t think this made Mount Sinai unusual among the nation’s health systems. But for me, it ignited an energy and a passion for change. My team at the Office for Diversity and Inclusion—working with partners across the Health System–revamped how we collect data, created education for staff, and worked with patients so that they would be more comfortable in sharing information. And we created a dashboard that enables providers to look at individual patients and populations to see who is faring well, and who is not.

The conversation with these business associates inspired a major transformation at Mount Sinai, and I will always be grateful for their honesty. We are now very well situated—actually, a leader in the nation—in being able to use patient data in a specific way to address equity and identify health disparities.

Pamela Abner, MPA, CPXP

Senior Vice President and Health Equity Officer

Mount Sinai Health System

Chief Diversity Operations Officer, Office for Diversity and Inclusion

Members of the Health Equity Data Analytics (HEDA) team, from left: Jefri Mesa; Pamela Abner, MPA, CPXP; Lyndia Hayden, MS, PMP; and Doran Ricks, RN, MSN, MBA.

strategic partnerships. This crucial initiative began with a simple meeting with business associates, front-line workers who handle patient intake. “We learned that staff across the system were not encouraged to obtain patient demographic information and were allowed to leave fields blank or indicate 'unknown' for their race/ethnicity,” says Ms. Abner. “We took it upon ourselves to radically change the way Mount Sinai addresses the collection and reporting of patient demographic data. This included educating staff and leaders on best methods to collect patient information; unifying and updating fields in our patient registration systems; and communicating directly with patients to determine the concerns they may have about sharing their personal information. As a result, we have vastly improved our data completeness and reliability rates, which allows us to use these data to conduct analysis to determine any variance or potential disparities in care.”

Collecting race, ethnicity, and language data gives the organization the ability to look at its quality metrics as a function of socio-demographics. To aid in this mission, the Health Equity Data Analytics (HEDA) Committee was created as an institutional hub, providing data and analytical tools to clinical teams to identify variances and potential disparities. Allowing clinical teams across the Health System to have access to reliable data allows medical professionals to tailor treatment to each individual patient while considering conditions or circumstances that may be relevant to that patient’s life. In other words, recognizing that one size—or treatment—does not fit all.

“It means understanding who a patient is and how a situation can be managed differently,” says Dr. Butts. “No one should die of asthma, yet I see Black and Latino kids dying. It reflects an overarching system that either ignored them or didn’t understand the differences in people—or that the people didn’t have access to health services.”

In a further effort to close health disparities, a team developed the Race/Ethnicity/Language Dashboard to track progress in collecting patients' race, ethnicity, sexual orientation and gender identity (SOGI), and language preference. A team of experts, including Lyndia Hayden, MS, Senior Director of Data Integrity and Equity Analytics, and Jefri Mesa, Management Analyst, work closely with practices to help improve their performance. In addition, Ms. Hayden developed a “Data Integrity and Equity Analytics” education unit, teaching best practices to ensure data accuracy and completeness.

As of 2022, the initiative increased the systemwide capture rate—the percent of patient encounters where race/ethnicity is identified—from 91 percent to 95 percent, providing significant support for equity in clinical care and research.

Mentoring Recognizing that members of some groups are underrepresented in middle and upper levels of management, ODI, Human Resources Talent Development and Learning and Talent Acquisition, and other Mount Sinai entities have created pathways for career advancement through networking, mentorship, and advancement opportunities. Today, the Health System promotes equity in mentorship by identifying best practices and gaps in mentoring and leveraging existing and new resources. The resources include these initiatives:

• The LINC Mentorship Program is designed for individuals from underrepresented groups in health care who are interested in Learning, Investing, Networking, and Connecting (LINC) through mentorship. LINC participants are granted access to opportunities for career development, advice, exposure, and advocacy to further accelerate their professional growth.

• GOALS, the Growth in Operations, Administration, and Leadership Society, is an initiative to increase the representation of Black men in middle and upper levels of management. GOALS is focused on creating pathways for career advancement through networking, mentorship, and advancement opportunities. This initiative furthers Mount Sinai’s continuing commitment to growing a diverse workplace and providing equitable care for patients.

• The Friends of Odysseus (FOD) Mentoring Program at Mount Sinai was launched in 2012 by Reginald W. Miller, DVM, DACLAM, Dean for Research Operations and Infrastructure at Icahn Mount Sinai, to support Black male medical students navigating Mount Sinai by providing mentoring in career advancement. FOD provides a safe space for discussions on structural racism and tools to overcome challenges to encourage and empower Black professionals in the program.

• Black Women Leaders Connect is an initiative focused on increasing the numbers of Black women in executive roles at the Health System and mentoring the next generation of leaders within the Mount Sinai community. “From the sheer desire to make connections, ODI started hosting small gatherings after work for senior Black women at the VP administrative level,” says Ms. Abner, noting that there

Expanding the Mission

were only a few women in those positions. “We have since grown in numbers and continue to expand the group to women in leadership roles across the system. Ultimately, our goal is to position ourselves as the role models, mentors, coaches, and support for Black women across the organization and within our communities.”

• Office for Women’s Careers, led by Founding Director Sandra K. Masur, PhD, advances women’s academic careers and addresses potential impediments to success through networking opportunities, advocacy, and mentoring, and providing a forum for support, education, and discussion.

• Faculty Scholars Program , led by ODI’s Center for Multicultural and Community Affairs, is a highly individualized career-development coaching program for Icahn Mount Sinai faculty who are racially and ethnically underrepresented in medicine and science. Since 2002, approximately 100 faculty of color have participated and have acquired leadership positions in medical education, graduate medical education, and within their respective departments..

Jessica Reid-Adam, MD, MSCR, a Faculty Scholars participant, is now Pediatric Residency Program Director and Associate Director for Diversity Initiatives in the Jack and Lucy Clark Department of Pediatrics at Mount Sinai and the Senior Associate Dean for Diversity, Equity, and Inclusion in Graduate Medical Education. As an intern, Dr. Reid-Adam was the only Black categorical Pediatric

resident in her class. Now, as program director, she oversees a diverse residency program grounded in social justice and health equity. Dr. Reid-Adam mentors students and residents from backgrounds underrepresented in medicine and educates her residents, fellows, and colleagues about the importance of anti-racism. Drawing on nationwide data that point to persistent health inequities, and speaking from personal experience, she frequently talks of the importance of anti-racist education and action. These critical aspects of medical training and clinical care make residents more effective doctors and better colleagues—and send a welcoming signal to residents from backgrounds underserved in medicine.

“Mentorship from Black pediatricians, such as Sharon Edwards, MD, and others at the Center for Multicultural and Community Affairs, allowed me to thrive as a resident and fellow,” Dr. Reid-Adam says. “While I felt alone, there actually was a critical mass of Black and Brown doctors, but we were all so scattered, every one of us felt isolated. When I connected with other physicians with a similar background, I found my ‘family’ in a way, and now I want to help my residents find that belonging, too.”

A meeting of GOALS, the Growth in Operations, Administration, and Leadership Society—an employee resource group at Mount Sinai.

Jessica Reid-Adam, MD

MOMENTS OF CHANGE › ISSUES OF INCLUSION

Terrell D. Holloway, MD Clinical Instructor Department of Psychiatry

Yale

School of Medicine

Intervention Psychiatrist

PTSD/Trauma

Mood Institute

Specialist

My journey at Mount Sinai began in 2008, where I initially served as a basic science and clinical researcher. I transitioned to Icahn School of Medicine in 2013 and graduated in 2018 with a medical doctorate with distinction in research before proceeding to the Yale Department of Psychiatry for my residency.

As a researcher, I played a part in founding the Society for Equal Opportunity in Science, a sister organization to the Students for Equal Opportunity in Medicine. This group, predominantly composed of graduate students and researchers, aimed to enhance the representation of underrepresented minorities in science and medicine. Our goal was to provide a platform for aspiring applicants to connect with both students and faculty members. Through these efforts and our collaboration with Terry Ann Krulwich, PhD, Founding Director of the MD/PhD program and Director of the Post-Baccalaureate Research Education Program, we helped the graduate school make strides in diversifying.

However, issues of inclusion persisted, particularly in relation to the representation of Black men. Throughout my tenure as a medical student, I encountered instances of both unconscious and conscious bias in both clinical and learning environments. As a Black man, I was frequently stopped at security desks and singled out in private learning spaces, often with demands to present my ID. These requests were made regardless of whether I was wearing a white coat or accompanying other students, and despite my personal relationships with security personnel. Assumptions about my academic performance were frequently made based on stereotypes, particularly when I encountered academic challenges. Failures were sometimes treated as if they were almost expected. Despite these challenges, I alongside many other students played a pivotal role in building broad coalitions with students, staff, and faculty to address diversity and inclusion issues in our clinical education, recruitment, and training settings.

I am heartened to see the ongoing dialogue and actions at Mount Sinai focused on enhancing diversity, equity, and inclusion. The progress made is commendable, and due to the committed efforts of so many students, staff, and faculty. I hope that through these continued efforts and collaboration, we can mitigate these types of experiences and create an even more inclusive and equitable environment for all in the Mount Sinai community.

Rising to the Challenge

As in earlier times of change, separate efforts arose to address the latest challenges to patients, staff, and students.

Center for Transgender Medicine and Surgery (CTMS)

CTMS was created to meet needs that the Office for Diversity and Inclusion identified as critical for transgender and gender diverse people. Barbara Warren, PsyD, CPXP, Senior Director for LGBT Programs and Assistant Professor of Medical Education, was integral in bringing this to the attention of leadership. David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens, then became a champion and leader in the initiative to create CTMS.

The center, led by Executive Director Joshua Safer, MD, is now a world leader in care for transgender and gender diverse people, providing advanced and compassionate services—including primary care, gender-affirming hormone therapy, gender-affirming surgeries, and other medical services for patients across all ages. CTMS is the largest surgical program for transgender and gender diverse people in North America and is the most

comprehensive program for the medical care of transgender and gender diverse people.

“CTMS has treated almost 9,000 transgender patients since it was founded in 2016 and performed 4,000 gender-affirming surgeries, such as facial feminization and genital reconstruction. There are more than 4,000 transgender and gender diverse patients who make their medical home in the Mount Sinai Health System” says Dr. Safer, Professor of Medicine (Endocrinology, Diabetes and Bone Disease). “The one thing that transgender people have in common is that their gender identity is not aligned with the physical anatomy that we see. But there is great variability in what they want to do about that, and we think patients should have customized choices, just like treatment for any other medical circumstance.”

The comprehensive team at CTMS can provide full medical care or specific targeted services to support a person’s existing medical providers. An individual may choose to receive their primary care at Mount Sinai, or they may come to Mount Sinai for specialists in the areas of endocrinology, behavioral health, plastic surgery, urology, gynecology, and more.

CTMS developed the first full-year fellowships to train doctors in genderaffirming surgery, medicine, and psychiatric care. CTMS has a genderaffirming urology program and is a key component of Mount Sinai’s LGBTQ+ medicine fellowship program. All Mount Sinai endocrinology fellows spend time learning gender-affirming hormone therapy in CTMS, and all Mount Sinai plastic surgery residents spend time learning surgical techniques with CTMS surgeons. In addition, medical students and residents can sign up for elective experiences to gain exposure to all areas of transgender health. These programs will train the next generation

Jess Ting, MD, a leader in gender-affirming surgery, with a patient at the Center for Transgender Medicine and Surgery.

MOMENTS OF CHANGE › A MOVING SPEECH

In 2015, our organizational leadership's diversity, equity, and inclusion meeting included a moving speech by Barbara Warren on the nearly complete lack of access to transgender health care in our region. With the support of Drs. Kenneth Davis and Dennis Charney, and the incredible organizational efforts of Pamela Abner, we formed a group that created the Mount Sinai Center for Transgender Medicine and Surgery.

We performed our first gender-affirming operations in 2016, and now have the largest gender-affirming surgical program in the nation. While there is more work to do, Mount Sinai has made major contributions to the science and practice of medicine and surgery for transgender and nonbinary individuals.

David L. Reich, MD President, The Mount Sinai Hospital and Mount Sinai Queens

MOMENTS OF CHANGE › HE, SHE, AND THEY

Barbara E. Warren, PsyD, CPXP

Senior Director for LGBT Programs Office for Diversity and Inclusion

Assistant

Professor of Medical

Education

Icahn School of Medicine at Mount Sinai

CHANGE ›

In the 12 years that I have had the opportunity to lead LGBTQ+ diversity, equity, inclusion for the Mount Sinai Health System, I've experienced many moments where the need for change was both recognized and implemented, for which I give credit to Mount Sinai leadership, staff, providers and especially to our students, for contributing to these efforts.

A recent example of something that was a small change but significant is the inclusion of personal pronouns on employee badges. People have been really enthusiastic about this, and Human Resources endorsed it. So far, we have distributed about 20,000 pronoun stickers—he, she, and they—and the demand from employees for the stickers remains high.

This initiative sends a message of respect and inclusion for our employees who are transgender and gender diverse and LGBTQ+. And it sends a message to our patients that we respect everyone's identity and we want everyone to feel they can be who they are when they come to Mount Sinai.

Expanding the Mission

Medical students held a “die-in” at Mount Sinai in August 2014, part of a nationwide response to violence and race-related trauma.

of providers caring for transgender and gender diverse patients.

“I think some people might say, ‘Why is it important for us to have such a focus on LGBTQ+ patients and their families?’”

Dr. Warren says. “Well, first of all, LGBT+ people still have some of the highest health disparities, including at the intersection of other marginalized or minoritized identities. Second, a significant proportion of our population, both our employee population and our patient population, is LGBTQ+ identified, and we want to make sure that we give them the very best service. Finally, our LGBTQ+ patient population in New York are pretty educated consumers and expect to receive competent and affirmative health care, so we are here to provide them the highest quality and most equitable care.”

“Die-Ins” and a Time of Reckoning

On July 17, 2014, Eric Garner was killed when a New York City police officer used a prohibited chokehold on him, after stopping him on suspicion of illegally selling cigarettes. The next month, on August 9, 2014, unarmed 18-year-old Michael Brown was shot and killed by police

officer Darren Wilson in Ferguson, Missouri. When neither white officer was indicted for the killing of these Black men, protests erupted across the country. In New York, demonstrators staged “die-ins” in the main concourse of Grand Central Terminal and at intersections around the city. This is a type of protest in which a group of people lie down in a public place and refuse to leave or allow normal activities to continue.

At Icahn Mount Sinai, in December 2014, medical students and staff joined the die-ins that were being held at 70 medical schools nationwide and organized by #WhiteCoats4BlackLives. The organization released this statement: “We as medical students feel that this is an important time for medical institutions to respond to violence and race-related trauma that affect our communities and the patients we serve. We feel it is essential to begin a conversation about our role in addressing the explicit and implicit discrimination and racism in our communities and reflect on the systemic biases embedded in our medical education curricula, clinical learning environments, and administrative decision-making.”

MOMENTS OF CHANGE › A WAKE-UP CALL

There are a number of moments that I can think of that were sort of a wake-up call, but one in particular comes to mind. This was in 2014, after students at medical centers across the country staged die-ins related to a number of young Black men who were killed by police, long before George Floyd. In fact, medical students at Mount Sinai and at the University of California San Francisco were the two groups that launched the initiative, and they were followed by students across the country.

At some point after that event, students confronted us about issues related to racism. That was a real wake-up call, but the moment that I am thinking about occurred months later: Our leadership group in Medical Education decided to bring someone in as a consultant; someone who had real expertise in this work and who was outside of our group, because our students made it clear that we needed this external perspective to see clearly around issues related to racism. Leona Hess, who subsequently joined Mount Sinai full time, started to work with us as a consultant, not around racism and health care, not even around racism as it related to the experience of our medical students, but within our small team of seven or eight people.

She wanted us to begin to process this concept of race and racism as it related to the interpersonal dynamics among us as a team. Did we really understand it? Had we ever deeply explored it? In those sessions, there were some earth-shattering moments. People in our group had long worked together, some of us for decades, but we had never really explored beyond the most superficial level what it meant to be different, or how we thought about or talked about each other. That was a moment that turned a light bulb on in my head and helped me understand how little I appreciated the ways in which racism is threaded through literally everything that we do. It was terrifying and revealing, and I think it helped to propel us forward as a team and then eventually as a school, with anti-racism as our top priority and as the most enduring thing that we wanted to leave behind as our legacy.

David Muller, MD

Inaugural

Director

Institute for Equity and Justice in Health Sciences Education

Icahn School of Medicine at Mount Sinai

Expanding the Mission

MOMENTS OF CHANGE › STUDENTS TAKE A STAND

I think the first moment for me was when our students, particularly our Black and Brown students, organized and put together a nonviolent demonstration on behalf of White Coats for Black Lives and did a “die-in” in the Guggenheim Pavilion lobby.

It was one of the most profound moments of my career as a diversity affairs professional, because this act demonstrated how their own individual personal and social identities informed their role as medical students and how they leveraged that role to take a stand for the lives of Black and Brown patients and call out the medical profession for not doing more to protect communities of color. This moment was also personal for me as a member of the Latinx community, which is why I chose to join the demonstration and lie down with the students.

Upon reflection, it has been a profound honor and privilege to be a part of that endeavor, and it's been probably the most rewarding part of my 25-year career at Mount Sinai so far.

Ann-Gel Palermo, DrPH, MPH

Senior Associate Dean for Diversity, Equity, and Inclusion Icahn School of Medicine at Mount Sinai Chief Diversity, Equity, and Inclusion Officer in Education and Research Mount Sinai Health System

David Muller, MD, then Dean for Medical Education at Icahn Mount Sinai, says the action of students heightened his personal commitment to eliminating prejudice and racism. In his “Dean’s Report,” a newsletter of Icahn Mount Sinai, Dr. Muller recounted his initial reluctance to hear the students.

“I am sure there are educators who would argue that such a controversial issue has no place in a medical school,” Dr. Muller wrote. “I, too, was initially resistant. We began reading books about racism in health care. And slowly, we learned.” Dr. Muller says because of the events of 2014, the efforts of the Medical Education leadership were “put into a new perspective.”

Icahn Mount Sinai leaders who were present for the die-in say it changed the way they viewed their work and shifted their thinking about what work needed to

be done. Michelle Sainte-Willis, who was part of the team that created CMCA and is now Senior Associate Dean for Medical Education Administration, was among administrators who decided to join with the protesting medical students in the die-in. “What changed that day was me,” Ms. Sainte-Willis says. After she stood in solidarity with students and reflected on her own role and life experiences, “I think it became possible for me to have honest and transparent dialogues. And people responded to me differently. We were able to be reflective and talk about really difficult and challenging things.” After this pivotal event, the School’s focus gradually shifted, as well.

“We have excellent students who come from sociocultural backgrounds where the acclimation to some norms of the medical profession can be either challenging or unfamiliar. Thus, to foster an equitable and inclusive

MOMENTS OF CHANGE › OBSTETRICS AND EQUITY

Toni Stern, MD, MS, MBA

Vice Chair for Diversity, Equity, and Inclusion and Clinical Transformation

Department of Obstetrics, Gynecology

and

Reproductive Science

Senior Associate Dean for Gender Equity and Clinical Affairs

Icahn School of Medicine at Mount Sinai

learning environment, we must recognize and respect the experiences of all students, even as we address any unproductive remnants of the past, such as paternalism and power-hoarding,” says Ann-Gel Palermo, DrPH, MPH, Senior Associate Dean for Diversity, Equity, and Inclusion.

The new goal was systems change—to identify and shift the conditions that hold the problems in place. To that end, Icahn Mount Sinai has spent years developing collaborations between leaders of the medical education program, and students, with a spirit of change

Within obstetrics, gynecology, and reproductive science, health equity is critical. The stark disparity in maternal morbidity and mortality rates—where we see Black birthing people in the United States dying at rates that are nearly three times that of white birthing people—is especially alarming. We are very focused on addressing and evaluating these disparities and evaluating these disparities within our department, and have partnered with our patients, faculty, and staff to make strides in tackling these issues together.

Our department’s executive leadership support has been foundational in building a strong health equity infrastructure, which has paved the way for us to continue to do this work. We have also partnered with the Mount Sinai Clinical Data Operations team and Office for Diversity and Inclusion to build patient experience and quality dashboards that align with our data-driven approach. The data that we analyze from our dashboards allows us to evaluate our patients' care through the critical health equity lens—not just race, ethnicity, and payor, but also social determinants of health, language, and ZIP code. With this information, we evaluate factors such as Cesarean birth rates, perinatal care measures, highrisk conditions, readmission rates, and overall patient experience. After we assess these key components, we can then drill down to identify and address the differences that exist within various patient populations.

For me, seeing this effort come to fruition was a crystallizing moment, because without an interdisciplinary team of like-minded people coming together to combat this pressing issue, you really cannot make progress.

and continuous improvement that relies on active listening, analyzing, and asking. These efforts led to the launch of the Racism and Bias Initiative in 2015. (Details on Page 95.)

“We are still learning to view medical education through a different lens,” says Dr. Muller, inaugural Director of the Institute for Equity and Justice in Health Sciences Education at Icahn Mount Sinai. “Bias, inequity, and racism exist in our working, teaching, and learning environments, undermining the values we have taken an oath to protect.”

A Defining Moment

An anti-racism demonstration at Mount Sinai Queens on June 2, 2020, after the murder of George Floyd. Vigils were held across the Mount Sinai Health System.

After the murder of George Floyd in 2020, Mount Sinai leadership recognized a need to ensure anti-racist principles were integrated into all aspects of the Health System.

A Defining Moment

The Health System has a strong moral and ethical foundation, and through innovative programs and initiatives, Mount Sinai has been a leading force in gender equity and racial diversity, equity, and inclusion. After the murder of George Floyd in 2020, however, leadership recognized a need to ensure anti-racist principals were integrated into all aspects of the Health System and make Mount Sinai among the first anti-racist health care and medical education institutions.

To create a comprehensive strategy to work toward that goal, a task force was commissioned by Kenneth L. Davis, MD, then Chief Executive Officer of the Mount Sinai Health System, and Dennis S. Charney, MD, the Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and chaired by Gary C. Butts, MD, Executive Vice President for Diversity, Equity, and Inclusion. The task force, which included

51 front-line staff, students, hospital presidents, board members, and everyone in between, took a hard look at the entire Health System. Its charge was to evaluate, investigate, and engage in meaningful action and dialogue, and report back to leadership with specific recommendations that move the system forward to ensure a more fair, just, anti-racist, and equitable community for its staff, patients, and students.

On June 2, 2020, silent vigils were held for 8 minutes, 46 seconds, the time it took Mr. Floyd to suffocate under the knee of a Minneapolis police officer. These demonstrations were held across the Health System, including Mount Sinai Morningside, left, and The Mount Sinai Hospital, below.

A Defining Moment

Road Map Leaders

The Road Map project was led by a dedicated team of people who came from multiple divisions across the Mount Sinai Health System. Leaders were Kenneth L. Davis, MD, then Chief Executive Officer, Dean Dennis S. Charney, MD, Gary C. Butts, MD, the 11 strategy leads (including Dr. Butts), and the co-authors of the Road Map Bulletin. Leona Hess, PhD, MSW, now Co-Director of the Institute for Equity and Justice in Health Sciences Education, was a crucial architect of the Road Map, and the strategist behind programs related to anti-racism and the innovative use of the change-management structure and methodology. The team also relied on the hard work and dedication of Mount Sinai’s employee resource groups and diversity councils.

All told, more than 100 employees played a critical role in the Road Map efforts—whether in leadership or through their committed engagement within one of Mount Sinai’s organized groups.

Directly or indirectly, everyone involved worked together, and all were committed to making Mount Sinai a more equitable institution, both inside and out. “From delivering more equitable care to our patients and the community we serve, to treating current and prospective colleagues with an anti-racist mindset, the progress we’ve made would not be possible without every single member of our team,” Dr. Charney says. “We are grateful to everyone involved in this mission.”

Highlighting Road Map Leaders

Kenneth L. Davis, MD

Executive Vice Chairman, Mount Sinai Boards of Trustees

Dennis S. Charney, MD

Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai; President for Academic Affairs, Mount Sinai Health System

Gary C. Butts, MD

Executive Vice President for Diversity, Equity, and Inclusion, Chief Diversity and Inclusion Officer, Mount Sinai Health System, and Dean for Diversity Programs, Policy, and Community Affairs, Icahn School of Medicine at Mount Sinai

Strategy Leads

Pamela Abner, MPA, CPXP

Senior Vice President and Health Equity Officer, Mount Sinai Health System

Stephen Harvey, MBA

Chief Financial Officer, Emeritus, Mount Sinai Health System

Doran Ricks, MS, RN, MBA

Vice President, Data Quality and Stewardship, Mount Sinai Health System

Diane Adams, MS, LCSW, CPXP Chief Learning Officer

Jeremy Boal, MD

Then-Executive Vice President and Chief Clinical Officer, Mount Sinai Health System

Jane Maksoud, RN, MPA

Senior Vice President and Chief Human Resources Officer, Mount Sinai Health System

Jeffrey S. Silberstein, MBA

Chief Administrative Officer, Mount Sinai Health System; Chief Operating Officer, Icahn

Mount Sinai

Ann-Gel Palermo, DrPH, MPH

Senior Associate Dean for Diversity, Equity, and Inclusion, Icahn Mount Sinai

Bulletin Co-Authors

Angela Diaz, MD, PhD, MPH

Jean C. and James W. Crystal Professor in Adolescent Health, and Dean for Global Health, Social Justice, and Human Rights, Icahn Mount Sinai

Art Gianelli, MBA, MPH, FACHE

Chief Transformation Officer, Mount Sinai Health System

Emma Palmer Chief of Staff to Chief Executive Officer, Mount Sinai Health System

Shawn Lee Director of Operations, Central Billing Office

Creating the Road Map

Throughout the fall and winter of 2020, the Health System participated in listening tours, held town halls, and engaged in other communitybuilding efforts focused on health equity and anti-racism. In April 2021, the task force released their recommendations—A Road Map for Action to Address Racism—and hosted a virtual systemwide event to discuss their work. The Road Map outlines 11 distinct strategies to ensure antiracism. The document remains core to Mount Sinai, but recognizes that to create true, lasting change, the Health System will need to regularly re-evaluate its efforts, double down where progress is seen, and pivot to new strategies when roadblocks emerge. The strategies include:

distinct strategies to ensure anti-racism

Measurement

Strategy 1 Develop an equity scorecard to measure performance in order to identify where we are meeting with success and where more or different efforts are needed.

Health Care Delivery

Strategy 2 Unify and integrate clinical practices, where possible, while advocating for payment and regulatory reforms that would allow for the full integration and unification of clinical practices, regardless of insurance status.

Community Engagement

Strategy 3 Enhance community partnerships and accountability.

Strategy 4 Build connection and community within the Health System to adopt a racial equity culture.

Strategy 5 Forge new, and leverage existing, strategic partnerships and networks within the Health System to accelerate and spread anti-racism and equity efforts.

Finance and Business

Strategy 6 Develop a sustained financial investment in racial equity and anti-racism.

Strategy 7 Examine and redesign business structures with an anti-racist and equity lens.

Organizational and Institutional

Strategy 8 Increase recruitment efforts, hiring, and retention of Black and other underrepresented minority (URM) staff and faculty, and ensure they are represented in all levels of leadership, including high-impact leadership roles in the Health System.

Strategy 9 Promote equity in mentorship.

Learning and Enrichment

Strategy 10 Enhance leadership learning, capacity, knowledge, engagement, and accountability so that all leaders are able to participate fully in anti-racism and equity efforts.

Strategy 11 Provide anti-racism education and resources throughout the Health System in order to foster a learning community at all levels and to help advance an anti-racism and equity culture.

A Defining Moment

Building a Structure to Create Organizational Change

In order to create lasting organizational change, Mount Sinai created a multilayered and interdisciplinary structure to implement the Road Map strategies. All of this work is directed by the Planning and Implementation (or P&I) Team, which is made up of senior leaders across Mount Sinai, including the Icahn School of Medicine at Mount Sinai, engaging representatives from the Office for Diversity and Inclusion, Human Resources, Finance, and Operations.

Eleven leaders—including all members of the P&I Team and others—have each been tasked with bringing together interdisciplinary teams to implement the 11 Road Map strategies. These strategy leads each work with their teams, staff from across the Health System, and experts from The Winters Group consulting firm to create lasting, structural change. These teams work hand in hand with existing employee resource groups (ERGs) and diversity councils to ensure employees interested in equity work are able to make their voices heard and be part of improving the Health System.

While this work is still underway, Mount Sinai has already made real progress. Highlights include:

• Soon after the Road Map was finalized, Mount Sinai elevated equity as a systemwide core value, stating explicitly that the Health System “creates a diverse and inclusive environment for our patients, students, and colleagues, free from bias, racism, and favoritism, to foster optimal care and just opportunities based on one’s individual needs and abilities.”

• In May 2020—just as the Road Map work was beginning—Mount Sinai established the Institute for Health Equity Research. This institute at the Icahn School of Medicine at Mount Sinai supports the Road Map efforts through its mission of examining the causes and magnitude of health and health care disparities affecting nonwhite, low-income, immigrant, uninsured, LGBTQ+, and other vulnerable populations across all ages, abilities, and genders in order to devise, test, and implement innovative solutions to eliminate disparities in health while fostering long-term collaborations with community organizations and policymakers.

• Mount Sinai has revamped its hiring and retention policies and practices to explicitly include anti-racist language and expectations—including making antiracism a key aspect of the Mount Sinai Leadership Model. For example, the Health System has launched multiple mentorship programs for staff from underrepresented minority (URM) groups; it now works with a recruiting firm that shares a focus on ensuring URM candidates have access to top jobs, and it has partnered with a job training and career development nonprofit in East Harlem that helps local community members access jobs at Mount Sinai.

• After creating the Committee to Address AntiAsian Bias and Racism, Icahn Mount Sinai launched the Center for Asian Equity and Professional Development, the first center in the nation at an academic medical institution dedicated to understanding how implicit bias and racism affect Asian American and Pacific Islander (AAPI) medical professionals and addressing equity in their professional development.

Critically, Mount Sinai and the Road Map team recognized that simply having a group of employees pursue this work will not in and of itself create lasting change. To ensure that Mount Sinai is and remains an anti-racist institution, the Road Map must influence the Health System’s very culture—Mount Sinai must regularly and clearly communicate why anti-racist work matters, what progress is being made, and how people can get involved.

To address this need, Mount Sinai launched a systemwide email newsletter, titled the Road Map for Action Bulletin, in August 2021. Over the last two years, more than 75 editions of the Bulletin have educated the Mount Sinai community about structural racism, provided updates on the Health System’s anti-racism work, explored the causes of and solutions to health disparities, shared updates on critical topics like policies for dealing with racist behavior from patients and guests, and provided deep dives into the 11 Road Map strategies, among many other topics. It is developed by a team and posted each week by Angela Diaz, MD, PhD, MPH, Dean of Global Health, Social Justice, and Human Rights, the Jean C. and James W. Crystal Professor in Adolescent Health, and Professor of Pediatrics, Environmental Medicine and Public Health, and Global Health, and Shawn Lee, Director of Operations, Central Billing Office for FPA Administration at The Mount Sinai Hospital.

MOMENTS OF CHANGE › MESSAGES OF SOLIDARITY

CHANGE

Shana Dacon-Pereira, MPH, MBA, CPXP

Assistant Vice President

Corporate

Health System Affairs

Office for Diversity and Inclusion

In the weeks between George Floyd’s murder on Memorial Day and Juneteeth 2020, we came together as a system to denounce racism, bias, and discrimination in all its forms—punctuated by a nine-minute demonstration of solidarity on June 2, when staff from our hospitals stood together in silence to honor George Floyd. Subsequently, my team and I began to collect messages of solidarity and hope from staff and leadership across the Health System, which I was able to compile into a video against the backdrop of John Legend and Common’s song “Glory” from the movie Selma . This video was widely shared on Juneteenth, alongside the launch of the United in Solidarity website, which we had the task of creating in just a few weeks. All of this seemed to mark the start of a new era at Mount Sinai; one marked by prioritizing equity and anti-racism as core values of our organizational culture.

Among many other important initiatives at Mount Sinai, the United in Solidarity website and resource guide have become staples for our community, informing staff on efforts to instill an anti-racist culture and promote antiracist behaviors. Equity became one of the core values of the health system. Requests for education on cultural awareness, unconscious bias, and anti-racism increased, ultimately leading our Office for Diversity and Inclusion to partner with Talent Development and Learning to develop a course for leaders in 2021 titled 'Creating a Brave Space for Conversations About Race.' These occurrences highlight the fact that we at Mount Sinai view this work as 'forever' work and that diversity, equity, inclusion, and anti-racism are part of the fabric of our Health System.

A Defining Moment

Road Map Progress

The work to advance the Road Map was personally, culturally, and operationally transformative, representing changes to the Health System, both big and small, to create bridges across silos and service lines and integrate anti-racism into all of our day-to-day work.

In 2022 and 2023, Mount Sinai achieved great success carrying out recommendations, creating resources, and holding events to honor our progress and mission to become an anti-racist health care institution.

In 2022, 33 diversity, equity, and inclusion events were held across the Health System, and 48 issues of a systemwide staff email—the Road Map for Action Bulletin—were read by an average of 23,000 community members each week. More than a dozen new protocols and hiring practices were implemented to promote diversity across all levels and departments, and 229 interactive and learning webinars and tabling events were held to increase awareness of cultural, religious, gender, and socioeconomic differences and encourage employees and staff to unlearn unconscious biases.

In this time of reflection and change, a range of innovative initiatives were either launched or were greatly expanded. They include the following:

Building Gender Equity Together Initiative

In 2022, Mount Sinai launched the Building Gender Equity Together (BGET) Initiative. BGET is a series of facilitated dialogues in which all members of the Icahn School of Medicine at Mount Sinai community are invited to participate in conversations leading to the development of powerful community-led solutions that can improve gender equity across the School. Equity Action Teams of students, trainees, faculty, and staff are working closely with the Office of Gender Equity to bring solutions generated from these dialogues into action. In 2022, 28 sessions were held, with the purpose of identifying what was working well, what could be improved, and what programs and initiatives could be piloted to advance gender equity. From these sessions, three topics rose to the top, in terms of interest and feasibility: building awareness of family-friendly policies and resources, developing priority metrics for departments to track gender representation, and implementing a campaign that celebrates leaders with caregiving responsibilities who leverage their family-friendly benefits.

BGET and the Center for Transforming Culture, a consulting partner and leader in leadership development, in 2022 led an intensive two-day training to foster trustbuilding conversations with community members around gender equity issues. The most common theme in posttraining feedback has been that participants appreciated the opportunity to join, and discover common concerns, with others whom they may not have otherwise met.

Center for Asian Equity and Professional Development

The Center for Asian Equity and Professional Development (CAEPD) was established in 2023, building on Icahn Mount Sinai’s commitment to counter racism and enshrine equity as a core principle. CAEPD was developed after Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, founded the Committee to Address Anti-Asian Bias and Racism in response to the troubling rise in anti-Asian sentiment and violence in 2020. Amanda Rhee, MD, MS, is the inaugural director of CAEPD, and James Tsai, MD, MBA, is its executive advisor.

CAEPD is the first center in the nation at an academic medical institution dedicated to understanding how implicit bias and racism impact AAPI professionals and addressing equity in their professional development. It has allowed Mount Sinai to equip AAPI employees with the necessary resources for career development, collect critical data to drive diversity, and ensure quality care for patients.

CAEPD has a range of subcommittees addressing components of its mission. They include:

• Professional Development Address anti-Asian bias and racism in recruitment and career development, establish a mentorship program, increase Asian American leadership representation, and ensure diversity and inclusion in all campaigns.

• Education and Research Educate the Mount Sinai community on AAPI history and anti-Asian racism, while promoting the need for more research on AAPI populations. Active projects include a data dashboard, data disaggregation, and incorporating AAPI patient perspective into the Medical School curriculum.

• Safety Educate the Mount Sinai community on personal safety and ways to confront verbal and physical threats. In this effort, CAEPD is distributing safety pamphlets and devices.

MOMENTS OF CHANGE › UNITING AGAINST BIAS

MOMENTS OF CHANGE ›

Amanda Rhee, MD, MS

Inaugural Director of the Center for Asian Equity and Professional Development

Executive Director, Perioperative and Procedural Quality, Mount Sinai Health System

Associate Professor, Anesthesiology, Perioperative, and Pain Medicine

The COVID-19 pandemic and rhetoric generated by our highest level of government led to senseless acts of violence against Asian Americans and Pacific Islanders across the world. Our own AAPI community at the Mount Sinai Health System was not spared, with multiple people coming forward with reports of having been physically or verbally attacked in and out of our hospitals. The Dean asked us to create a committee to address this racism and bias against the AAPI community, then formally supported us in the creation of the Center for Asian Equity and Professional Development.

There is an abundance of evidence that AAPI people comprise significant parts of the medical workforce but are promoted to positions of leadership disproportionately less compared to all other races and ethnicities. This is known as the 'bamboo ceiling' phenomenon, which is present in many fields outside of medicine as well. The Center aims to better understand these professional development challenges and create interventions to address them. It is important for us all to stand united against any discrimination and bias against a person based upon their background and identity.

At a Lunar New Year event in February 2023, from left, Nimay Hazare, MBBS, Amanda Rhee, MD, MS, and Michael DeGuzman, MPH, FACHE. Dr. Rhee is the inaugural director of the Mount Sinai Center for Asian Equity and Professional Development, which was created to address anti-Asian bias and racism.

Michelle Tran, right, an MD-PhD student at Icahn Mount Sinai, co-founded Soar Against Hate to address anti-Asian violence.

A Defining Moment

MOMENTS OF CHANGE › DIWALI AND PRIDE

Hamel Vyas, JD

Senior Associate Dean, International Personnel

Mount Sinai Health System

Perioperative, and Pain Medicine

In my role at Mount Sinai, I oversee all the employment-based immigration matters for the Health System. With all the people we interact with, in a way, we get to travel the world every day. Through these daily interactions, we have come to appreciate and celebrate the diversity of our stakeholders. We have learned the importance of cultural nuances, and learned about traditions and holidays we would not otherwise known of. It is a unique exposure. However, I felt that this was not always celebrated on a larger scale at Mount Sinai.

As Mount Sinai became a pioneer in diversity, equity, and inclusion, I noticed that only announcements acknowledging Judeo-Christian holidays were being sent out. Given the diverse workforce, I felt that it was important to acknowledge and highlight more holidays that employees celebrated. Growing up in the 1970s, Hindu holidays weren’t as well known as they are now. In elementary school, I would always have to explain our gods and beliefs and was often mocked by other students. As a child, I remember being embarrassed when my father, who was a Hindu priest, would put up Christmas lights in our window during Diwali— the festival of lights—at least two months before December. A lot has changed since then. There are now Diwali balls at the Pierre Hotel, Diwali at the White House, and Diwali sales in department stores!

About 10 years ago, I reached out to diversity and inclusion leaders and offered to help write something about Diwali, which is a meaningful and spiritual holiday for Hindus and observed by Sikhs, Jains, and Buddhists. It was circulated in a broadcast email throughout the Health System. I was so happy that it was there. I felt that I belonged and that others could appreciate the holiday. Unlike my childhood days, nobody was mocking me. What was really meaningful was that one of the security guards stopped me and asked if I had anything to do with the Diwali message that was broadcast. I told him that I helped write it, and he thanked me, saying that it was so nice to have our holiday acknowledged and that he felt it was a proud moment to be at Mount Sinai.

I didn’t realize it would have had such an impact. Today, Mount Sinai continues to acknowledge and celebrate several diverse holidays. I am proud to be part of the Mount Sinai family.

Increasing Access to Health Care

Many Health System ambulatory practices, including cancer and cardiac care services and the transplant program, are now unified, helping ensure equal treatment for all patients regardless of insurance status—and more are on that pathway.

In 2022, the Department of Urology launched its Robert F. Smith Mobile Prostate Cancer Screening Unit, which brings state-of-the-art imaging equipment and specialized staff directly to underserved local

communities as part of programming to address racial inequities in early detection and treatment. Black men are 70 percent more likely to develop high-risk prostate cancer than white men, and more than twice as likely to die from it. “The most important thing people can do is find this cancer early, when it is easier to cure. That starts with understanding your own risk, and talking with your doctor before there are any symptoms,” says Ash Tewari, MBBS, MCh, Professor and Chair, Milton and Carroll Petrie Department of Urology, and Director of the Center of Excellence for Prostate Cancer at The Tisch Cancer Institute at Mount Sinai.

The Robert F. Smith Prostate Cancer Screening Unit, launched in 2022, brings state-of-the-art imaging equipment and specialized staff directly to underserved communities, part of an effort to address racial inequities in detection and treatment of prostate cancer.

MOMENTS OF CHANGE › COVID-19 AND COMMUNITY

CHANGE ›

Zorina Costello, DMin, MS

Director of the Community Engagement Center for Spirituality and Health and the Center for Stress, Resilience, and Personal Growth

A pivotal time that I would like to highlight is when the Center for Stress, Resilience, and Personal Growth and the Center for Spirituality and Health, within the Icahn School of Medicine at Mount Sinai, quickly and compassionately responded to community requests for assistance during the COVID-19 pandemic. The Center for Spirituality and Health had been working for years to address the need for health education and access in the underserved Black, Indigenous, and People of Color community. During the pandemic— as calls, emails, and text messages were received concerning trauma, grief, anxiety, stress, and loss—a model of community collaboration and education was quickly adapted to create the Building Community Resilience Project.

This project was an extension of two long-standing Mount Sinai programs—the Multi-Faith Initiative on Community and Health (MICAH®) and Health through Early Awareness and Learning (HEAL). HEAL includes a program that trains the leaders of faithbased and community-based organizations to teach a health curriculum, including mental health, that incorporates discussions of faith and health. Adding to this, the Center for Stress, Resilience, and Personal Growth adapted its resiliency training program to include discussions of topics such as faith, hope, and self-care in the pandemic. A time-limited grant was obtained to support faithbased and community leaders in doing this important work. Taken together, these efforts reflect the DEI values of Mount Sinai, by keeping public health and systemic racial issues in the forefront of practice while addressing the needs of all people in the community, especially the most vulnerable.

A Defining Moment

MOMENTS OF CHANGE › CHANGING THE ROOM

Carol

R. Horowitz,

MD, MPH

Inaugural Dean for Gender Equity

Founding Director of the Institute for Health Equity Research

Icahn School of Medicine at Mount Sinai

Decades ago, women and many diverse people in medicine and research were not allowed in the room. Over time, we were allowed in, but had to work to fit in.

Then, a national movement of women in medicine, academia, and industry, said, ‘Enough is enough. We don't want to just be allowed in the room, we don't want to just fit in the room, we are going to change the room.’ There was sufficient data demonstrating the benefits of having a diverse workforce— and a groundswell of people building pathways by which all people could succeed—that change became possible.

At Mount Sinai, we changed the room. Over the last decade, we had conversations about the rooms we wanted to see, and how we wanted everyone to be treated. We created a policy banning ‘manels,’ all-male panels. We changed the way we recruit faculty. We identified and addressed barriers to academic advancement and expanded benefits for women and caregivers.

With deep support of senior leadership and outstanding initiatives developed by members of our Mount Sinai family, there has been a sea change in a very short time. Ten years ago, under 10 percent of department chairs and deans at Mount Sinai were women. Now, nearly 40 percent of chairs and more than half of deans are women. Together, we will continue to have conversations and take actions to ensure an inclusive, equitable future.

As of spring 2024, the unit had screened 5,500 patients— two-thirds of them Black men. Among those, nearly 20 percent had blood test results that required follow up, and cancer was eventually detected in 30 patients. About half had surgery at Mount Sinai, and all received follow-up on their testing and treatment.

“We are very excited about this initiative,” Dr. Tewari says. “We want to reach patients who cannot easily access a urologist, and we want to make it easier to screen for prostate cancer and treat them if necessary to save their lives.”

Institute for Health Equity Research (IHER)

In May 2020, Icahn Mount Sinai established the Institute for Health Equity Research to study and understand the effects of health issues, including COVID-19, affecting at-risk communities, including those that are nonwhite, low-income, immigrant, uninsured, and LGBTQ+ across all ages, genders, and abilities. The disproportionate impact of COVID-19 in underserved populations has highlighted the importance of rigorously studying disparities, and translating discoveries into sustainable, scalable initiatives and policies that benefit communities in New York City and the nation.

“Now that we have come through the worst of the COVID-19 pandemic, it is important that we thoroughly investigate all of the causes of its disproportionate impact on racial/ethnic minorities and vulnerable communities, which are layered on top of many longstanding, pre-existing health and health care disparities,” says Lynne Richardson, MD, Co-Director of the Institute.

The Institute studies the systems that have led to groups of individuals being disproportionately and unjustly affected by inequitable policies and practices that lead to excesses in illness, suffering, and death. Its researchers work collaboratively with an extensive network of patients, providers, payers, policymakers, and industry leaders to produce discoveries that translate into initiatives that impact real-world policy, systems, and environments.

“Health equity is the idea that everyone should have all of the resources needed to be healthy, including nutritious food, stable housing, safe places to play and exercise, good education, fair-paying jobs, clean air and

water, quality health care, and freedom from exploitation and racism,” says Carol R. Horowitz, MD, MPH, Director of IHER, and founding Dean for Gender Equity in Science and Medicine. “Progress toward health equity requires that the myriad causes of health and health care disparities be understood and addressed.”

Investing in Harlem

With more than 3,000 Mount Sinai employees living in Harlem, the Health System recognizes the importance of making core investments there for staff and patients alike. In May 2022, Mount Sinai opened the Mount Sinai-Harlem Health Center, an $80 million state-of-the-art facility at 124th Street in Harlem, bringing health care closer to where

MOMENTS OF CHANGE › RESEARCH AND POLICY

MOMENTS OF CHANGE ›

Lynne Richardson, MD

Founding Co-Director of the Institute for Health Equity Research

Professor of Emergency Medicine, and Population Health Science and Policy

The Institute for Health Equity Research was created to elevate health equity science to the same level as other important areas of science at Mount Sinai by creating a dedicated research institute, bringing together scholars who are experts in studying disparities and equity to accelerate the conduct of policy-driving, practice-changing, paradigmshifting research.

The Institute is unique within the academic realm in that it really focuses on all kinds of equity, and it is very much outward-facing. We study health equity in order to change the way things are. For example, we are conducting an NIH-funded, multicenter, five-year study investigating practice segregation in health care and the extent to which it affects the quality of care across New York City. Like all of our studies, this is designed not merely to discover new knowledge, it is intended to produce findings that will inform changes in policy and practice that will really make a difference for patients.

I'm very proud of the work that Mount Sinai has done in the equity space. I think the Road Map to Address Racism is resulting in landmark work being done across the Health System.

One of my proudest moments at Mount Sinai was when the Quality Leadership Council, which oversees all of the clinical care that is provided across the Health System, began to look at their quality metrics as a function of race, ethnicity, and language preference. This was the culmination of a concerted and intentional effort to embed the measurement of equity into the measurement of quality. And now, this is being done at the highest levels in this institution.

This is really pioneering work that Mount Sinai is doing, and I'm very proud to have been a part of it and to have the Institute for Health Equity Research support it.

The Mount Sinai-Harlem Health Center provides high-quality outpatient primary care, specialty care, and behavioral health treatment.

A Defining Moment

more Mount Sinai patients live and work. The new facility both combines and expands services for two Harlembased hospitals, Mount Sinai Morningside and The Mount Sinai Hospital, providing high-quality outpatient primary care, specialty care, and behavioral health treatment. The Center also offers programs specifically designed for the LGBTQ+ community and for people with chronic medical conditions, including HIV/AIDS. In addition, this site will be the home for the recently launched Diversity Innovation Hub, a unique community-driven incubator created to invest in health innovations that address social determinants for underrepresented populations, while increasing the capacity of minority and women entrepreneurs. (More details are on Page 86.)

Human Resources Initiatives

• Establishing Talent Review Committee to specifically promote internal diverse talent across the Health System

• Implementing a Direct Employer Platform that posts jobs to various websites to recruit diverse talent

• Hiring URM talent through building partnerships with local nonprofit organizations (20+ as of summer 2023)

• Bringing diverse talent through internship opportunities (e.g., Spring Forward CUNY internships, which are all paid opportunities)

• Conducting informational sessions for URM communities, exposing them to available roles/careers within health care,

To support staff in all settings, Mount Sinai instituted a policy to guide employees in responding to racist behaviors. The policy was created by a coalition of leaders, including, from left, Tamiesha Frempong, MD, MPH; Erica Rubinstein, Vice President of Service Excellence and Patient Experience; and Pamela Abner, Senior Vice President and Chief Diversity Operations Officer.

The policy is available to all staff as a pocket guide.

Pocket Guide

Responding to Racist and Discriminatory Behavior

with

Mount Sinai does not tolerate racist, biased, learners or trainees. You are not alone. First report the behavior to your supervisor. Suggested

A. “Please do not use that type of language as it is offensive to others and not acceptable at Mount Sinai Health System.”

B. “At Mount Sinai, we have a no tolerance policy for inappropriate or offensive behavior or comments. Please refrain from making such remarks.”

C. “We are committed to providing the very best care to all. Your behavior is preventing us from providing this care. We ask that you please stop (describe the behavior) so that we may help you to the best of our ability.”

D. Your comments have no place in this hospital. Our staff are well-trained and very capable of providing high-quality care; all are professionals and we expect that you will treat them with respect.”

A. “Our policy is to staff our hospitals with care providers without or discrimination based on race, ethnicity, religion, age, sexual orientation, gender identity or gender expression, disability any other bias. Our staff/learners/trainees are well-trained extremely competent.”

B. We will not make staff changes based on your request, which perceive as discriminatory. We treat all of our patients, staff, learners/trainees with respect, and we expect the same our patients.”

C. “Your request has been denied. You will continue to be cared (provider’s name). All of our staff are well-trained in providing highest quality of care.”

and training on how to succeed as a candidate

E. “You will be cared for by another clinician. Your current clinician is no longer comfortable treating you based on your offensive behavior/comments.”

D. Based on your behavior and/or discriminatory comments, specifically denied your staff change. However, we will you a new clinician because your current clinician is no comfortable providing you treatment.”

• Bringing recruiters to participate in career fairs for diverse talent, both remote and on-site events

• Establishing job search engine for veterans utilizing their military code

• Expanding the focus to recruit diverse talent by including veterans, people with disabilities, LGBTQ+, BIPOC, formerly incarcerated individuals, and domestic abuse victims to provide support to communities around hospital sites

• Launching youth mentorship program for the children of staff members to help them build skills for future workforce and assist internal staff with child care needs during summer months

• Training staff in “How to Create Gender Reaffirming Workforce” and “Unconscious Bias”

Responding to Racist and Discriminatory Patient Behaviors

Mount Sinai instituted a new policy to guide employees in responding to racist patient behaviors, with a focus on disrupting the harmful behaviors while supporting staff in both clinical and nonclinical settings. This policy was created by a coalition of administrators, physicians, and senior leadership, including Pamela Abner, MPA, CPXP, Senior Vice President and Health Equity Officer, Mount Sinai Health System, and Chief Diversity

Patient, family member, or visitor makes a discriminatory comment or uses profanity or abusive language toward a staff member or learner/trainee.

MOMENTS OF CHANGE › CALLING OUT RACISM

Erica Rubinstein, LCSW, CPXP Vice President, Patient Experience Mount Sinai Health System

I am very passionate about encouraging colleagues and patients to feel safe enough to call out behaviors that are racist and discriminatory in any way here at Mount Sinai. I think a defining moment for me was when I finally felt the courage to speak up in a meeting and call out an interaction toward a patient’s family member as 'racist'. It was challenging for the team I was speaking about to hear but it led to an important discussion that is still reverberating today in many forums. Most important, it stood out for me as a moment where it was necessary to call out something as 'racist' and to break the taboo against the use of this word. If we cannot name the issues that exist, they will never be addressed in a meaningful way. I continue to challenge myself and my team to identify these inequities as they come up, and to not shy away from them.

I also recall when we finally were able to get system approval for a stand-alone policy that addresses racist and discriminatory behaviors from patients and visitors. This policy came after years of staff requesting support in the wake of being targeted by various patients both verbally and physically. Following the murder of George Floyd, we came together as an interdisciplinary team to collaborate and create this policy as a way to support staff first and foremost when they are targeted. I am proud to say that the policy has gained quite a bit of traction, and our Talent Development and Learning Team has created a learning module to support our efforts. We have even had other groups create easy-to-reference cards with key information about the policy to have as a pocket guide.

Marsha SinananVasishta

DNP, MBA, MSN, RN, NEA-BC, CPXP

Operations Officer, Office for Diversity and Inclusion; Tamiesha Frempong, MD, MPH, Assistant Professor of Ophthalmology; and Erica Rubinstein, Vice President of Service Excellence and Patient Experience for the Mount Sinai Health System.

The policy formalizes a strongly held principle at the Health System—that hateful, discriminatory, racist, bigoted, or abusive speech or behavior is not tolerated—while also including a distinct focus on supporting staff members who are targeted and harmed by these behaviors. A printed pocket guide outlining the policy, and how to carry it out, was made available to the staff.

“This initiative was a year in the making, and we feel really good about the final product as both a way to help support the policy and share it with a wider audience, and also as reassurance for

A Defining Moment

employees to know that they have the support of the organization behind them to help respond to racist behaviors,” says Marsha Sinanan-Vasishta, DNP, MBA, MSN, RN, NEA-BC, CPXP, Vice President and Chief Nursing Officer of Mount Sinai Morningside and Mount Sinai West.

Supplier Diversity

Through a formalized partnership with a Minority Business Enterprise (MBE) consulting group, Mount Sinai’s supplier diversity program increases business and partnerships with underrepresented vendors, encourages nondiverse vendors to engage underrepresented businesses as subcontractors, and develops mentorship programs for empowerment.

Approximately $73 million was spent with underrepresented vendors in 2023 across the following categories: MBE, Women-Owned Business Enterprise, Veteran-Owned Business Enterprise, Disability-Owned Business Enterprise, and LGBTOwned Business Enterprise.

“With support from the Mount Sinai Health System’s supplier diversity initiative, underrepresented vendors are able to attain the necessary resources to compete in the market and potentially create more opportunities for people in marginalized communities,” says Carlos Maceda, Vice President and Chief Supply Chain Officer.

In February 2024, Mount Sinai held its inaugural Million Dollar Circle Recognition event—honoring 28 underrepresented vendors that each provided more than $1 million in products and services to the Health System in 2022 and 2023. Among the vendors honored were an Asian American-owned business that procured iPads for patients during the COVID-19 pandemic, a veteran-owned business that supplied crisis nurses during the pandemic, and a womanowned office furniture business that helped redesign health system spaces to support employee well-being.

Ms. Abner said that community vendors provide solutions through innovation and creativity in ways that would have been challenging for larger companies. She also noted how Mount Sinai’s relationship with local vendors helps New York City. Ms. Abner said, “By building community wealth, we build community health.”

A Mount Sinai supplier diversity initiative honored vendors at the inaugural Million Dollar Circle Recognition event in March 2024.

MOMENTS OF CHANGE › NURSING AND EQUITY

Kimberly T. Souffront, PhD, RN, FNP-BC

Assistant

Professor,

Emergency Medicine

Core Faculty, Institute for Health Equity Research

Associate Director, Center for Nursing Research and Innovation at Mount Sinai

As an emergency nurse practitioner and nurse scientist, I've long recognized health care inequities, predating the COVID-19 pandemic and George Floyd's tragic events, which brought them into sharp focus. As Associate Director of the Center for Nursing Research and Innovation, my mission goes beyond my own research on hypertension and health equity. It focuses on equipping nurses in the Mount Sinai Health System with the skills and knowledge to translate research into equitable clinical practice, thereby building research capacity for our critical health care foundation—our nurses.

Recently, I achieved a significant milestone by securing National Institutes of Health funding for a pioneering program, led jointly with my colleague Bevin Cohen, PhD, MPH, MS, RN. This initiative aims not only to enhance workforce diversity but also to provide comprehensive training to underrepresented Doctor of Nursing Practice (DNP) students in cardiovascular disease translational research and its integration into clinical practice. It uniquely addresses persistent health care disparities in heart, lung, blood, and sleep disorders.

When I think of health equity, I always think of a patient that I’ll call Mr. Williams. He was seen in an emergency department (ED) and treated for a simple laceration. As Mr. Williams was discharged, the provider noted that his blood pressure was very high, 186/100, and told him to follow up, which is consistent with national guidelines for patients in the ED who have hypertension, but no other pressing symptoms.

Well, this patient had a severe stroke three months after leaving the ED.

This is a perfect example of an inequitable health outcome that could have been prevented. Poor outcomes occur, despite clinicians 'checking the box', clinicians providing 'equal care' by adhering to policy or guidelines. This situation would have gone much differently if the clinician had asked about social determinants of health: Did Mr. Williams have transportation to follow up? Did he have a primary care physician to follow up? Did he actually have a history of hypertension, but couldn’t afford his medication?

Nurses are often the first and last people to see patients as they interact with the health care system. Nurses are well positioned to chart a path for health equity and save future patients like Mr. Williams who we encounter every day.

A Defining Moment

Engagement Events

Chats for Change is a series of one-hour virtual dialogues developed and led by Icahn Mount Sinai’s Racism and Bias Initiative. The sessions are built on the concept that, in order to respond to racism and be anti-racist, institutions and individuals must engage in dialogue, learning, and action. In 2022, Chats for Change expanded beyond Icahn Mount Sinai and conducted 51 systemwide Chats for Change sessions with more than 1,500 participants. Begun as an effort to encourage dialogue among the Icahn Mount Sinai community, Chats for Change is being adopted as a model by other schools around the nation.

One notable session was “Equity Lens—How Does It Work,” a discussion of how, why, and when to use an equity lens, a tool designed to help decision-makers and teams focus on equity in both their processes and outcomes.

In an October session in honor of Hispanic/ Latinx Heritage Month, participants explored the intersectionality of Spanish language/culture and

interactions between physicians and patients in the United States. In this discussion, participants took a closer look at the treatment of Hispanic patients in clinical settings and provided tools on how to be a better advocate for patients from different backgrounds.

Conversations With Leaders

—In June, Women in Information Technology at Mount Sinai and the Office for Diversity and Inclusion held a conversation with Angela Diaz, MD, PhD, MPH, then Director of the Mount Sinai Adolescent Health Center—one of the nation’s largest adolescent health centers—about her unique professional journey from being a former patient of the Center to leading it. It was one of a continuing series of conversations in which Health System leaders shared their personal and professional journeys with staff at the Corporate Services Center.

Hope in Harlem —Icahn Mount Sinai was a proud sponsor of this free in-person conference in May 2023, which brought together nationally recognized experts and community partners to share best practices around innovative mental health services in Harlem and the surrounding New York City area with

Lena Green, Director of the HOPE Center, and Sidney Hankerson, MD, MBA, Director of Mental Health Equity Research at Mount Sinai, spoke at Hope in Harlem.

the aim of building bridges between community-based organizations and hospital-based services to strengthen culturally inclusive care for vulnerable populations.

Let’s Connect —Launched in May 2023, Let’s Connect is a series of discussions to inform and educate the community on how Mount Sinai is promoting and fostering an equitable and anti-racist culture across the Health System. Each session will allow attendees to learn about the progress of our Road Map for Action to Address Racism and provide an opportunity to engage in meaningful discussion, offer feedback, and voice perspectives. In the first session, Pamela Abner, Vice President and Chief Diversity Operations Officer, engaged in an open conversation with Mary-Frances Winters, Chief Executive Officer of The Winters Group, to better understand resistance and the importance of racial justice to advance our system’s anti-racism efforts. More than 150 people registered to attend the event.

Chats for Change is a series of one-hour dialogues on antiracism issues. It was featured in October 2020 on Good Morning America

financial empowerment, leadership, and literacy for Latina women.

Our Seat at the Table —The Corporate Services Center Diversity Council and Heritage of Latinx Alliance Employee Resource Group spearheaded a panel discussion in honor of Women's History Month in March. The discussion focused on driving

Reflections of Healing and Hope —This event in June 2022 brought together members of the Black Leaders Advocating for Change and Community (BLACC) Employee Resource Group and staff from across the Health System to reflect on recent racial and ethnic tragedies and to exchange stories of strength and resilience. The discussion included how the group is building a coalition of Black leaders at Mount Sinai to guide and support employees of color and the need to be “patient yet stern” in pushing for structural change.

Three young participants at Hope in Harlem, a free conference that brought health information to the community.

A Defining Moment

The Road Map for Action Bulletin

Shawn Lee and Angela Diaz, MD, PhD, MPH, are the voices of the systemwide Bulletin email read by an average of 23,000 members of the Mount Sinai community each month. These Bulletins discuss important and timely topics in health equity, serving as a channel to inform and to reaffirm Mount Sinai’s commitment to the Road Map for Action to Address Racism. Two years after the first Bulletin appeared, Shawn and Angela sat down to reflect on their work so far and answer a few questions about themselves and the Road Map.

What is one adjective to describe the goals of the Road Map?

Shawn: Difficult. Angela: Inspirational.

What are your roles and responsibilities at Mount Sinai and on the Road Map team?

Shawn: As a member of the Central Billing Office management team, I’m responsible for contract compliance, and I’m a liaison for managed care issues in partnership with our Mount Sinai Health Partners Independent Practice Association. As a member of the Road Map team, I collaborate with a wonderful team of like-minded individuals who craft insightful bulletins that continue to inspire engagement throughout the Mount Sinai Health System.

Angela: I am Dean of Global Health, Social Justice, and Human Rights; the Jean C. and James W. Crystal Professor in Adolescent Health, and Professor of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai. With regard to the Road Map, I am a member of a team that brings together and communicates important issues related to Mount Sinai’s efforts to address inequities and further health equity. Mount Sinai community members often send Shawn and me questions or comments they have after reading the Road Map for Action Bulletins. In that sense, we are responsive to its readership and

help facilitate the resulting conversations.

If you had to describe what the Road Map is to someone in a short elevator ride, what would you say?

Shawn: Mount Sinai’s blueprint to building a culture of inclusiveness and equitable pathways through an anti-racist lens for all students, faculty, and the patients we serve.

Angela: The Road Map is Mount Sinai’s inspirational and transformative effort to create an equitable institution that works for all of our community and is responsive to its needs at all levels.

How would you describe the other members of the Road Map team?

Shawn: Dedicated to the process of learning and growing.

Angela: They are very passionate and creative people with a deep understanding of issues related to inequity. They are committed to finding solutions, communicating their efforts effectively, and being responsive to input.

Road Map for Action Bulletins deployed

Average deployed Engagement rate 48,332 44% 75

as of October 2024

Why is the Road Map important?

Shawn: The Road Map is important because it’s requiring us, as a system, to turn the mirror around on ourselves and examine all areas of our operation and acknowledge the improvements that need to be made, which in turn can be very difficult to accept.

Angela: The Road Map is important because it shows that all of us at Mount Sinai, including leadership, have the courage to address these very important issues using an anti-racist lens and highlights the great outcomes of the work.

What role do you think the Bulletins play in the larger goals of the Road Map?

Shawn: I think the Bulletins help make our system seem a bit smaller by connecting our Mount Sinai family with not just the initiatives that support the Road Map, but also with each other. Individuals who you’ve probably never heard of are being introduced, right to your email. Bulletin printouts are right at your fingertips in break/huddle rooms for those who may have limited or no access to emails. All of this supports the larger goal of keeping everyone informed and aware of how to get involved on all things Road Map related. Angela: The Bulletin communicates the amazing work that

Road Map leaders and teams are doing in a timely way. The Bulletins are short, easy to digest, and personable; they bring the audience in so they understand that they are a part of these efforts and that we are doing this work together. No one who wants to be a part of the Road Map is left behind.

What was your favorite Road Map for Action Bulletin and why?

Shawn: The afternoon of August 19, 2021, will forever remain in my memory. Nothing beats the first broadcast that was the introduction to the Road Map strategies. After we did the Road Map Town Hall in May 2021, it was important to keep the momentum around this work vibrant throughout the system, and the Road Map for Action Bulletin has been a key part of that.

Angela: I couldn’t choose just one; all of the Bulletins work together to create a more complete picture of the Road Map and how Mount Sinai continues to work toward equity from many different angles. Each Bulletin speaks to a different issue, ensuring that the work reaches and resonates with a wider range of people.

Learn more about the Road Map for Action to Address Racism in a special report in the journal Academic Medicine.

› A research article, describing the Road Map for Action to Address Racism and Mount Sinai’s success in unifying and systematizing anti-racism efforts across the Health System, was published in June 2023.

The Way Forward

From left: Marta Filizola, PhD, Dean for the Graduate School of Biomedical Sciences; Ann-Gel Palermo, DrPh, MPH, Senior Associate Dean for Diversity, Equity, and Inclusion; Leona Hess, PhD, MSW, Co-Director of the Institute for Justice and Equity in Health Sciences Education; Jay Johnson, education program manager, and David Muller, MD, Director of the Institute for Justice and Equity in Health Sciences Education.

In a complex and changing world, the people of the Mount Sinai Health System continue to work intentionally on recruiting, educating, and retaining a diverse workforce.

The Way Forward

The year 2020, in myriad ways, was a dividing line between past and future, before and after. The COVID-19 pandemic caused untold death and suffering and brought health disparities into sharp relief. And in May 2020, the killing of George Floyd prompted a nationwide trauma and call for individuals, organizations, and companies to take action in addressing societal injustices that affect historically marginalized groups.

In the years since, Mount Sinai, like the rest of the nation, has been working out how the future should look. On a national level, the future carries echoes of the past, reopening issues debated decades ago.

In June 2023, the Supreme Court struck down affirmative action in college admissions, declaring race cannot be a factor in admission decisions, forcing institutions of higher education to look for new ways to achieve diverse student bodies. The potential implications of that decision are expected to extend beyond higher education. Soon after it was delivered, the governors of both Florida and Texas targeted diversity, equity, and inclusion initiatives, limiting their funding and their authority, and some states banned workplace affirmative action.

This is the world in which the people of the Mount Sinai Health System continue to work intentionally on recruiting, educating, and retaining a diverse workforce, and providing high-quality and equitable health care for all.

“The Supreme Court’s recent decision introduces new obstacles in addressing health inequities and ensuring our health care workforce reflects our patients’ diversity,” Ann-Gel Palermo, DrPH, and Gary Butts, MD, said in the Mount Sinai Road Map to Action Bulletin.

“We want to reiterate that Icahn Mount Sinai, like all of the Mount Sinai Health System, remains unwavering in its commitment to the fundamental principles of diversity, equity, inclusion, and anti-racism,” they said. “These principles form the foundation of our excellence, innovation, and entrepreneurship, aligning with our vision to provide health care, education, and groundbreaking scientific advancements that are free from racism.”

Dr. Butts, Dr. Palermo, and many committed leaders at Mount Sinai have been in this space in history before. They have listened to the demands of frustrated and angry protesters. They have witnessed instances of backlash that followed the expansion of diversity work. Yet they have also seen the remarkable changes that have come from persistent work by ordinary people who seek to optimize health care for everyone.

Dr. Butts says he often thinks about a time when it was very uncomfortable to even mention the word “race” at a hospital or in the halls of a medical school.

“Earlier, when I was an intern and starting out as a physician, if you mentioned the term 'race', you were looking over your shoulder,” he says. “The fact that we can talk about race and racism relatively publicly, with some degree of comfort, is something you cannot measure.”

Of diversity, equity, and inclusion work, Dr. Palermo says, “There is no destination about being anti-racist. You don’t get there. It is a journey with no destination. The work will never, never be done, because there is so much to unlearn and undo.”

Nevertheless, Mount Sinai is continuing to develop and support a multitude of initiatives and programs that are pushing the way forward:

Administrative Fellowship Program

Mount Sinai has had extensive programs and initiatives to increase Black, Indigenous, and people of color (BIPOC) representation among physicians and faculty for decades. In recent years, however, an honest analysis of BIPOC representation among corporate and administrative leadership showed that the Health System needed to do more to assure that staff were also able to move up the ladder into these roles. Among the initiatives developed to address this disparity was the Administrative Fellowship

Fellowship alumni at the Aspen Ideas Festival in 2023, with Anthony Fauci, MD, former Chief Medical Adviser to the President. From left, Loudmila Hassan, MHA, Senior Manager, Quality and Specialty Excellence, Population Health, Mount Sinai Health Partners; Lenjo Kilo, MHA, PMP, Administrative Manager, Operations, Mount Sinai Doctors; and Oladapo Durojaiye, MS/HSA, MPH, Director, Patient Training Access and Revenue Enhancement, Mount Sinai Morningside and Mount Sinai West; and another festival attendee.

Program, a two-year leadership development program for master’s-prepared students of traditionally underserved backgrounds in health care leadership.

Created and managed by the Mount Sinai Health System’s Office for Diversity and Inclusion (ODI), the program launched in 2015 with support and guidance from Human Resources and executive and senior leadership. The goal of this innovative program is to recruit, develop, retain, and promote participants into leadership roles within the organization by providing participants, known as administrative fellows, with an intensive, accelerated managerial learning experience. Administrative fellows complete departmental rotations and projects in operations, ambulatory care, financial planning, resource allocation, data analytics, and patient experience, among other corporate functions;

attend educational conferences and webinars to hone business acumen; and receive mentorship from senior hospital leadership and corporate preceptors.

Fulfilling the mission and promise of the program, administrative fellows graduate and move into fulltime managerial positions at Mount Sinai, including director, administrative director, senior manager, administrative manager, and administrator roles, and are poised to be promoted in the future. As of spring 2024, 24 administrative fellows completed the program, with five preparing to graduate and three moving into their second year. Among the alumni, 11 are still currently employed with the Health System; six have received promotions and/or transitioned into new leadership roles within the past two years. “Every leader in this organization is genuinely interested

Administrative

The Way Forward

MOMENTS OF CHANGE › MENTAL HEALTH IN HARLEM

I experienced a positive moment of change in diversity, equity, and inclusion the minute that I came to the Health System, in 2022. We received tremendous support from the administration to create a formal partnership with the Hope Center in Harlem, which is a community mental health clinic affiliated with First Corinthian Baptist Church. At the Hope Center, we now have a rotation for fourth-year psychiatry residents to provide high-quality psychiatric treatment—free of charge. This really addresses the issues of limited access to care that contribute to treatment disparities that communities of color have experienced for decades. The Mount Sinai-Hope Center initiative is a striking example of diversity, equity, and inclusion.

Sidney Hankerson, MD, MBA

Associate Professor and Vice Chair, Department of Psychiatry; Director of Mental Health Equity Research, Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai

in your growth and development,” says former fellow Oladapo Durojaiye, MS/HSA, MPH, Director at Mount Sinai Morningside and Mount Sinai West. “The fellowship provided us an opportunity to build relationships and leverage our resources.”

Anti-Racist Transformation in Medical Education (ART in Med Ed)

In 2021, with a grant from the Josiah Macy Jr. Foundation, Icahn Mount Sinai established the Anti-Racist Transformation in Medical Education initiative, a coalition with 11 other North American medical institutions. Collectively, the medical institutions work to transform the landscape of medicine through initiatives that stop the perpetuation of racism in medical education.

Dismantling racism in medical school settings requires a strategy that is broadly transformative, ongoing, peopledependent, and responsive to the world around us. Like all American institutions, medicine has been shaped by a legacy of racial injustice. In recent years, medical schools have begun efforts to tackle this deeply ingrained reality, most focusing largely on curriculum, recruitment strategies, and unconscious bias training, actions that fall short of addressing systemic racism.

Through an interactive virtual learning platform, participating medical schools will establish and maintain their capacity for transformational change, while building a community of practice within and across participating schools. Students, staff, and faculty will engage in experiential learning, assessments, outcome and performance monitoring sessions, and coaching, allowing them to move beyond knowledge transfer to change that is systemic and adaptive.

In 2021, ART in Med Ed officially welcomed its 11 inaugural schools:

• Brody School of Medicine, East Carolina University

• College of Medicine, University of Saskatchewan

• Columbia University Vagelos College of Physicians and Surgeons

• David Geffen School of Medicine at the University of California, Los Angeles

• Duke University School of Medicine

• The George Washington University School of Medicine and Health Sciences

• The Ohio State University College of Medicine

• University of Arizona College of Medicine - Phoenix

• University of Minnesota Medical School

• University of Missouri-Columbia School of Medicine

• University of the Incarnate Word School of Osteopathic Medicine

Biomedical Laureates and Junior Laureates Program

The Mount Sinai Biomedical Laureates Program is designed to increase the number of Black and Latinx research faculty at Icahn Mount Sinai and support with strong mentoring their growth as investigators and as leaders. Biomedical Laureates and the companion Junior Laureates Program were launched in January 2021, and announce new Laureates annually.

The Biomedical Laureates Program underpins larger institutional efforts to drive diversity among faculty. The program is administered through the Dean’s Office of Icahn Mount Sinai and through the Institute for Health

Equity Research (IHER). The program is among the first of its kind in the country dedicated to the enhancement of diversity among senior research scientists at an academic medical center.

The Laureate is selected based on the candidate’s scientific track record and future promise as a leader in academic medicine. Candidates undergo a rigorous review by a committee of senior researchers from across the institution. Selected Laureates are given a competitive startup package based on scientific and professional development needs, which includes five years of salary and support. Two Biomedical Laureates are selected each year, one in basic science, the other in translational or clinical science. The Junior Laureate

Center for Scientific Diversity team members, from left: Jamila Sly, PhD, Kirk Campbell, MD, Uraina Clark, PhD, and Emma K.T. Benn, DrPH, MPH.

The Way Forward

Program seeks candidates who have completed their doctoral degrees. Junior Laureates have the opportunity to develop their own independent research program as a member of an existing research team. Upon completion of research milestones, the Junior Laureate transitions to a Mount Sinai Biomedical Laureate position and benefits package. Two Junior Laureates are selected each year, again one in basic science, the other in translational or clinical science. Laureates are mentored and guided by an advisory group of diverse leaders in science and medicine.

Icahn Mount Sinai expects that in five years these programs will add 20 Black and Latinx scientists to the faculty, fundamentally changing the basic and clinical research landscape at Mount Sinai. Increasing research faculty diversity at Mount Sinai will provide a critical mass of role models and mentors to foster the recruitment and retention of students, fellows, and other junior investigators from these underserved groups, planting the seeds for further diversity in future years.

Center for Scientific Diversity (CSD)

This is an initiative of the Dean’s Office and the Department of Population Health Science and Policy, founded to increase the research success and equitable advancement of diverse faculty investigators and trainees in academic medical centers nationwide. The Center was founded by Emma K. T. Benn, DrPH, MPH, Associate Professor of Population Health Science and Policy at Icahn Mount Sinai. It has served as an “incubator lab” to identify research-driven strategies that will increase the research success and advancement of diverse faculty and support the pathway of underserved trainees in the biomedical research workforce.

The Center brings together voices and talents across multiple academic departments with the shared goal of developing and implementing best practices for diversifying the biomedical research workforce while promoting a transformative culture of inclusive excellence.

CSD has as its mission: Increasing both the diversity of the clinical investigator workforce and the research success of underserved investigators. The CSD team focuses on departments with expertise in biostatistics,

basic science, behavioral psychology, community psychology, epidemiology, medicine, neuropsychology, neuroscience, inclusive excellence, research capacity building, and health disparities research.

CSD seeks to foster an academic culture of inclusive excellence in which diverse members of the research workforce, inclusive of faculty and trainees, can thrive. This is accomplished through synergistic, collaborative activities governed by three foundational pillars: research, advocacy, and training and enrichment.

DEI Academy

The DEI Academy serves as a central hub for the development and advancement of learning opportunities that build the capacity of members of the Mount Sinai community to embrace the principles of diversity, equity, and inclusion as key drivers for excellence and innovation. It aims to:

• Expand awareness of behaviors and practices that perpetuate racism and bias in the work and learning environments.

• Equip participants with tools, strategies, and resources to mitigate racism and bias and promote DEI.

• Inspire ongoing learning in content areas related to diversity, equity, and inclusion.

Mount Sinai faculty, staff, and trainees can access the DEI Academy through the PEAK online platform and do the following:

• Request an in-person or virtual learning opportunity by completing the “Educational Offering Request Form.”

• Complete online learning modules on foundational DEI topics, including:

- Cultural Awareness

- Everyday Bias for the Health Professions

- Microaggressions

- Race and Ancestry

- The Words You Use

• Access the complete DEI online learning course catalog, which includes education to enhance the collection of patient demographic data and provide best practices to care for patients with disabilities and who are part of the LGBTQ+ community.

MOMENTS OF CHANGE › A

LEADER

LISTENED

Emma K. T. Benn, DrPH, MPH

Founding Director of the Center for Scientific Diversity

Principal Investigator, NIH FIRST Associate Professor of Population Health Science and Policy Icahn School of Medicine at Mount Sinai

I can think back to late 2018, maybe early 2019, when Dean Charney came to our department to do a listening session, and was talking about a host of new initiatives. I remember we discussed the institution's commitment to artificial intelligence and creating a new Institute, and then I remember him briefly mentioning something about diversity, equity, and inclusion. And I said, 'Maybe this is a time to speak up.' I had been thinking a lot about how in my field of biostatistics, I've always been aware of the lack of diversity, and have always strived to create a culture that is inclusive. But when I arrived in academic medicine, about 12 years ago, I was aware that there were many faculty who were diverse, but I wasn't seeing as many advancing as successful researchers or as institutional leaders.

So in this room, with everyone in my department, I raised my hand and I said, ‘Dean Charney, you mentioned that the institution is committed to diversity, and I don't think that this is just a problem within our institution, but I don't see enough commitment. I can count on two hands, probably, the amount of Black researchers in the investigator track at our institution.’ And he said, ‘Maybe it's a problem of the pool,’ and I said no, because I'm here, and I know we exist, so I think there's a bigger problem.

Instead of moving on to the next topic of discussion, the Dean asked me to meet with him to think about how Mount Sinai could more effectively address this problem. I actually met with the Dean multiple times, and he really encouraged me to not just call attention to the problem, but to approach finding the solution in the same manner I would approach any complex biomedical challenge as a scientist and biostatistician.

Now, as Founding Director of the Center for Scientific Diversity, which includes scientists, innovators, and thought leaders from neuropsychology, community psychology, epidemiology, nephrology, behavioral science, biostatistics, and computer science, I can say that we're all here, and we are really trying to evaluate what works. We now have the NIH FIRST initiative, for which the Center has been the driving force, consisting of a $16 million grant from the National Institutes of Health and an equivalent institutional investment to not only transform the demographic landscape of the biomedical research workforce but to also promote and sustain an academic culture of inclusive excellence, driven by research.

At that listening session years ago, the Dean could have easily said, ‘Thank you for your concern, let's move on.’ He could have brushed aside what I said, or he could have gotten defensive. But in that moment, he said, ‘Well, what do you think is the problem?’ And to be empowered, to be able to say there's a problem and to have your institutional leader want to hear what you think should be done—that was an important moment for me.

The Way Forward

Participants

Diversity Innovation Hub (DIH)

Launched in 2019, DIH is a special initiative of the Mount Sinai Health System’s Office for Diversity and Inclusion. The initiative aims to facilitate and accelerate the participation of women and people of color in the health tech space, innovate the practice of diversity, and advance innovation and equity in academic medicine and health care. The mission of the DIH is to initiate, accelerate, and launch innovative solutions to address social and structural determinants of health that perpetuate disparities in health and health care.

DIH recognizes that the lack of diversity in tech is actually worsening health outcomes. When local community needs are not understood, health disparities are perpetuated. DIH is a unique community-driven incubator that tackles social determinants of health-driven disparities. The initiative focuses on three pillars:

• Pipeline: The Office for Diversity and Inclusion invests in the community by using technology and design thinking to address social determinants of

health. This investment includes supporting startup founders who are women and other individuals underserved in science and medicine with capital and mentorship.

• Partners: DEI in Health Tech – This initiative accelerates the work of diversity and inclusion in health care technology. Health tech partners are coached on bestfit diversity practices and have access to well-rounded diverse talent.

• Fellows: Creating Partnerships – This program focuses on creating capacity for people of color and women in the innovation space. Students are awarded fellowships to partner and work at health tech startups.

The vision of DIH is to help eliminate disparities in health and health care and to provide economic opportunity by creating solutions with community members through technological innovation, entrepreneurship, and design. To fulfill this vision and create a future drastically different than today, DIH created the DIH Pitch Day, Incubator, and Fellows programs, each of them a way to invest in earlystage entrepreneurs who are on a mission to address social determinants of health.

in the Diversity Innovation Hub Pitch Day in September 2023.

Diversity in Neuroscience

The goal of Diversity in Neuroscience (also referred to as DiverseBrains) is to support highly innovative and productive research in basic, translational, and clinical neuroscience by promoting an exciting, equitable, diverse, and inclusive environment that empowers all members of the Mount Sinai community to contribute to scientific discovery and clinical translation. The goal is to generate an environment that fosters creative approaches to fully understand brain and nervous system function and develop therapies and cures for disease and eventually preventive measures. The initiative is committed to listening to and learning from the many diverse voices of the community in order to remove barriers to opportunities and success for everyone.

One component of this effort is Mentoring in Neuroscience at Sinai (MiNDS). And a signature event each spring is the Brain Awareness Fair, hosted by MiNDS and the Center for Excellence in Youth Education, with support from The Friedman Brain Institute at Mount Sinai. More than 100 volunteers from the Mount Sinai Health System and 500 local students and members of East

Harlem and surrounding communities participated in the 2024 Brain Awareness Fair at The Mount Sinai Hospital, which included educational hands-on activities and demonstrations that included building neuron models out of pipe cleaners, examining models of brains from different animals, and learning how the five senses function within the brain.

“Over the last 10 years, we have seen a large increase in the number of women who have entered neuroscience, and are beginning to see at long last a significant increase in the number of senior women faculty and the number of women in leadership, both at Mount Sinai and nationally,” says Eric Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, Dean for Academic Affairs, and Chief Scientific Officer. “The situation is at earlier stages for people from underserved groups. We realize that we can’t solve all of society’s problems, however, the goal is that perhaps we can serve as a template of what short-term measures can be taken to drive further progress, and in the long term, we want to see the neuroscience workforce reflect the full diversity of our nation.”

Young students take part in an educational activity at the Brain Awareness Fair in March 2024.

Diversity, Equity, and Inclusion Summit

In October 2023, the Health System held its first inperson DEI summit since the start of the COVID-19 pandemic. The event, titled “Taking Action for Equity and Justice,” was organized by the Office for Diversity and Inclusion in collaboration with stakeholders across the Health System.

“This summit was a celebration of our commitment to DEI and a recognition of efforts to address racism at all levels, advocate for marginalized peoples, and treat all people with humanity and respect,” says Pamela Abner, MPA, CPXP, Senior Vice President and Health Equity Officer, Mount Sinai Health System, and Chief Diversity Operations Officer, Office for Diversity and Inclusion.With attendees and speakers from all corners of the Health System, the event offered a platform for the community to come together to reflect on antiracism efforts, with sessions on subjects including digital health equity, environmental racism, supplier diversity, and Mount Sinai’s overall mission in becoming a safe, equitable, and anti-racist health care and learning institution.

“From the panel discussions to the advancements we are making in inclusive medical illustrations, it was fascinating to hear from all of the speakers,” says

attendee Andres Moreira, MHA, Senior Director, Patient Experience and Patient Relations, and Mount Sinai West Diversity Council Co-Lead. “It truly was humbling to learn about all the work that is happening to advance diversity, equity, and inclusion at Mount Sinai and the work we are all collaboratively doing to support and be leaders in this space.”

Environmental, Social, and Govern ance (ESG)

ESG is a framework used to assess an organization’s business practices and performance on various sustainability and ethical issues. While sustainability, ethics, and corporate governance are generally considered to be nonfinancial performance indicators, the role of an ESG program is to ensure accountability and the implementation of systems and processes to manage a company’s impact, such as its carbon footprint and how it treats employees and suppliers. Over decades, America has witnessed that one’s zip code can define health outcomes and predict life expectancy. Across the country and globally, residents of vulnerable communities have been and continue to be victims of environmental racism due to existing structures and practices in place and the lack of resources stemming from social determinants of health and political and economic disenfranchisement that result in disparities between communities. In addition to Mount Sinai’s ongoing sustainability

efforts to reduce greenhouse emissions, eliminate waste, and address the depletion of resources, the health system recently signed on to the federal government’s Health & Human Services Climate Change Pledge. As part of this commitment, system leadership acknowledges and embraces ESG as a framework to understand the need and influence health and safety issues in communities at disproportional risk of climate-related harm. Through the Office for Diversity and Inclusion’s long-standing commitment to working with young people from marginalized and vulnerable communities, Mount Sinai is uniquely prepared to address these inequities and, as a result, launched the Youth Advocacy Program to Address Climate Change and Environmental Racism in 2023.

Hazel Rogers, MPH, Assistant Director, Office for Diversity and Inclusion, has managed the program since its inception and has been the driving force behind its development and success. “From forging relationships with faith-based organizations to recruiting and mentoring students, she has had a lasting impact, empowering participants to make a difference in their communities,” Ms. Abner says. Launched as an eight-day program over three weeks in the summer and hosted in partnership with Mount Sinai’s Department of Spirituality and Health and several faith-based organizations, high school participants in the Youth Advocacy Program attended sessions facilitated by Mount Sinai faculty and ODI staff to:

Students in the summer 2023 session of the Youth Advocacy Program to Address Climate Change and Environmental Racism.

Hazel Rogers, MPH, Assistant Director of ODI, has led the Youth Advocacy Program since its inception.

• gain an understanding of the intersection of climate change and health;

• increase their critical thinking on climate change and the effects of social determinants of health;

• learn to analyze data and present their findings on actionable solutions; and

• take concrete steps to become future transformational leaders in climate action.

“Because of this program, I feel empowered to go out and encourage and motivate other people around environmental justice,” says Imani, a youth advocate who attended the summer program. “I feel like our environment should be cared for more, and if people know about it, more people can do something about it.”

Icahn Mount Sinai Pathway Programs

• The Summer Undergraduate Research Program for Underserved Scholars (SURP4US) is for college students interested in the biomedical sciences who are socioeconomically disadvantaged and/or have limited access to hands-on research opportunities. Students spend the summer in the laboratory, engage in supervised research, and participate in exciting, hands-on projects in one of the PhD training areas.

The Way Forward

• The Advanced Certificate in Public Health is a 15-credit hour program completed within one year. Students choose from three concentrations of study: General Public Health, Global Health and Outcomes Research.

• The Clinical Research Training Program is a oneyear certificate program that focuses on core work in biostatistics and epidemiology, and does not require the second-year research seminars and thesis required of master’s students.

• The Post-Baccalaureate Research Education Program (PREP) provides support and guidance to post-baccalaureate students with a passion for research. The goal of the program, as defined by the National Institute of General Medical Sciences, is to develop a diverse pool of well-trained postbaccalaureates who will transition into and complete rigorous, research-focused doctoral degree programs in biomedical fields.

• With the MERRIT , (the Multidisciplinary Engineering and Renal Research for Innovation of Technology) Fellowship, Icahn Mount Sinai collaborates with The Cooper Union to offer a training program for engineering students to promote advances in the development of new technologies and therapeutics for treatment of kidney disease. This 10-week, paid summer undergraduate research program pairs engineering students with one of the 17 kidney research labs in the Division of Nephrology. The goal is to create solutions for people who suffer from kidney disease by connecting engineering students to the top talent in the field of nephrology and preparing them with the knowledge needed to make meaningful contributions.

Institute for Equity and Justice in Health Sciences Education

In October 2023, the Institute for Equity and Justice in Health Sciences Education was established to expand upon Icahn Mount Sinai’s efforts to be an anti-racist, anti-biased learning and training environment in medical and graduate education.

At the Institute, the goal is to enable medical and biomedical educators, across disciplines and health professions, to recognize and disrupt racism, bias, and oppression. The Institute provides learning opportunities to accelerate anti-racist and anti-biased transformational change in educational programs through systems change, strategic planning, and priority setting. It also serves as a national resource for consultation and best practices.

NIH FIRST Cohort

This Icahn Mount Sinai initiative is funded by a $16 million grant from the National Institutes of Health (NIH) to foster inclusive excellence in the biomedical sciences using evidence-based approaches. The NIH Faculty Institutional Recruitment for Sustainable Transformation (FIRST) award fuels a multi-institution effort to identify and implement new strategies to recruit faculty members from groups underserved in medicine by supporting faculty development, mentoring, sponsorship, and promotion.

Panelists at Mount Sinai’s Diversity, Equity and Inclusion Summit in October 2023, from left: Kenneth L. Davis, MD, Dennis S. Charney, MD, Lynne Richardson, MD, Kirk Campbell, MD, and Sherria McDowell, MPH.

CHANGE

MOMENTS OF CHANGE › BILLING, WITH AWARENESS

Shawn Lee Director of Operations Central Billing Office

The School aims to recruit and hire 12 faculty members from underserved groups across four research areas and institutes: The Friedman Brain Institute, the Institute for Health Equity Research, The Tisch Cancer Institute, and the Global Health and Emerging Pathogens Institute. Progress has been outstanding, with recruitment of 11 of the 12 faculty hires already finalized, Dr. Nestler says.

Icahn Mount Sinai is working closely with several other leading institutions that also receive FIRST grant funding. Morehouse College, an established partner of Icahn Mount Sinai, serves as the Coordination and Evaluation Center for the FIRST grant.

In 2016, when I first joined the Heritage of Latinx Alliance (HOLA) employee resource group, I was exposed to so much that the Mount Sinai Health System had to offer in diversity, equity, and inclusion efforts. But when I would talk about this with colleagues in the billing department, they had no idea what the Office for Diversity and Inclusion was. In that moment, it triggered a motivation to bring awareness to our staff, but I had to be strategic about it because diversity was not a focal point in our department at the time.

Billing for gender-affirming surgery—known as transitional surgery in our paperwork—presented a unique opportunity to bridge the gap between what we do on a day-to-day basis and DEI. Our staff saw a significant amount of denials by insurers, and couldn’t figure out what was going on. Through my networking in ODI events, I met a billing specialist who was knowledgeable in transitional surgery billing, so we were able to hold four sessions in two days where the staff was able to learn tips and tricks on how to appeal these denials.

This session not only brought awareness of health equity to HOLA ERG members, but it sparked an interest in our staff to ask more questions and get more involved in the diversity events we hosted.

Icahn Mount Sinai’s involvement in the NIH FIRST initiative builds upon the institution’s earlier groundwork to address faculty diversity, most notably, the Biomedical Laureates Program. This Program was one of the first in the United States that sought to hire new research-intensive faculty across all areas of biomedical sciences who are from underserved communities. The Laureates Program, too, has been highly successful.

“What we know from studying the careers of underserved groups in academic medicine is that our strategies on an individual level can be successful, but to drive a level of change that is institutional and systemic, we need an approach that is integrated and broad,” says Dr. Nestler.

The Way Forward

Office for Diversity and Inclusion

Pathway Programs

The three units within ODI annually partner with academic institutions and community-based and national organizations to provide educational, learning, and internship opportunities for students in middle, high, undergraduate (college), graduate, and medical school. Through these programs, ODI exposes students to the diverse career pathways in health care while offering the tools, skills, and knowledge necessary to succeed in the health care industry. Brief summaries of the specific program offerings in each unit are detailed below.

Center for Excellence in Youth Education (CEYE)

• Academic-Year Middle School Program

- Day-With-a-Scientist: Full-day immersion experiences orienting eighth grade students to a different major organ during each session.

- Neuroscience 101 with MiNDS (Mentoring and Discovery at Sinai): Partnership with P.S. 171 through which Mount Sinai graduate students and post-docs teach lessons throughout the school year. Students are invited to participate in the annual Brain Awareness Fair in March.

• Academic-Year High School Programs

- Biomedical Science Enrichment Program: Twoyear program for juniors and seniors attending the High School for Math, Science, and Engineering offering lab skill preparation in the field of biotechnology in Year 1 and clinical and laboratory internship in Year 2.

- The Lloyd Sherman Scholars Program: Two-year research preparation program geared toward high school-aged boys belonging to groups that are underserved in medicine that offers classroom and laboratory training in DNA and technology.

• Summer Programs

- Internship Placement Hospital Placement: In-person summer program designed to expose current eleventh grade students to health careers through a hands-on internship in a single department within the health system. Dr. Mmen: Doctors Reaching Minority Males Exploring Neuroscience: Summer mentorship program for Black and Latino young men in high school that includes clinical immersion within neurosurgery and related fields; partnership with the Mount Sinai Department of Neuroscience.

Veterinary Sciences: Internship-based program designed to expose high school students to veterinary sciences in a biomedical research environment while enhancing their basic science knowledge and language skills.

- Introduction to Bioinformatics: Summer online course designed to teach high school students the basic concepts of cellular and molecular biology, genomic science, and computer programming.

- Medical and Scientific Exploration Program: Summer online course is designed to guide students through different laboratories and clinical departments within the health system through realworld application and scientific concepts.

Patricia S. Levinson Center for Multicultural and Community Affairs (CMCA)

• Northeast Regional Alliance (NERA) MedPrep HCOP National Ambassadors Program: A partnership between Icahn Mount Sinai, Rutgers New Jersey Medical School, Columbia University Vagelos College of Physicians and Surgeons, ManhattanStaten Island Area Health Education Center and funded by the U.S. Department of Health and Human Services Administration, this program expands health careers preparation for underserved and disadvantaged students with the goal of increasing their competitiveness for medical school. Over three summers, students participate in academic enrichment, MCAT instruction, primary care clinical exposure, and mentored research. The curriculum is focused on primary care and community medicine to encourage students to give back to their own communities.

Student Naomi Calhoun, right, in the lab with Emily Bernstein, PhD, in the Summer Undergraduate Research Program for Underrepresented Scholars (SURP4US) program in 2022.

• NERA Behavioral Health

Undergraduate Social Work Fellowship: A partnership with the Department of Social Work, this program targets disadvantaged college students who are enrolled in a Bachelor of Social Work program during their junior year with the goal of increasing their competitiveness for graduate school programs in social work and increasing overall application submissions to graduate degree programs among this population.

• Visiting Elective Program for Students Underserved in Medicine (VEPSUM): Offers four-week electives throughout Mount Sinai to a limited number of qualified fourth-year medical students who attend U.S.-accredited medical schools and who are from underserved backgrounds.

Corporate Health System Affairs (CHSA)

• Administrative Fellowship Program: A two-year leadership development program for master’sprepared students of traditionally underserved backgrounds in health care leadership with the goal to recruit, develop, retain, and promote participants into leadership roles within the health system.

• Administrative Internship Program: An internship program primarily held during the summer and, at times, during the academic year, for high school, college, and graduate students to gain leadership and professional development, experiential, and educational opportunities in administration, corporate services, medicine, and other health care career pathways. The program includes a robust series of educational sessions centering diversity, equity, and inclusion; career and professional development; and “Learning from Leaders” panel discussions that allow students to engage with and learn from Health System leaders, providers, faculty, and staff.

• Lesbian, Gay, Bisexual, Transgender and Gender Diverse (LGB/TGD) Youth Health Careers Pathway Program: A program featuring virtual and in-person workshops geared toward introducing LGBTQ+ identified youth to careers in health care and providing networking opportunities with LGBTQ+ health care professionals and medical students. The program includes an annual “Saturday at Sinai” event for high school and undergraduate students to meet, network, and learn from LGBTQ+ providers and researchers; participants are invited to apply to the Administrative Internship Program.

• Mount Sinai/Seeds of Fortune Innovation Research Program: A partnership program with Seeds of Fortune, Inc.—the largest online platform matching young women from diverse backgrounds to education, finance, and career opportunities. The program engages young women of color in a group project to learn about the health care field, identify with and assume C-suite roles, and work together to design a hospital and develop innovative solutions to address the needs of their communities.

• Mount Sinai/Sure Start Artificial Intelligence/ Machine Learning (AI/ML) Program: A partnership program with SureStart—an organization committed to educating and mentoring high school and college students from communities underserved in AI/ML. The program aims to connect students with internship opportunities through our Administrative Internship Program to learn the applications of AI/ML in the health care field and develop AI-based solutions to real-world challenges.

• Nursing Pathway Program: A program co-sponsored by ODI and the Department of Nursing and in partnership with 1199SEIU and New York City public schools. The goal is to introduce students to the nursing profession and its diverse career pathways, fostering an early interest in the field. Participants are paired with nurse leaders to learn and experience the many ways in which nurses care for patients and serve an important role in the health system.

Madeline Fields, MD, with a student in a Center for Excellence in Youth Education internship program.

The Way Forward

• Youth Advocacy Program to Address Climate Change and Environmental Racism: An environment, social, and governance (ESG) initiative designed in partnership with the Department of Spirituality and Health and several faithbased organizations in Harlem to increase awareness of the link between climate change, the environment, and health. The goal is to encourage young people to become advocates for environmental justice within their communities.

Office of Faculty Development

The Office of Faculty Development (OFD) at the Icahn School of Medicine at Mount Sinai is committed to creating an equitable, just, and inclusive culture by supporting faculty members as they develop in each stage of their career.

OFD works with other offices, most closely with the Office of Well-Being and Resilience, to find out the needs of faculty members and to cultivate opportunities for them to experience high-quality enriched mentorship and leadership development training. The office holds networking events, skills training, and discussion groups, and distributes practical resources such as guides and FAQ documents on its three focus areas: career advancement, mentorship enrichment, and leadership development.

Through its efforts, OFD aims to increase the transparency and efficiency of the appointments, promotion, and tenure process with the ultimate goal of creating a faculty of compassionate leaders from diverse backgrounds. Always evolving, OFD is developing a new platform to help faculty find and communicate with potential mentors and forming an advisory board of senior and junior faculty who are passionate about mentorship and career development.

Office of Gender Equity in Science and Medicine

The Gender Equity team works hard to ensure that the Mount Sinai Health System plays a role in developing initiatives and promoting equity for professionals in science and medicine nationally and internationally, regardless of gender. The Office of Gender Equity in Science and Medicine includes these priorities:

* Robin Chemers Neustein Mid-Career Women Faculty Award is designed for women faculty members who have held the rank of associate professor for at least two years and are not full professors. The program provides mentorship, sponsorship, concrete tools, and support to become full professors. In addition to six months of programming, the award provides funds to be used for professional development and coaching support.

• The Office for Women’s Careers collaborates with leaders at the School and the Health System to develop school-wide initiatives and programs.

• The Gender Equity Accelerator at Mount Sinai is a transdisciplinary team of experts from across the Mount Sinai community that comes together quarterly to share and catalyze ideas.

• Distinguished Scholars Award Program invites assistant professors with independent research programs to apply for internal funding that can help them maintain momentum as they integrate family caretaking responsibilities into their careers at Icahn Mount Sinai. The award receives support from the Doris Duke Charitable Foundation Fund to Retain Clinical Scientists.

• The Learning as Leaders program is open to women faculty members who have held the rank of associate professor for at least five years or who are full-time professors. The six-month program provides an

Jennifer Chan, PhD, winner of the 2022 Robin Chemers Neustein Postdoctoral Fellowship Award, with mentor Ian S. Maze, PhD.

opportunity to cultivate practical management and organizational skills while exploring novel leadership models and principles needed to thrive in academic medicine.

* The Building Gender Equity Together Initiative was a series of facilitated dialogues in which all members of the Icahn Mount Sinai community were invited to participate in conversations leading to the development of powerful, community-led initiatives aimed at improving gender equity across the School. Today, there are three Gender Equity Action Teams (GrEAT) working together to bring initiatives these conversations identified to life.

The Amplifying Equity Series features Icahn Mount Sinai colleagues who are working toward advancing gender equity in the institution and beyond. The seminars have focused on topics ranging from equity and diversity in biomedical research to mentorship and sponsorship.

Public Health and Racial Justice Program

The Mount Sinai Department of Health Education in summer 2023 hosted its first in-person, full-time cohort of the Public Health and Racial Justice Program. Over the course of six weeks, 15 youth participants met daily at The Mount Sinai Hospital to explore a variety of public health issues through a racial justice lens.

The Public Health and Racial Justice Program emphasizes the power and importance of civic engagement, community advocacy, and youth activism in addressing the inequities that drive health disparities. The program aims to build skills, foster pride, and nurture community connection so that participants understand themselves as lifelong stakeholders invested in shaping the policies, institutions, and structures that affect the health and well-being of their families and their communities.

This program was developed in the spring of 2020 as a direct response to the COVID-19 pandemic and Black Lives Matter movement. With generous support from the Helen Gurley Brown Foundation , and in partnership with the Blavatnik Family Women’s Health Institute , the Department of Health Education has been able to significantly expand this initiative, and now offers this program as a full-time opportunity with a stipend for participating youth.

Racism and Bias Initiative (RBI)

The Racism and Bias Initiative was launched in 2015 to explicitly address and undo racism and bias in all areas of medical school, and to center racial justice, health equity, and underserved voices and experiences of all medical education colleagues. As the chief strategist, Leona Hess, PhD, MSW, incorporated a transformational change strategy, where the future state is: radically different from the current state; initially unknown; and to be determined by a coalition of individuals who represent the full spectrum of an organization’s constituents through a process of trial, error, and course correction as new information is gathered. The RBI is overseen by the Institute for Equity and Justice in Health Sciences Education (formerly known as the Center for AntiRacism in Practice), and it expanded and launched the gRBI in the Graduate School of Biomedical Science in 2023. In addition, the RBI offers Anti-Racism Student Fellowships, which provide a new opportunity for medical and graduate students to contribute to the existing body of anti-racism work oriented toward systems change across the medical and graduate schools. Student Fellows work on school-specific projects throughout the year, and receive mentorship and training from anti-racism thought leaders within the Department of Medical Education and the Graduate School of Biomedical Sciences.

Participants in the Public Health and Racial Justice Program in summer 2023.

MOMENTS OF CHANGE › DEFINING DEI

DEI, diversity, equity, and inclusion, is personal to me, and it’s part of my professional being as well. It’s personal to me because my wife is Caribbean, my children are Black, and so I live the issues that they live each and every day. I see the challenges that they confront each and every day. I see the way they overcome those challenges each and every day, and that inspires me to do the work that I try to do here in my own way to try to make a difference and to make us increasingly an organization that is diverse, that is equitable, that is inclusive, and that is anti-racist.

Arthur Gianelli, MBA, MPH, FACHE

Chief Transformation Officer

Mount

Sinai

Health System

MOMENTS OF CHANGE › HELPING OTHERS

OF

Anthony Smalls, MBA Program Manager

The moment I decided a change was needed was when I wanted to change my employee status from hourly entry-level worker to a salary mid-level career. The sad reality is that education alone does not prepare one for a career path; it is one’s vision that creates the desire for a career path. I knew that my self-awareness and creativity were growing stagnant, partially due to biases confronting me and partly due to my own complacency. I tried to apply for supervisor and manager positions and for transfers for new opportunities, but this was frustrating at first.

Eventually, networking inside and outside the institution allowed me to meet the right people—really, the right person, Reginald Miller, DVM, DACLAM—who gave me the opportunity I sought. Now, as a program manager, I oversee initiatives for DEI change, ideally helping other young people of color feel supported and heard as they strive for their own goals. Our Scholar-athletes With Academic Goals (SWAG) initiative is for junior high, high school, and college students and aims to increase the number of underrepresented groups in science, medicine, research, and health care. Our Friends of Odysseus (FOD) mentoring program is for Black and Latinx residents, fellows, and medical students (inside and outside the institution). Our Growth in Operations, Administrations, and Leadership Society (GOALS) is an employee resource group for Black and Latinx men to build a network for mentorship, fellowship, and career advancement community.

The Selikoff Centers for Occupational Health

The Mount Sinai Selikoff Centers for Occupational Health is dedicated to providing clinical services with a focus on prevention to keep workers healthy and their workplaces safe. The multidisciplinary health care team includes physicians, nurse practitioners, social workers, and workers’ compensation and benefits specialists who provide comprehensive services.

The Selikoff Centers is home to the largest World Trade Center Health Program Clinical Center of Excellence in the region, providing free medical monitoring, treatment, mental health services, and benefits counseling for 9/11 responders and volunteers. In addition, it is especially dedicated to serving undocumented immigrant workers, who are more likely to face dangerous working conditions than nativeborn workers—with jobs in construction, cleaning services, transportation—but are less likely to seek care and benefits for a work-related injury or illness. There are many reasons for this: fear of employer retaliation, lack of awareness of rights and resources; intimidation by complex systems and processes; and mistrust in government and health care institutions. Anti-immigrant rhetoric in the United States intensifies many of these fears.

The Selikoff Centers, as part of its mission through the New York State Occupational Health Clinic Network, provides no-cost, confidential health care and other support services to all workers who have suffered a workrelated injury or illness, regardless of documentation or insurance status.

SWAG (Scholar-Athletes With Academic Goals)

The SWAG Initiative creates a pathway program for scholar-athletes in junior high, high school, and college interested in science and medicine. The consortium organizes summits and symposiums to build the SWAG network and funnel members to various programs and produce academic opportunities. SWAG is one of many innovative programs under the Friends of Odysseus (FOD) Mentoring Program at Mount Sinai, launched in 2017 by Reginald W. Miller, DVM, DACLAM, Dean for Research Operations and Infrastructure.

SWAG recognizes that participation in athletics and academics requires the unique abilities of tenacity,

determination, and a commitment to excellence. Scholar-athletes develop character traits of selfconfidence, dedication to tasks, resilience, and time management, which are also important for success in science, technology, engineering, and math. SWAG focuses on scholar-athletes seeking careers in the sciences and health professions.

In the past, the SWAG Initiative partnered with Black Men in White Coats to hold a virtual conference, bringing together stakeholders for a week of group discussions and lectures about scientists and health care professional careers. Participants included scholar-athletes, parents, medical student-athletes, educators, coaches, physician-athletes, medical and graduate school recruiters, and national leaders.

Icahn Mount Sinai also hosted the first New York City SWAG Summit, a one-day event for young adult scholar-athletes to learn about opportunities in the science and health professions. The Game Plan Series is a monthly meeting series featuring a guest speaker who is a former athlete (collegiate or professional) currently in the field of medicine. The discussions help participants understand managing sports and academic studies—and how to excel in both. SWAG Live Discussions are informative conversations with various physicians that provide care to athletes (collegiate and professional). And the SWAG Curriculum offers links to videos, practice exams, and other resources to help build a student’s knowledge and career preparation.

Participants at the inaugural Scholar-Athletes With Academic Goals event in 2019.

Conclusion

A nursing team at The Mount Sinai Hospital, from left: Sheryll Salvilla, RN, Leon Kohan, RN, Mansi Patel, RN, Yatman Wong, RN, and John Schwartz, RN.

“This is not the beginning nor end, but we have a clear vision forward and are well on the path toward becoming an equitable, anti-racist health care system.”

Gary C. Butts, MD

Decades of collective work was done at Mount Sinai in diversity, equity, and inclusion before this report was undertaken. It was work at times known only by the doers; in some ways invisible work, but intentional, challenging work completed with purpose, pushing forward the mission of Mount Sinai to become an anti-racist health care and medical educational institution.

There have been moments of hope and inspiration over the years:

• Staff and leaders have been educated on best methods to collect self-reported patient information on race, ethnicity, sexual orientation/gender identity, and language data, using a unified systemwide data system to capture socio-demographics that may save lives.

• Angela Diaz, MD, PhD, MPH, visited the Mount Sinai Adolescent Health Center as an adolescent who struggled with depression and had dropped out of high school. She returned to Mount Sinai in 1984 as a young doctor and went on to become a renowned figure in adolescent health and Director of the Center for decades.

• A fearful undocumented immigrant, injured on the job, can arrive at the Mount Sinai Selikoff Centers for Occupational Health in Manhattan and be evaluated and treated free of charge. She is assured that all of her information is confidential.

• The Islamic Community of Mount Sinai and the Asian Resource Network, two dedicated employee resource groups, combined efforts and sent out a systemwide message informing people how to donate to support individuals affected by floods in South Asia, Puerto Rico, and the coastal United States.

• Medical students in underrepresented groups saw a need for change in their curriculum and took a courageous stand that transformed and uplifted the School.

These seemingly unrelated threads create a tightly woven tapestry of health care and compassion for all of the patients, employees, and communities that enter the world of Mount Sinai. When the dots are connected, they form a framework for equity and inclusion that had its start in the earliest days of what has become the Mount Sinai Health System.

“Delivering world-class medicine is critical to our identity, but delivering it in a way that is meaningful and feels safe to the communities that we serve is just as important,” says Brendan G. Carr, MD, MA, MS, Chief Executive Officer, and Professor and Kenneth L. Davis, MD, Distinguished Chair, Mount Sinai Health System. “Mount Sinai is committed to diversity, equity, and inclusion, not only because it is the right thing to do but because it is a differentiator for us. It makes us provide better care.”

Gary C. Butts, MD, Executive Vice President for Diversity, Equity, and Inclusion, Mount Sinai Health System, says, “This is not the beginning nor end, but we have a clear vision forward and are well on the path toward becoming an equitable, anti-racist health care system. It is a privilege to be part of this incredible journey.”

The Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 5.2 million annual patient visits, 48,000 employees, and 9,000 physicians, along with the Mount Sinai Phillips School of Nursing and the Icahn School of Medicine at Mount Sinai.

Each day we rise to discover new science, deliver the best care, and teach and inspire the next generation of healers and medical leaders.

We believe in equity. Where we see health disparities, we unite to counter them. And we treat every person with the empathy, dignity, and respect they deserve.

www.mountsinai.org/about/odi

Icahn School of Medicine at Mount Sinai students during orientation in August 2017.