Mount Sinai Health System Road Map for Action Report 2023

Mount Sinai Health System Road Map for Action to Address Racism

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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.

We are pleased to present to you our first annual report on the Mount Sinai Health

System’s Road Map for Action to Address Racism.

Mount Sinai staff distributed information at the Hope in Harlem mental health equity event in May 2023.

A demonstration by White Coats for Black Lives on June 7, 2020, in Central Park.

As many in our community are aware, we developed this Road Map in 2020 in the wake of the murder of George Floyd as a part of our response to the urgent need to address systemic racism and promote equity in health care. Our goal from the start has been to create a health care system and medical education institution that are free from racial bias and discrimination, where all patients receive equitable care regardless of their race, ethnicity, or background. Through this inaugural report, we hope to share with you the progress we have made toward achieving this goal and demonstrate our continued commitment to this important work.

Over the past year, tremendous strides have been made by our team, which includes hospital and school leaders, faculty, staff, trainees, and students. We established a framework to meet our goals and hosted a number of events that have provided a platform for open and honest discussions about the impact of racism on health care delivery and outcomes. Additionally, we have expanded our partnerships to promote health equity, working in collaboration with community organizations and others to launch and expand initiatives aimed at addressing the social determinants of health and reducing health disparities. Our weekly Bulletin emails have also been a valuable resource, providing updates on our progress, educating our community about anti-racism, and highlighting the achievements of our staff and partners.

We are proud to outline all of these—and more—in further detail in the pages that follow, and we are grateful for everyone who has been a part of our team, including our dedicated staff, our expert partners, and engaged community. We recognize that this work would not be possible without the support of all those who share our vision of a more equitable health care system.

Finally, we want to note that this report will now be an annual process, providing a critical new tool to hold us accountable to our original goals, set back in 2021. We recognize that transparency and accountability are essential to the success of the Road Map, and we are committed to sharing our progress with our stakeholders and the broader community on an ongoing basis.

There is still much work to be done. But we believe that with continued collaboration and hard work, we can make our vision a reality. We are hopeful and optimistic about the future, and we look forward to continuing this important work together.

Sincerely,

Kenneth L. Davis, MD

Dennis S. Charney, MD Gary C. Butts, MD

Road Map Leaders

The Road Map project would not be possible without our dedicated team of people, who come from multiple divisions across the Mount Sinai Health System. Led by Chief Executive Officer Kenneth L. Davis, MD, Dean Dennis S. Charney, MD, Gary C. Butts, MD, our 11 Strategy leads, and our Bulletin co-authors, the Road Map team also relies on the hard work and dedication of our Employee Resource Groups and the Diversity Councils. All told, more than 100 Mount Sinai employees play a critical role in our Road Map efforts— whether in leadership or through their committed engagement within one of our organized groups.

Directly or indirectly, everyone involved works together, and all are 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 our current and prospective colleagues with an anti-racist mindset, the progress we’ve made and will continue to make would not be possible without every single member of our team. We are grateful to everyone involved in this mission.

Kenneth L. Davis, MD Chief Executive Officer, 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

Dennis S. Charney, MD

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

In particular, we want to take a moment to highlight our Road Map leaders:

Strategy Leads

Stephen Harvey, MBA Chief Financial Officer, Mount Sinai Health System

Diane Adams, MS, LCSW, SPXP Chief Learning Officer

Jeremy

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

Art Gianelli, MBA, MPH, FACHE Chief Transformation Officer, Mount Sinai Health System; President, Mount Sinai Morningside

Jane Maksoud, RN, MPA Senior Vice President and Chief Human Resources Officer, Mount Sinai Health System

Ann-Gel Palermo, DrPH, MPH

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

Bulletin Co-Authors

Emma Palmer Vice President, Government Affairs and Public Policy, Mount Sinai Health System

Doran Ricks, MS, RN, MBA Vice President, Data Quality and Stewardship, Mount Sinai Health System

Jeffrey S. Silberstein, MBA Chief Administrative Officer, Mount Sinai Health System; Chief Operating Officer, Icahn Mount Sinai

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 School of Medicine at Mount Sinai

Shawn Lee

Associate Director of Operations, Central Billing Office for FPA Administration

Boal,

Pamela Abner, MPA, CPXP Vice President and Chief Diversity Operations Officer, Mount Sinai Health System

The Defining Moment

The Mount Sinai Health System’s mission is to provide compassionate and advanced care to the diverse communities it serves, especially those traditionally ignored, oppressed, or facing bias. 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, 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 and sustained 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.

Protests were held across the nation in the summer of 2020, after the murder of George Floyd was captured on cellphone video and became a symbol of systemic racism and a catalyst for action.

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.

Creating the Road Map for Action

Throughout the fall and winter of 2020, the Health System participated in listening tours, held town halls, and engaged in other community-building 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 anti-racism. 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.

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, lowincome, 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 anti-racism a key aspect of the Mount Sinai Leadership Model. For example, the Health System has launched multiple mentorship programs for staff from under-represented 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 AAPI medical professionals and addressing equity in their professional development.

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.

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 antiracism 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 Health Systems Design, and Shawn Lee, Associate Director of Operations, Central Billing Office for FPA Administration at The Mount Sinai Hospital.

Outside Experts: The Winters Group

As Mount Sinai does the hard work to create organizational change, the Road Map strategy leads are working with experts from The Winters Group, a Black-owned and woman-led diversity, equity, inclusion, and justice consulting firm with nearly four decades of experience. Founded in 1984 by Mary-Frances Winters —an expert in strategic planning, change management, diversity, organization development, training and facilitation, systems thinking, and qualitative and quantitative research methods—the firm has worked with hundreds of companies to dismantle the status quo and embrace equity.

Task Force Members

The Task Force of the Road Map to Address Racism was made up of 51 members from the Mount Sinai community, who worked together with a singular focus in fall and winter 2020. It included a cross-section from across the organization—staff members, students, hospital presidents, and board members—to provide an authentic mix of perspectives, voices, opinions, and ideas.

Their charge was to evaluate, investigate, and engage in meaningful and sustained 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.

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To ensure accountability, the Task Force included 24 Health System leaders: presidents, vice presidents, chiefs, deans, and directors.

The Task Force represented:

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4 4 18 Corporate Services Units Hospitals Academic Departments Special Offices

Task Force Chair:

Gary Butts, Executive Vice President for Diversity, Equity, and Inclusion

Task Force Strategy and Support:

Pamela Abner, MPA, CPXP, Vice President and Chief Diversity Operations Officer, Mount Sinai Hospitals Group (Advisor)

Gabriel Bershadscky, Assistant Vice President, Marketing and Communication (Creative Lead)

Ben Cotilletta, Associate Director, Strategic Operations and Implementation, Mount Sinai Health System (Project Manager)

Leona Hess, PhD, MSW, Director of Strategy and Equity Education Programs, Medical Education, Icahn Mount Sinai; Founder and Co-Director, the Center for Anti-Racism in Practice (Strategy Lead)

Marc Kaplan, then Vice President, Associate Dean, Icahn Mount Sinai (Communications Lead)

Ann-Gel Palermo, DrPH, MPH, Senior Associate Dean for Diversity, Equity, and Inclusion, Icahn Mount Sinai; Chief of Diversity, Equity, and Inclusion, Education and Research, Mount Sinai Health System (Advisor)

Task Force Members:

Ernest Barthelemy , MD, MA, MPH, Resident, Neurosurgery

Emma Benn , Associate Dean for Faculty Well-Being and Development, and Associate Professor, Population Health Science and Policy, Diversity Research Center, Icahn Mount Sinai

Jeremy Boal , Executive Vice President and Chief Clinical Officer, Mount Sinai Health System; President, Mount Sinai Beth Israel and Downtown

Yvette Calderon , MD, MS, Dean and Vice President for Equity in Clinical Care, and Professor of Emergency Medicine, Icahn Mount Sinai, and Chair of Emergency Medicine, Mount Sinai Beth Israel

Neil Calman , MD, Chair of Family Medicine and Community Health, President, CEO, and Co-Founder, Institute for Family Health

Judy Cho , MD, Professor, Pathology, Molecular and Cell Based Medicine, Genetics and Genomic Sciences, and Medicine (Gastroenterology); Ward-Coleman Chair in Translational Genetics

Uraina Clark , PhD, Associate Professor, Neurology, Icahn Mount Sinai

Edith Cooper , Mount Sinai Health System Trustee; former Managing Director and Global Head of Human Capital Management at Goldman Sachs

Angela Diaz , MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center at Icahn Mount Sinai; Jean C. and James W. Crystal Professor of Pediatrics, and Professor Environmental Medicine and Public Health at lcahn Mount Sinai

Anne Dickerson , Faculty Practice Assoc

Kamini Doobay , MD, Icahn Mount Sinai Alum

Sharon Edwards , MD, Associate Professor of Pediatrics, and Medical Education; Program Director of the Adolescent Medicine

Fellowship at the Mount Sinai Adolescent Health Center; Vice Chair of Diversity Initiatives for the Jack and Lucy Clark Department of Pediatrics at Mount Sinai Kravis Children’s Hospital; Director of the Teen Parenting Program

David Feinberg , Senior Vice President, Chief Marketing and Communications Officer, Mount Sinai Health System; Dean for Marketing and Communications, Icahn Mount Sinai

Dania Figueroa , Student, Graduate School of Biomedical Sciences

Marta Filizola , PhD, Dean, Graduate School of Biomedical Sciences; Professor of Pharmacological Sciences, and Neuroscience

Evan Flatow , MD, President, Mount Sinai West

Niyum Gandhi, then Chief Financial Officer, Mount Sinai Health System

Art Gianelli , FACHE, President, Mount Sinai Morningside; Chief Transformation Officer, Mount Sinai Health System

Jill Goldstein , MS, MA, BSN, Deputy Chief Nursing Officer and Vice President, Nursing and Patient Care Services, Mount Sinai Queens

Basil Hanss , PhD, Senior Associate Dean for Student and Postdoctoral Affairs and Associate Dean for Graduate School WellBeing and Resilience, Graduate School of Biomedical Sciences; Associate Professor of Medicine (Nephrology), Medical Education, and Pharmacological Sciences

Taylor Harrell , Medical Student, Icahn Mount Sinai; President, Student National Medical Association

Carol Horowitz , MD, MPH, Dean, Gender Equity in Science and Medicine; Director, Institute for Health Equity Research, Professor of Population Health Science and Policy, and Medicine

Yasmin Hurd, PhD, Ward-Coleman Chair of Translational Neuroscience and the Director of the Addiction Institute at Mount Sinai; Professor of Pharmacological Sciences, Neuroscience, and Psychiatry

Carolyn Hutson , Department of Social Work

Lucia Lee , Vice President of Media and Public Affairs, Mount Sinai Health System

Shawn Lee , Associate Director of Operations, Central Billing Office for FPA Administration, Mount Sinai Health System

Michael Leitman , MD, FACS, Dean for Graduate Medical Education, and Professor of Medical Education, Icahn Mount Sinai; Chair of Surgery, Mount Sinai Beth Israel

Giselle Lynch , Resident Physician, New York Eye and Ear Infirmary of Mount Sian; Icahn Mount Sinai alum

Jane Maksoud , RN, MPA, Chief Human Resources Officer and Senior Vice President of Human Resources and Labor Relations, Mount Sinai Health System

Donna Mendes , MD, Associate Clinical Professor, Surgery

Reg Miller , DVM, DACLAM, Dean for Research Operations and Infrastructure; Professor of Comparative Medicine and Surgery, and Environmental Medicine and Public Health, Icahn Mount Sinai

David Muller , MD, Dean for Medical Education, Icahn Mount Sinai, and Professor and Chair of the Leni and Peter W. May Department of Medical Education at Mount Sinai

Barbara Murphy , MD, (Chair of the Department of Medicine, and a renowned nephrologist, researcher, and mentor, died in June 2021.)

Eric Nestler , MD, PhD, Dean for Academic and Scientific Affairs; Director, Friedman Brain Institute, Professor of Neuroscience, Pharmacological Sciences, and Psychiatry, Icahn Mount Sinai; and Chief Scientific Officer, Mount Sinai Health System

Emma Palmer , Vice President, Government Affairs and Public Policy, Mount Sinai Health System

David Reich , President and Chief Operating Officer, The Mount Sinai Hospital and Mount Sinai Queens; Professor of Pathology, Molecular and Cell Based Medicine, and Anesthesiology, Perioperative and Pain Medicine, at Icahn Mount Sinai

Lynne Richardson , MD, Professor of Emergency Medicine, Population Health Science and Policy, and Artificial Intelligence and Human Health, and founding Co-Director of the Institute for Health Equity Research, at the Icahn Mount Sinai

Jonathan Ripp , MD, MPH, Senior Associate Dean for Well-Being and Resilience and Chief Wellness Office, and Professor of Medicine (General Internal Medicine), Medical Education, and Geriatrics and Palliative Medicine, at Icahn Mount Sinai

Toni Stern , MS, MBA, Senior Asso ciate Dean for Gender Equity in Clinical Affairs; Vice Chair of Quality and Clinical Transformation; and Chief Patient Experience Officer, Obstetrics, Gynecology and Reproductive Science, Icahn Mount Sinai

Donnette Truss , Director of Human Resources, Mount Sinai Beth Israel

Rachel Vreeman , MD, MS, Chair, Health System Design and Global Health; Professor and Chair of Global Health, and Professor of Pediatrics, at Icahn Mount Sinai; and Director of the Arnhold Institute for Global Health

Rocky Walker , then Spirituality and Health Chaplain , The Mount Sinai Hospital

Robert Wright , MD, MPH, Professor and Ethel H. Wise Chair, Environmental Medicine and Public Health, Icahn Mount Sinai, and Co-Director of the Institute for Exposomic Research at Mount Sinai

William Wright , Mount Sinai Health System Trustee, former Managing Director of Morgan Stanley

2022 Road Map Progress at a Glance

The work to advance the Road Map has been personally, culturally, and operationally transformative, representing changes to our Health System.

Aris Novas of the Talent Acquisition Team visited the Urban Upbound fair in Queens, part of an initiative to promote an equitable and inclusive workforce.

The work to advance the Road Map has been personally, culturally, and operationally transformative, representing changes to our 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.

Over the last two years, we have 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. While we remain proud of how far we’ve come, we acknowledge that there is still room to grow and look forward to moving closer to our goals in 2023.

In 2022, we held 33 diversity, equity, and inclusion (DEI) events and distributed 48 issues of the Road Map for Action Bulletins across the Health System, read by an average of 23,000 community members each week. We implemented 13 new protocols and hiring practices to promote diversity across all levels and departments, and held 229 interactive and learning webinars and tabling events to increase awareness of cultural, religious, gender, and socioeconomic differences and encourage employees and staff to unlearn unconscious biases.

New Hiring Protocols

• Implementing Black Executive Acceleration Program (BEAP)

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

• Including a designated number of slots for diverse talent on interview events

• Implementing a Direct Employer Platform that posts our 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, and training on how to succeed as a candidate

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

• Launching youth mentorship program for the children of our own internal staff 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”

• Social media marketing campaigns to “celebrate diverse talent” and “managers who drive diversity” that highlight internal URM high performers and managers playing an active role in developing diverse talent

Sessions:

Between 2020 and 2022, the total number of education sessions focusing on diversity, equity, and inclusion issues we held increased by 30 percent, and the number of participants also rose by 30 percent.

Education 2022

Looking Ahead

The next phase of this multifaceted work will build upon the progress we have made so far, continuing our work to increase diversity and cultural competency among our workforce and leadership, implement policies to reduce racial and ethnic disparities in health care, and work to improve health outcomes for marginalized communities by addressing social determinants of health, such as poverty, housing instability, and food insecurity.

By taking a comprehensive approach to anti-racism, we are creating a more equitable and just society, where every individual has access to high-quality health care and the opportunity to live a healthy and fulfilling life.

Strategies 2022 Progress

• Develop an equity scorecard to measure performance.

• Unify and integrate clinical practices.

• Develop a sustained financial investment in racial equity and anti-racism efforts and programs.

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

• Established health-equity data assessment (HEDA) as the Health System’s hub for equity-related research and analytics. Outlined a strategy for identifying disparities that align outcomes with social determinants of health. Created standardization of DEI language and terminology.

• Uncovered ways to change existing regulatory and payment paradigms.

• Completed initial inventory of ambulatory practice sites with regard to insurances accepted and patients cared for. Launched partnership with the Institute for Health Equity Research DISRUPT study to examine variability in ambulatory practices.

• Creating payroll disbursement options to ensure employees can receive pay when needed to reduce financial stress.

• Increased the sourcing of supplies and equipment from minority-owned businesses.

Goal Ensure that diversity, equity, and inclusion (DEI) is a stand-alone and integrated priority of Mount Sinai business valuation and shared measurement system.

To address disparities, Mount Sinai set a goal of collecting patients’ race, ethnicity, and language preference at least 90 % of the time.

Strategies

• Increase recruitment , hiring, and retention of Black and other URM staff and faculty.

• Promote racial equity in mentorship.

2022 Progress

• Developed a hospital-by-hospital report on local hiring and benefits.

Embedded DEI competencies and statement of leadership accountability in senior-level job descriptions across the Health System.

• Created a tool to identify engagement opportunities with key stakeholders and evaluate potential gaps.

• Developing a school and community-based nursing pathway program to attract students to careers in nursing.

• Designed and launched the LINC System Mentoring Program.

• Launched a “Responding to Racist and Discriminatory Patients” course for leaders.

• Created and offered “Creating a Brave Space” education for leaders and mentors.

• Prepared talent portfolio of all Black Executive Acceleration Program members to be presented during executive leadership meetings for potential future vice president and other leadership opportunities.

• Designing and establishing advancement program for underrepresented staff.

Goal Sustain an equitable talent acquisition process that focuses on the retention and development of URM employees.

At Mount Sinai Queens, members of the Nurses Against Racism Employee Resource Group.

Goal Foster partnerships, using an anti -racist lens, that promote a thriving and equitable culture for staff and communities served.

Strategies

• Enhance community partnerships and accountability.

• Build connection and community within the Health System to advance racial equity.

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

2022 Progress

• Established an equity platform to support data-driven processes to identify and address disparities. Partners in this effort are: the Office for Diversity and Inclusion, the Data Stewardship Team, Enterprise Reporting, the Institute for Health Equity Research, Human Resources, the Quality Leadership Council, Digital and Technology Partners, and Community Engagement.

• Building a new strategy for Employee Resource Groups, and site Diversity Councils’ involvement in anti-racism efforts.

• Partnering with Community Engagement to promote and involve staff in community-based health services in East and West Harlem.

• Partnering with the Committee to Address Anti-Asian Bias and Racism and the new Center for Asian Equity and Professional Development to integrate and synergize efforts with Road Map strategies.

• Embracing a focus on the Environment, Social, and Governance framework. Establishing a youth-focused community program on climate change to address environmental racism.

• Developing a Diversity Innovation Hub platform in Harlem, engaging women and minorities in entrepreneurship.

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

Strategies

• Enhance leadership learning , capacity, knowledge, engagement, and accountability.

• Provide anti-racism education and resources throughout the Health System.

2022 Progress

• Strategy and site leads completed anti-racism training aligned with increasing their capability to execute the anti-racism Road Map.

• Strategy leads and staff received 1:1 coaching in support of their personal development and implementation of their strategies.

• Working with PEAK to build education modules on DEI topics, including antiracism.

• Launching a strategy through the Center for Anti-Racism in Practice to disrupt bias in the learning and work environment of the Graduate School of Biomedical Science.

• Developing the Leadership Model, which will include anti-racism behavioral expectations, including mentoring by leadership level.

• Posted weekly Road Map for Action Bulletins, a broadcast email to the entire Mount Sinai community, covering a broad range of topics.

Goal Equip employees with the knowledge and skills needed to engage in anti-racist and equitable practices.

Leaders of the Center for Anti-Racism in Practice: Ann-Gel Palermo, DrPh, Talia Swartz, MD, PhD, and Leona Hess, PhD.

HOLA, the Heritage of Latinx Alliance Employee Resource Group at the Corporate Services Center, gathered supplies for Hour Children, a nonprofit in Long Island City that supports incarcerated women and their children.

Programs and Initiatives

The Robert F. Smith Prostate Cancer Screening Unit, launched in 2022, brings stateof-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.

Programs and Initiatives

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.

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

Guillermo Villegas, assistant Core operations manager, marched with Mount Sinai colleagues in the 2022 NYC Pride Parade.

The 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 antiAsian 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 Asian American and Pacific Islander (AAPI) medical 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.

Executive Diversity Leadership Board

The overarching strategy to advance DEI across Mount Sinai is guided by the Executive Diversity Leadership Board (EDLB), which is chaired by Kenneth L. Davis, MD, Chief Executive Officer, Mount Sinai Health System. The EDLB has successfully led equity and support initiatives and teams that advance

The Center for Asian Equity and Professional Development led Lunar New Year celebrations that also raised awareness of anti-Asian violence.

CAEPD distributed information on how to stay safe, as well as safety whistles and personal alarms.

■ Programs and Initiatives

system DEI best practices, including cultural education, eliminating health disparities with clinical enhancements, partnering with Diversity Councils and Employee Resource Groups to drive inclusivity and involvement, empowering demographic diversity in hiring practices, and more. Throughout 2022, the EDLB supported the strategic direction for the Road Map and a forum for leaders to discuss progress made on Road Map strategies, among other DEI efforts across the Health System, such as the Disparities Reporting Working Group and the Center for Asian Equity and Professional Development.

Increasing Access to 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 Prostate Cancer Screening Unit, a mobile unit that brings state-ofthe-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. Between the program’s inception and January 2022, the team saw more than 2,000 patients, surpassing its initial goal for the first year; nearly 20 percent of them required follow-up. Importantly, two-thirds or more of those seen were Black men.

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

more Mount Sinai patients live and work. The new facility both combines and expands services for two Harlem-based hospitals, Mount Sinai Morningside and The Mount Sinai Hospital, providing highquality 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.

Mount Sinai is also developing a Diversity Innovation Hub platform in Harlem, engaging women and minorities in entrepreneurship.

Quality Leadership Council

The Quality Leadership Council is a committee on clinical care, composed of about 65 chief medical officers, hospital presidents, quality and patient experience leaders, and chief nursing officers. When the Council started to have conversations about COVID-19 and the disproportionate death rates in communities of color, it was inspired to take a closer look at the Health System as a whole—and at its own membership. As a result, Mount Sinai has declared equity a key component of the systemwide quality agenda, actively engaging the leadership group in learning to discuss racism and using demographic data such as race and ethnicity as part of Mount Sinai’s standard quality analytics. Equally important, the Quality Leadership Council is working to expand the membership of the council to include more leaders in URM groups and is intentionally advancing and recruiting URM leaders in systemlevel roles.

In May 2022, Mount Sinai opened the Mount SinaiHarlem Health Center, an $80 million facility at 124th Street in Harlem, providing high-quality outpatient primary care, specialty care, and behavioral health treatment.

Health System Policies

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, Vice President and Chief Diversity Operations Officer.

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

Conversations with a Patient,

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, Vice President and Chief Diversity Operations Officer for Mount Sinai Hospitals Group; 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.

Pocket Guide

Responding to Racist and Discriminatory Behavior

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

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.”

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

Mount Sinai does not tolerate learners or trainees. You are report the behavior to your

Patient or family member asks to change on the perceived identity of the provider. be honored, except in rare cases determined Nurse Administration.

A. “Our policy is to staff our hospitals with or discrimination based on race, ethnicity, orientation, gender identity or gender any other bias. Our staff/learners/trainees extremely competent.”

B. “We will not make staff changes based perceive as discriminatory. We treat learners/trainees with respect, and our patients.”

C. “Your request has been denied. You (provider’s name). All of our staff highest quality of care.”

D. “Based on your behavior and/or discriminatory specifically denied your staff change. you a new clinician because your comfortable providing you treatment.”

and harmed by these behaviors.

The policy formalizes that which we uphold within the Health System—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

Hiring and Retention

Patient, Family Member, or Visitor

tolerate racist, biased, or discriminatory behavior toward staff members, are not alone. First evaluate and meet any urgent medical needs. Then your supervisor. Suggested messaging to patients is below.

change staff assignments based provider. Such requests will not determined by the care team or

Mount Sinai has restructured and diversified the search committees for leadership positions. The Road Map Strategy 8 (Organizational and Institutional) Team has been working with a team of human resources professionals to review all Health System job descriptions to ensure that they include specific, deliberate anti-racist language. Vice presidents from Human Resources and Labor Relations are reviewing the Health System’s HR policies through an equity lens to cement antiracist behaviors and practices.

with care providers without bias ethnicity, religion, age, sexual gender expression, disability or staff/learners/trainees are well-trained and based on your request, which we treat all of our patients, staff, and and we expect the same from You will continue to be cared for by are well-trained in providing the discriminatory comments, we change. However, we will assign your current clinician is no longer treatment.”

Patient or family member asks to change rooms based on the perceived identity of the roommate or visitors. Such requests will not be honored, except in rare cases determined by the care team or Nurse Administration.

A. “Our policy is to provide safe and appropriate room assignments to all patients regardless of race, ethnicity, religion, age, sexual orientation, gender identity or expression, disability or any other bias.

Increasing Supplier Diversity

B. “We do not discriminate based on race, ethnicity, religion, age, sexual orientation, gender identity or expression or disability when making room assignments. Your request has been denied.”

C. “We do not make room assignments that discriminate based on race, ethnicity, religion, gender identity, or sexual orientation, but we will have to change your room if your behavior toward your roommate concerning one of these personal characteristics makes them uncomfortable.”

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 non-diverse vendors to subcontract to underrepresented businesses, and develops mentorship programs for empowerment. As small businesses and underrepresented minority-owned businesses have historically been excluded from contracting opportunities, Mount Sinai is intentionally partnering with businesses that are at least 51 percent owned, operated, and

controlled by individuals from underrepresented groups. Between 2021 and 2022, there was a $7.6 million increase in spending with MBEs, totaling $46.2 million over the last year. In total, $83.5 million was spent with underrepresented vendors in 2022 across the following categories: MBE, WomenOwned Business Enterprise, Veteran-Owned Business Enterprise, Disability-Owned Business Enterprise, and LGBT-Owned Business Enterprise.

Talent Acquisition Team members, from left, Priscilla Rivera, Aris Novas, and Jemimah Carrington.

Patrice GordonPoyser, Supplier Diversity Manager, is a point person in increasing the number of Mount Sinai vendors that are minority-, woman-, or veteran-owned.

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.

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

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.

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 decisionmakers 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, 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 the aim of building bridges between community-based organizations and hospitalbased 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.

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 financial empowerment, leadership, and literacy for Latina women.

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 in Hope in Harlem, a free conference that brought health information to the community.

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 Thursday. 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. Nearly 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 Director of the Mount Sinai Adolescent Health Center; 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, and Global Health and Health

Systems Design 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 that we serve.

25,948 44% 48

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.

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.

Weekly Road Map for Action Bulletins deployed

Average opens Engagement rate

Selected Bulletins in 2022

January 20, 2022

Examining Racial Disparities in the COVID-19 Pandemic

Health care disparities, like those made clear during the COVID-19 pandemic, spurred Mount Sinai to establish the Institute for Health Equity Research in May 2020. The Institute’s mission is to better understand and address the health issues—including but not limited to COVID-19—that plague our most vulnerable communities. The Institute is led by Carol R. Horowitz, MD, MPH, Dean for Gender Equity in Science and Medicine, and Lynne D. Richardson, MD, Professor of Emergency Medicine, and Population Health Science and Policy.

› Links to Further Information and Resources

• To find out more about various Diversity Councils and Employee Resource Groups (ERGs), visit here

• To find upcoming events from the Office for Diversity, Equity, and Inclusion, visit here

• Send an email at RoadMap@mountsinai.org to suggest a topic, highlight a coworker, or provide some feedback. Past Bulletins can be viewed here

• To find out about the upcoming Chats for Change schedule, visit here.

Co-Director Lynne Richardson, MD, left, and Co-Director Carol Horowitz, MD, MPH, are guiding the Institute for Health Equity Research.

July 21, 2022

The Racial Disparities of Abortion Bans

Following the Supreme Court’s decision to overturn Roe v. Wade, more and more states are moving to restrict people’s right to abortion access. Studies show abortion bans have specific, disproportionate impacts on under-resourced, marginalized groups, an added burden during a well-documented Black maternal mortality and morbidity crisis.

While the right to safe and legal abortion is protected in New York State, Mount Sinai is working to help expand access for those who need abortion care, including those coming from out of state for care, with the Division of Complex Family Planning (CFP) leading the charge. Monica Dragoman, MD, MPH, Director of Complex Family Planning, and other CFP leaders have been working with colleagues across the Health System and external stakeholders, like government officials and community organizations, to identify how Mount Sinai can best contribute to existing efforts.

Monica Dragoman, MD, MPH

November 3, 2022

The Link Between Medical Records and Discrimination

There is a not-so-obvious link between medical records and racial discrimination. Medical records are intended to document objective observations. However, when biased language—such as using quotation marks to communicate sarcasm or question a patient's sincerity—is included, it may impact care by sending an incorrect signal to future clinicians about a patient.

The Mount Sinai Health System is educating staff to ensure that race and ethnicity data are collected in an inclusive, accurate manner, and has taken action to ensure clinicians use standardized language when writing on patients’ charts. Bruce Darrow, MD, PhD, Chief Medical Information Officer for the Health System, says the overarching idea is that “patients are owners of their medical records,” which helps clinicians think holistically about what they are writing down and ensures they are not unintentionally using biased language.

In a further effort to close health disparities, a team at Mount Sinai developed the Race/

Ethnicity/Language Capture Dashboard to track progress in collecting patients’ race, ethnicity, sexual orientation and gender identity, and language preferences. A team of experts, including Lyndia Hayden, MS, Director of Disparities and Data Analytics, and Jefri Mesa, are working closely with practices to help improve their performance. And the Health System has been reaching its goal of recording this information 90 percent of the time.

Lyndia Hayden, MS, Director of Disparities and Data Analytics, with team member Jefri Mesa.

The Way Forward

As we conclude this year’s annual report, we express our heartfelt gratitude to all our strategy leads, Health System leaders, and stakeholders who have been instrumental in our progress toward creating a health system and educational institution that is free from racial bias and discrimination, where all patients receive equitable care regardless of their race, ethnicity, or background. Our efforts so far mark the starting point for our work, not the end of the journey.

In the last year, we have worked together to achieve progress toward four overarching goals:

• Ensuring our diversity, equity, and inclusion effort is a stand-alone and integrated priority of Mount Sinai business structures;

• Fostering partnerships using an anti-racist lens that promote a thriving and equitable culture for staff and communities served;

• Sustaining an equitable talent acquisition process that focuses on the retention and development of underrepresented minority employees across the Health System; and

• Equipping Mount Sinai employees and students with the knowledge and skills needed to effectively engage in anti-racist and equitable practices.

The Mount Sinai Health System has long been committed to the principles of diversity, equity, and inclusion, and as we reaffirm our focus on our mission and vision, we are optimistic about what the future holds.

Mount Sinai staff, family, and friends marched in the African American Day Paradein Harlem in September 2022. Mount Sinai was a sponsor of the event, also shown on the cover of this report, sharing a message of health and equity.

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. Read more.

We look forward to continuing growth, innovation, and partnership in our journey to become an anti-racist health care and learning institution.

The Mount Sinai contingent at the NYC Pride Parade in June 2022. Pride Month is an important time for Mount Sinai to affirm the right of all to access equitable, safe, compassionate, gender-affirming, and nonjudgmental care.

Our

mountsinai.org/road-map

efforts so far mark the starting point for our work, not the end of the journey.