Kenneth L. Davis, MD
President and Chief Executive Officer
Mount Sinai Health System

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

Update on Anti-Racism and the Mount Sinai Health System

On Tuesday, June 2, thousands of our Mount Sinai family members stood and kneeled together in support of Black lives and against all forms of racism. In the aftermath of that solemn moment, and in accordance with our founding principles, we recommitted to being an organization that is actively anti-racist. We acknowledged the moral responsibility to better educate ourselves so that we can root out the causes and conditions that lead to inequity. And we acknowledged the need to get comfortable with being uncomfortable as we open our eyes and hearts to the lived experiences and realities of many of our co-workers, students, trainees, and patients. Most importantly, we acknowledged the need to work with a sense of urgency even while we recognize that systemic racism has been with us for hundreds of years and will require a sustained commitment over the long haul to eradicate.

Within that context, we are extremely heartened to see what has already occurred or is being accelerated in less than two months since that day of solidarity. At the same time, we also must acknowledge that we have so much more to do.

Below are highlights to keep you informed as we advance in this journey together:

Creating Space for Meaningful Dialogue
While it would have been unheard of even one year ago, in the past two months there have been massively attended town halls on racism at many of our hospital and school campuses. These events have helped launch honest, and frequently painful, dialogues that were long overdue. All hospital, school, and department diversity councils have also been engaged in these conversations, which will be important to informing the work of the recently launched Taskforce to Address Racism. This must continue at all levels.

Enhancing Seamless Care
Colleagues in ambulatory care, finance, strategy, and operations are working to untangle the complicated structural underpinnings of the insurance system as we move toward more fully unifying our practices. This will allow us to offer more seamless care in centralized locations to all of our patients and eliminate disparities in care related to insurance status, which can otherwise lead to disparities in care by race and ethnicity among sites. We are heartened to see so many thoughtful and creative leaders making this a priority.

Eliminating Racism and Bias
The Office of Diversity and Inclusion (ODI) is being inundated with requests for help in dialogue and efforts to eliminate racism and bias within our Health System. As with safety reporting, we view these requests as a positive sign. They show that more people are finding space to bring forward issues they might otherwise have left unmentioned. We cannot thank Pamela Abner and Ann-Gel Palermo and their colleagues enough for the work they are doing at every level in leading and supporting these conversations to help us learn, grow, and do better. This work builds on the important efforts in the Department of Medical Education, led by David Muller, MD, and Leona Hess, PhD, through the Racism and Bias Initiative and its Chats for Change program. We must remember, however, and as we have stated before, that eliminating racism in our organization is not the responsibility of ODI. It is the responsibility of all of us and particularly of those in leadership throughout our Health System.

Health Equity Research
Led by Carol Horowitz, MD, and Lynne Richardson, MD, the new Mount Sinai Institute for Health Equity Research brings together a multidisciplinary team of experts to shed light on health-related problems that disproportionately impact at-risk groups across disease areas due to issues of race, ethnicity, age, sexual orientation, gender identify, disability, poverty, and residential segregation. The Institute will work closely with our clinical and basic science researchers and educators to embed equity considerations into all aspects of their work, and to ensure that pertinent questions are asked and addressed in research.

Identifying Diverse Talent and Advancing Leadership Diversity
It is vital that our leadership ranks reflect the diversity of our workforce and our communities. There is expanding awareness that we have so much untapped talent here in our Health System and it is the responsibility of those in leadership to actively work to identify and mentor and support Blacks and other people of color. It is heartening to see many of our leaders gain insight into this and take action.

Our colleagues in ODI continue to support and advance efforts to identify and develop talent through targeted programs in their Center for Excellence in Youth Education and the Corporate Health System Affairs office. This is a critical investment to expand our diverse pool of talent. This summer, we engaged more than 200 high school and college students from under-represented and disadvantaged groups to participate in these programs. Currently, there are nine participants in the ODI Administrative Fellows Program, which engages under-represented master’s degree graduates in a two-year hospital system administrative program; thirteen have graduated from the program, and almost all of them have joined our Mount Sinai community in management roles.

In addition, we are accelerating efforts to increase representation of students, trainees, and faculty from under-represented groups in science and medicine in the medical and graduate schools.

Quality, Safety, and Equity
Our systemwide Quality Leadership Council, which includes all the hospital executive teams as well as a broad array of other Health System leaders, has held three meetings in a row to become better educated about myriad related issues including racism, privilege, and health disparities. They have launched a workgroup to develop the processes by which we will measure and improve equity in our quality and safety efforts across the system. And they are working with partners in ODI and others to make sure that the Health System equity dashboard is front and center in our collective improvement efforts. These efforts will position us to better document any variations and target strategies and resources to close gaps that are identified.

Standardizing Race/Ethnicity Data Collection
Our colleagues in ODI are working with a group to revise patient data reporting to ensure that we have accurate race/ethnicity variables. Standard reports will regularly include this. This effort will help inform clinicians and researchers in targeting guidelines and care.

eGFR and Race
A workgroup has been formed to make recommendations regarding the use of race in the calculation of kidney function. This will be tied to work to examine the role of race in clinical calculations more broadly.

Task Force to Address Racism
The recently launched system-wide Task Force to Address Racism, under the leadership of Dr. Butts, is hard at work and will be issuing formal recommendations in the coming months. These recommendations will provide critical clarity with regard to programs, priorities and direction. Given the groundswell of activity that we have all seen in these past few months, the recommendations of the Task Force will be even more impactful because they will rest on a foundation of broad stakeholder support and action.

United in Solidarity
It is encouraging to see so many taking the time to learn so that we have a common understanding of how we got here and what it will take for us to do better. ODI has published a resource guide that you can find here.

In Conclusion
Together, let us continue to commit ourselves to learning what it means to be anti-racist as individuals and as a Health System. As a community, we will continue to treat anti-racism as an urgent priority and also as a lifelong commitment. We will never accept the status quo or think that it is someone else’s job to change. It is our job and it is your job. Let us keep moving forward together.

We will continue to update you regularly.