Mount Sinai Reports Progress on Its Road Map for Action to Address Racism
Authors detail strategies and implementation efforts in the journal Academic Medicine
In a paper published in the journal Academic Medicine, Mount Sinai Health System authors describe progress on the health system’s Road Map for Action to Address Racism, which was developed to unify, systematize, and accelerate antiracism efforts across one of the largest academic medical centers in New York City. The authors describe how the Road Map was developed by a Task Force to Address Racism with an overarching goal “to become an anti-racist health care and learning institution that intentionally addresses structural racism.”
Mount Sinai CEO, Kenneth L. Davis, MD, and Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs, created the Mount Sinai Health System Task Force to Address Racism in June, 2020, to develop specific, actionable recommendations to move the health system forward towards a more fair, just, anti-racist, and equitable community for its staff, patients, and students.
The Task Force to Address Racism was led by Gary C. Butts, MD, Executive Vice President and Chief of Diversity, Equity, and Inclusion for the Mount Sinai Health System and Dean for Diversity Programs, Policy, and Community Affairs at the Icahn School of Medicine at Mount Sinai. It included 51 members representing a cross-section of the organization—front-line staff members, students, hospital presidents, deans, and board members, embodying the rich racial, ethnic and gender diversity of the Mount Sinai community—to provide an authentic mix of perspectives, voices, opinions, and ideas. The Task Force completed its work in just over nine months, from July 2020 to March 2021; Road Map planning and implementation began in the spring of 2021 and this work is ongoing.
In the paper, the authors describe two of the distinct patient populations that The Mount Sinai Hospital, the Health System’s largest hospital, serves: patients who reside in Manhattan’s elite and wealthy enclave of the Upper East Side and those who live in East Harlem, a melting pot of diverse racial groups where one-third of residents live in poverty. “Our ultimate charge is to root out racism to better serve our diverse communities. To achieve this, we will need to address structural racism across our system, a challenge for most U.S. health systems and medical schools. An important part of the work includes a focus on equity in care delivery as well as greater workforce diversity in our faculty and among our leadership,” says Dr. Butts, the paper’s lead author.
Dr. Butts, Professor of Medical Education, and Pediatrics, at Icahn Mount Sinai, and his coauthors describe their process in detail. They describe how they worked amid an atmosphere of great urgency, heightened by the convergence of the Black Lives Matter movement, the public anguish resulting from the murder of George Floyd in 2020, and the COVID-19 pandemic, which illuminated health disparities nationwide and within the Harlem community that Mount Sinai doctors proudly serve.
“The pandemic rapidly ushered medicine into uncharted terrain while our Mount Sinai community of more than 40,000 faculty and staff became more united in shared pain and anguish in the aftermath of George Floyd’s murder, giving new purpose to our historic commitment to fight racism and the injustices it engenders. The Road Map emerged in this context of reconnecting with our roots in social justice in the midst of the pandemic,” says Dr. Butts.
To formalize this work, the Task Force adopted a social change methodology known as Collective Impact, originally defined in 2011 by John Kania and Mark Kramer as “the commitment of a group of important actors from different sectors to a common agenda for solving a specific social problem.” Working in this framework, the team developed five essential components:
- Identified critical issues and articulated key strategies to deliver more equitable care and education, invest in a diverse workforce, redesign business structures with an antiracist and equity lens, and instill antiracism as a core element of Mount Sinai’s culture
- Defined interventions to achieve these strategies
- Recommended methods for tracking progress
- Executed a communications plan to engage stakeholders across the Health System
- Provided backbone support
To move this process forward, the Task Force, working in a participatory decision-making process, developed 11 key strategies, which they shared systemwide with colleagues through a suite of communication vehicles, including the Mount Sinai website and bi-weekly Road Map Bulletin. For implementation, “strategy leads” were identified to oversee systemwide communication through a series of enrichment sessions facilitated by outside consultants.
The authors note a critical question that lies at the core of their Collective Impact work: how to develop a shared measurement system to evaluate progress. The Task Force team outlined a framework for the evaluation of equity measures across three domains: employees, patients, and community. To help accomplish this, they tapped the expertise of Mount Sinai’s recently created Institute for Health Equity Research (IHER), which was established to study the effects of health issues on at-risk communities, including those that are non-white, low-income, immigrant, uninsured, and LGBTQ+ across all ages, genders, and abilities.
“After substantial research and planning, we are finalizing the selection of metrics and methods for data collection, but measuring structural racism is a complex and emerging science. We anticipate that our process will evolve as the this field matures,” says corresponding author and Task Force member Lynne D. Richardson, MD, Mount Sinai Professor of Emergency Medicine and Health Equity Science at Icahn Mount Sinai. Dr. Richardson serves as Co-Director of the Institute. “Rigorous evaluation of the impact of our anti-racism strategies is essential to ensuring that we are moving in the right direction. IHER is committed to collaborating with institutional leaders to accomplish this challenging task.”
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the
eight member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to a large and diverse patient population.
Ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges, Icahn Mount Sinai has a talented, productive, and successful faculty. More than 3,000 full-time scientists, educators, and clinicians work within and across 34 academic departments and 44 multidisciplinary institutes, a structure that facilitates tremendous collaboration and synergy. Our emphasis on translational research and therapeutics is evident in such diverse areas as genomics/big data, virology, neuroscience, cardiology, geriatrics, and gastrointestinal and liver diseases.
Icahn Mount Sinai offers highly competitive MD, PhD, and master’s degree programs, with current enrollment of approximately 1,300 students. It has the largest graduate medical education program in the country, with more than 2,600 clinical residents and fellows training throughout the Health System. In addition, more than 535 postdoctoral research fellows are in training within the Health System.
A culture of innovation and discovery permeates every Icahn Mount Sinai program. Mount Sinai’s technology transfer office, one of the largest in the country, partners with faculty and trainees to pursue optimal commercialization of intellectual property to ensure that Mount Sinai discoveries and innovations translate into health care products and services that benefit the public.
Icahn Mount Sinai’s commitment to breakthrough science and clinical care is enhanced by academic affiliations that supplement and complement the School’s programs. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai. Additionally, MSIP develops research partnerships with industry leaders such as Merck & Co., AstraZeneca, Novo Nordisk, and others.
The Icahn School of Medicine at Mount Sinai is located in New York City on the border between the Upper East Side and East Harlem, and classroom teaching takes place on a campus facing Central Park. Icahn Mount Sinai’s location offers many opportunities to interact with and care for diverse communities. Learning extends well beyond the borders of our physical campus, to the eight hospitals of the Mount Sinai Health System, our academic affiliates, and globally.
* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Beth Israel; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties.