Eye on DEI

Beating Bias to Build Better Teams

By Susan McDonald

In the first overview of its kind, an Institute of Living (IOL) leader published research into the role implicit bias plays in collaboration between healthcare professionals.

The article — “Exploring Implicit Influences on Interprofessional Collaboration: A Scoping Review” — was published in the Journal of Interprofessional Care. Dr. Javeed Sukhera, chair of psychiatry at the IOL and chief of psychiatry at Hartford Hospital, was lead author.

“We know there are multiple tensions that can influence team performance, especially in healthcare,” Dr. Sukhera explained. “We also know that implicit biases can influence team communication and trust, ultimately affecting quality of care. That’s why we wanted to understand how bias influences team collaboration on multiple levels.”

The research is the first comprehensive review of how biases — related to race, age and gender — influence collaboration in healthcare.

“We found team members internalized biases about their profession. Perceptions of the biases influenced their attitudes and behavior toward themselves and others. This hindered meaningful, equitable collaboration,” he said.

In response, he said, people often adapt how they collaborate to reflect power structures and organizational hierarchy. The behavior of others can also condition some healthcare professionals to view themselves as having certain attributes or expertise.

“Learning how personal and professional identity influences collaboration is essential to help us build the health system of the future. If a team member sees themselves as powerless or lacking authority, they tend to disengage. To have a high-functioning team, it’s essential that everyone feels they belong,” Dr. Sukhera said.

Banners noting Equity as the fifth value were hung around hospital campuses.

Photo by Steve Coates

Sarah Lewis, vice president of health equity for Hartford HealthCare, said the research contributes “to our shared understanding of how bias influences the human experience in healthcare settings.”

“This research points us in the direction of the connection between colleague wellbeing, belonging and psychological safety,” Lewis said. “Improving our ability to succeed along all of these dimensions can positively influence how we care for our patients, and how we show up in the communities we serve.”

Leadership, both Dr. Sukhera and Lewis agreed, also plays a key role. Success, Lewis noted, “depends on our ability to bring everyone’s voice to the table, and that requires an inclusive environment fostered by inclusive leaders.”

“Having the ability to understand and mitigate biases are not skills traditionally expected of healthcare leaders,” she said. “We are learning that, going forward, they must be. The health and well-being of our workforce and our patients depends on it.”

Interestingly enough, Dr. Sukhera’s research uncovered the tendency of team members who see themselves as less dominant — social workers in one case — to align with those they perceive to be more dominant to increase their influence. These findings, he stressed, should help promote future research on bias and belonging in healthcare.

“We know bias can adversely influence healthcare quality. We hope this will spark further research on how bias, privilege and power intersect between and among different health professions,” he said.