Cover Story: Looking Ahead After ‘Racial Reckoning’
Just months before the COVID-19 pandemic highlighted the many ways quality healthcare was not equally available to all members of our communities, Hartford HealthCare accelerated its Diversity, Equity, Inclusion, and Belonging journey in earnest with the creation of a department and recruitment of a dynamic senior leader. What followed through the pandemic was a broad array of work — done mostly via Zoom — that will improve the way we interact with our patients and each other. As we begin our second year on this journey, we are sharpening the focus on why this is important work. There are bumps in the road locally and nationally — the Buffalo supermarket shootings, while hundreds of miles away, reminded us just how far we have to go. Read on and hear about the vision and the personal hopes of some of the colleagues who are involved.
‘Promises to Keep, and Miles to Go Before We Sleep’*
By Susan McDonald
Sarah Lewis, VP of Health Equity, speaks at the Supplier Diversity Summit this spring.
When COVID-19 hit, organized health equity, diversity, and inclusion (HEDI) efforts at Hartford HealthCare were just beginning to gel; the pandemic not only underscored the need for this work but helped chart a course.
“We had to build while reacting to the crisis,” said Sarah Lewis, vice president of health equity, diversity and inclusion who started in July 2019. “Now we’re looking at how to transform beyond COVID.”
HEDI work spans the system, with region-specific councils forming and colleague resource groups (CRGs) drawing members from all over. In addition, some colleagues were included in a climate assessment survey commissioned to gauge where we are and where we can go.
“COVID was happening so we were limited on observation, but the consultants asked questions about our culture and organization,” Lewis explained. “Without this survey, we couldn’t start this in such a holistic way.
“We have been very fundamentally focused on how things should be, while being very aware of how things were during COVID. I call it the ‘racial reckoning’ of COVID.”
The pandemic, she said, highlighted differences in the access populations have to quality healthcare due to race, income, residency and language. Understanding these discrepancies and wanting to eliminate them was the impetus for creating her department.
“I think about us as setting the gold standard regarding expectations about providing care that is excellent and equitable in all instances. I see us measuring equity like we measure quality and safety,” Lewis said.
The department, she continued, works to embed these practices into the HHC infrastructure so colleagues feel comfortable challenging inequities they see or experience.
“When colleagues feel safe to speak up and provide meaningful contributions, it enhances our capacity to provide equitable care,” she said.
As a result, things can improve for marginalized and disenfranchised groups, although Lewis said the work will never be completely done.
“Like quality and safety, you’re never done — you’re constantly putting your shoulder to the wheel,” she said. “People will evaluate their care based on this, so we need to demonstrate that we’re doing it. It’s right and people expect it.”
She used an example from a meeting of the LGBTQ+ CRG, when gay and transgender colleagues admitted they sought care outside HHC because the system didn’t offer services they needed.
“We have not been a provider of choice for a group of our employees and that’s just wrong,” Lewis said, adding that the work being done now will pay off even more when payers begin requiring equity metrics for reimbursement, as they do now for quality and safety. “It’s a moral imperative.”
HHC leaders have started taking ownership of the HEDI work — something Lewis called “particularly transformational” — and CRG members have identified and initiated projects tied to the system’s strategic priorities. It’s part of “creating a cycle of feedback” Lewis said makes people “feel seen” and improves organizations as a whole.
“There is a human call to action that is healthcare. People come into the field because they really want to help,” she said. “We’re tapping into that.”
In one year, there has been tremendous growth and the DEIB Councils and CRGs have become valuable resources for all colleagues, she said.
“It’s a place to discuss the most important issues the group cares about at that moment in a psychologically safe place,” Lewis said. “I’ve seen colleagues engaged in a way that feels good for them.”
*Title paraphrases the Robert Frost poem “Stopping by Woods on a Snowy Evening.”
Health, Equity, Diversity and Inclusion Journey
Core objectives include:
• For colleagues: Build trust and a sense of belonging among colleagues through a safe, diverse and inclusive work environment.
• For the organization: Evolve the structure and sustainability of Health Equity Diversity and Inclusion at HHC.
• For patients: Advance health equity and improve care for all patients by improving data collection, stratification and analysis.
• For the community: Build trust and loyalty with patients and communities through social impact, community engagement and anchor strategies.
• For all: Communicate the “why” of our commitment to equity and inclusion.
Racial Equity Achievements
Despite the pandemic, fiscal year 2021 experienced many DEIB accomplishments, including:
1. Establishing a system-level DEIB Council.
2. Creating Colleague Resource Groups.
3. Requiring bias awareness training for all colleagues.
4. Conducting CEO roundtables to listen, engage and hear concerns and suggestions.
5. Establishing a Supplier Diversity Council.
6. Engaging an external firm to conduct an equity and inclusion assessment and culture audit.
7. Creating the Fair Chance Program to provide employment and career advancement opportunities for those with criminal records.
Racial Equity Achievements (Cont.)
Projects carried into fiscal year 2022 include:
• Expanding the Health Equity Department.
• Expanding recruitment and career development programs for leaders from underrepresented backgrounds.
• Making strategic investments to advance racial equity in the communities we serve.
• Participating in the Institute for Healthcare Improvement Pursuing Equity Learning and Action Collaborative
• Joining the Healthcare Anchor Network and declaring racism a healthcare crisis.
From Flat-Lining to Flourishing: Successfully Stretching Skills at Work
By Susan McDonald
Tasha Roberts turned her temporary job into a fulfilling full-time position at Hartford HealthCare with her brainstorm “Stretch Assignment Program.”
Photo by Chris Rakoczy
Tasha Roberts said that, at one time, word in the local African American community once was that if you wanted to get a job at Hartford HealthCare, you either had to know someone or start as a temp and hope for the best.
Indeed, Roberts started as an administrative assistant temp with Hartford HealthCare at Home (HHCAH) in 2018 but how she got to where she is today involved more than “hoping for the best.” Her skills and friendly, get-it-done approach earned her the position full-time, which gave her more security, but not the challenge she knew she needed to thrive.
“I was flat-lining. There was no room for growth and I found myself wanting to leave,” Roberts said.
That’s when she read an invitation to apply to join HHCAH’s newly-forming Diversity, Equity, Inclusion & Belonging Council and, later, the Black and African-American Colleague Resource Group (CRG). An inaugural member of each group, Roberts saw an opportunity to push herself and provide opportunities for others who may be experiencing similar frustrations.
She proposed creating a “Stretch Assignment Program” to offer minority colleagues an opportunity to showcase their talents, develop new skills, gain exposure to other departments and stretch beyond their comfort zones. This was the stretch Roberts imagined others longed for as much as she did. Her entry-level position didn’t allow her to use her experience or knowledge, but applications for jobs across the system didn’t yield opportunity.
“I was applying for all sorts of jobs. Most times, I never heard back,” said the 54-year-old Hartford mother of two.
She took her idea for the Stretch Assignment Program — a Sharepoint listing of challenging projects currently available to HHCAH colleagues — to Laurie St. John, vice president of HHCAH, who listened and, with Roberts’ mentor, Laurel Regan, served as sounding boards as the project evolved simultaneous to her daily tasks.
The work also gave her the exposure she needed to earn the position of project specialist at Hartford HealthCare Medical Group (HHCMG) where she can finally “utilize skills I felt like I was losing.”
Roberts is convinced the struggle to find her niche is rooted in her race. Before joining HHC, she worked in other corporate environments, usually the only African American in meetings. She remembered a job that required overnights in Boston for meetings. White colleagues were given corporate American Express cards to pay for their stays.
“My card wasn’t approved even though I have good credit, better credit than some. I couldn’t figure it out — it’s a corporate card, not personal, and something I’d had at other companies. Why didn’t I get one there?” Roberts said.
Reactions to her at work at HHC are generally welcoming and collegial, but Roberts has a knack for identifying people whose behavior suggests they’re uncomfortable or worse.
“The workplace isn’t keeping pace with the world around us,” she noted. “If I’d had a different kind of personality, I probably would have left.”
She is heartened, however, by work being done by DEIB councils and CRGs. She enjoys sharing “fun facts” from DEIB newsletters in huddle, and is getting used to operating outside her comfort zone, having developed and presented the Stretch Assignment Program to HHC’s Executive Leadership Team.
Her presentation skills and desire to grow so impressed Sue Barrett, an HHCMG executive, she suggested Roberts apply for the job she now holds.
“I use all these opportunities to gain exposure, make connections and network,” she said. “You have to determine what you want and create a village to help you get there.”
She keeps an eye on the Stretch Assignment Program, which has helped six colleagues to date. Assignments include program development, virtual huddle board design and work for five candidates in HHCAH’s DEIB Mentoring Program.
“From an African-American perspective in the workplace, it always seems that everyone is connected except us,” she said. “Networking is what created an opportunity for me.”
With the CRGs, people of all backgrounds make connections and find opportunities to use their stories and experiences to change business as usual, she continued.
“We are as smart and innovative as any other race,” she said. “Some people may look at me as aggressive and outspoken, which is a stigma for African-Americans. The biggest difference between you and me is the history.”
Emboldened by her success, Roberts wrote a letter to HHC President and CEO Jeff Flaks, summarizing her experience. Her words so impressed him, he shared the letter with the Board of Directors. In part, she wrote, “I learned the level of patience it takes to develop a program which required constant feedback and approval, creation of Standard Work and the confidence needed in presenting to ELTs. Presenting to leadership was one of the many challenges that stretched me out of my comfort zone.
“Had I not joined the DEIB Council for HHCAH as well as the BAA CRG, I honestly believe I would’ve posted outside of HHC and gained employment elsewhere. So, thank you, Mr. Flaks, for making Diversity, Equity, Inclusion and Belonging one of the top priorities at HHC. It’s truly making a difference for all of us.”
From Immigrant Struggling with English to Leader
By Susan McDonald
“You find people with shared experiences, coming together to be vulnerable and wanting to drive systemic change.” – Jose Garcia, a Mexican immigrant, is co-chair of the Hispanic and Latinx Colleague Resource Group
There’s a scene in the ABC sitcom “Modern Family” in which the Spanish-speaking mother, played by Sofia Vergara, is frustrated that her son doesn’t want to study her native language in school.
Her dismay runs deeper than merely wanting someone to chat with freely, but hints at feelings of inadequacy and knowing people assume she’s not intelligent because she can’t always express herself well in English.
“You have no idea how smart I am in Spanish!” she exclaims.
That, according to Jose Garcia, is the immigrant experience in a nutshell.
Garcia, business program manager with Digestive Health & Surgery for the Hartford HealthCare Medical Group, immigrated to the United States from Mexico with his family when he was 15 and understands how Vergara’s character felt.
“English proficiency is not a measure of intellect.
That’s a huge component for Hispanic people, and I know my accent has made me self-conscious about professional interactions,” said Garcia, who is co-chair of the system’s Hispanic and Latinx Colleague Resource Group (CRG).
Even though he had studied English in school in Mexico, it was more proper use of the language so he didn’t initially fit in with his new high school peers in the Texas border town where his family settled so his father could continue practicing medicine in Mexico.
“I could not hold a conversation. It sounded so scripted and if they veered from the script, I was lost,” he remembered. “There was a kid in the lunch line once who commented on my shoes. I didn’t know how to respond, so I left the line.
“I didn’t know how to have an organic conversation.”
The move to Texas was to improve the family’s life, especially as Mexico faced a challenging and uncertain political climate, but Garcia remembered hearing comments that “this is America, speak English” in the hallways at school.
His parents still struggle with the language — his father speaks some English but his mother speaks none, although she can understand the language.
Adjusting to his new country took a while for Garcia, who chose a smaller college where he could have closer relationships with professors and feel comfortable asking more questions when needed.
“It was a period of significant adjustment and you’re always adjusting. Even moving from Texas to Connecticut required adjustment. When I first moved to the U.S., I needed to find a niche, make friends and assimilate to a different culture,” he said.
After graduating, when it came time to apply for jobs, Garcia still experienced overwhelming feelings of self-consciousness about speaking English with an accent.
“You’re translating everything in your head all the time. I would be the new guy at work, very quiet and not speaking up because I was worried that if I couldn’t find the words or if I stumbled upon certain words, people would think I wasn’t smart,” Garcia relayed.
At home, he watched videos to help him stop rolling his Rs, a characteristic of Spanish speakers, even as he continued to speak Spanish with his parents and a mixture he called “Spanglish” with his wife and 7-year-old daughter.
“At the end of the day, it’s who I am,” Garcia noted. “I keep it with me and choose to not see it as a detriment. What was once seen as a weakness is now a strength.”
His fluency, in fact, helps him working with Spanish-speaking patients and colleagues. He remembers a time working at a hospital in Texas a patient cried because they were so happy for help in a language they understood.
He’s also found a new level of collegiality in the CRG, which meets monthly and has targeted several projects to help others feel more comfortable working at HHC and coming to HHC providers for care.
“That’s what’s invigorating about the CRG,” he said, “you find people with shared experiences, coming together to be vulnerable and wanting to drive systemic change. It’s priceless.”
As they tackle things and identify opportunities to address he promised the group’s work will be revolutionary.
“It’s only just beginning. We’re just getting started!” he said.
What’s in a Name? A Whole Lot
By Susan McDonald
Mui Mui Hin-McCormick, second from left, celebrates Chinese New Year with her family, some of whom are dressed in traditional attire.
Smart, successful, law-abiding, healthy, polite – those are adjectives commonly used to describe Asian-Americans, and while they may seem positive, the results of painting an entire race with a broad brush of any kind can be detrimental.
Mui Mui Hin-McCormick, clinical director of adult residential services at Rushford and a member of the Asian-American and Pacific Islander Colleague Resource Group (CRG), said the practice “model minority myth” phenomenon can stand in the way of Asian-Americans receiving the support they might need.
“This has been haunting us for some time. It profiled us as racial success story as early as the 1960s,” Hin-McCormick said.
While many Asian-Americans are successful, grouping them into one category is not healthy or helpful, she continued. In addition, the practice ignores the innate diversity between various Asian-American cultures and can pit one against another if some are positioned as better.
“The model minority myth also places unrealistic expectations on us, and we place that on ourselves, causing stress,” said Hin- McCormick, a Chinese American.
Perhaps most importantly, she said the myth leaves many believing Asian-Americans do not need the help of social, economic or educational resources and programs. As a result, she said there are no social services tailored to the group’s specific needs.
Part of one of the few Asian-American families in her community growing up, Hin-McCormick remembered being bullied for having a different name and bringing Asian foods for lunch.
“I was the target of a lot of criticism and the teachers always expected us to be high achievers,” she said.
Teachers also urged her to ignore the bullies, and a language barrier at home meant her mother didn’t fully understand what was going on at school. The treatment caused “a host of impact,” which, like many Asian-Americans, she internalized until she got older and realized the value of talking about it.
“It was a struggle for me until I found an avenue to have these conversations,” Hin-McCormick said, noting that conversations at CRG meetings further help her address the challenges.
Talking — and starting the discourse with children early — can help dispel model minority myth and mediate its effects, she continued. In addition to chatting with her 12-year-old daughter, Hin-McCormick strives to provide role models “who look like her” to help her feel confident and capable.
“It’s wonderful to have a CRG that you can share experiences in, where people understand about the culture you came from because they came from a similar culture and understand,” she said. “For example, I am not the only one that has a different name that might be difficult to pronounce in this CRG.”
Members of the Asian-American and Pacific Islander CRG even created a video called “What’s in a Name?” to address the negative impact of mispronouncing people’s names and provide strategies to help create a more inclusive work environment.
“Not only does it feel like I belong, but it validates that I am not alone and I do have support from my colleagues. It also reinforces that I can support others,” Hin-McCormick said.
Hartford Hospital's Inpatient Rehabilitation Unit staff stand with red lanterns displayed for Lunar New Year created by the Asian American and Pacific Islander Colleague Resource Group. (Left to right) Akeem Green, RN; Emily Nguyen, Nurse Manager; Jessica Niggebrugge, Recreational Therapist; Kristy Gest, PCA; Merva Dixon, Nurse Pratitioner; and Catherine Thresher, Nurse Educator.
Waving the Flag for Authenticity
By Susan McDonald
Being LGBTQ+ can feel isolating, but for two Hartford HealthCare colleagues, the opportunity to bring about change with the formation of a new Colleague Resource Group (CRG) came with the chance to make friends.
Joanna Cotto has worked in the medical field for about 20 years, two years as office coordinator with Women’s Ambulatory Health Services at Hartford Hospital, and is usually the only openly gay person in her work area. Many colleagues through the years have been surprised to learn she is gay.
“I don’t fit the common stereotype. They tell me things like ‘You’re so feminine, I would have never known’ or ‘You’re just like us!’ For many of them, I’m the first colleague they’ve known who’s out, maybe the first person they’ve known at all,” said the Hartford resident who was 30, married to a man and raising a daughter when she came out. “I think I kind of always knew, but people said I needed to wait because it was about my daughter.
“I figured if I’m unhappy, my daughter would feel it. It was time to be my authentic self.”
A similar search for authenticity went on in Heather Pierzchala’s Simsbury home, where her young child was asking to shed the identity assigned at birth to wear the dresses and jewelry she admired. Teachers suggested the preschooler was going through a phase. The pediatrician suggested allowing girl clothes at home but not school. The boundaries, however, did not appeal to the child, now a 7-year-old second-grader named Leah (her choice!).
“She had a lot of anxiety that manifested into violent outbursts. She would bang her head against the wall, pull her hair out in clumps and say things like ‘I hate myself. I’m just a stupid boy!’” Pierzchala recalled. “It was very apparent that this was a deep, intrinsic thing in her.”
When she and her ex-husband decided to allow Leah to dress herself for school — after teachers explained the change to her classmates — “everything started leveling off.”
On their unique journeys, both women were interested in an opportunity to impact the journey of others in the LGBTQ+ community.
They applied to join the LGBTQ+ CRG and have enjoyed sharing stories and planning for a future that includes enhanced healthcare services for gay, lesbian, transgender and gender neutral people.
“I had zero experience dealing with anything transgender related before. I just knew I wanted my daughter to be herself and to be happy,” noted Pierzchala, who worked until recently as a lean sensei for the Community Network and Supply Chain. “Like her pediatrician said, ‘I don’t really know, but we’re going to go through this together.’
“This is a way I can help inform other people because there’s so much misinformation out there. And, I can help create better care that my daughter will ultimately benefit from.”
For Cotto, joining the CRG is a chance to feel like she fits in.
“I’ve never had a group, so to speak,” she said. “I was so excited when I first saw it and I feel I can represent people on a larger scope instead of being the only one in the clinic.”
Participating in events like Pride Fest with the CRG has also been a way to make connections with people, often patients.
“It’s nice to be in the community. It makes people feel more comfortable and welcome when they come into the office and know I’m a lesbian,” Cotto said. “It makes them less afraid to ask questions.”
Working with colleagues who understand the feelings of fear, frustration and uncertainty that can plague people in the LGBTQ+ community — or those raising them, in Pierzchala’s case — fosters strength.