Outpatient Surgery Magazine

Bring It On- December 2020 - S...

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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making clinical decisions based on automatic assumptions about patients' social, cultural or eco- nomic backgrounds. The earliest research on the impact of implicit bias on patient care centered on race, and showed that when black and white patients presented with chest pain suggestive of a potential heart attack, white patients were far more likely to receive timely access to life-saving cardiac interventions. Additional research has shown the same race- based treatment patterns existing for a number of diseases. Implicit bias isn't only about race, how- ever. It impacts assumptions, and consequently actions, about numerous characteristics, including gender, body size, sexual preference, religion and health behaviors. While we can't rid ourselves of implicit bias, taking the time to recognize it and checking one's assumptions can go a long way in combatting the effects on health outcomes. Awareness, then action Most providers lack the training and skills to imple- ment cultural humility fully in their daily practice. Making providers aware of the need to treat patients equally is a potentially more effective strategy than attempting to eliminate implicit bias. Surgical profes- sionals need to recognize that stereotypes and preju- dices occur in everyday thinking, and that acknowl- edgment is the first step in overcoming these uncon- scious barriers to cultural competence. The Implicit Association Test measures attitudes and beliefs people may be unwilling or unable to report (osmag.net/U4ajAT). Taking the free test could reveal implicit attitudes of which you and your colleagues might not have been aware. This test is a good way to begin implicit bias training. Continuing with educational sessions conducted at least annual- ly will help your team recognize biases they have, and therefore make them aware of the assumptions they make about certain patient characteristics. Providers who are more aware of these assumptions can act more deliberately to ensure they provide the same processes of care to all patients. Approaching each patient interaction with empa- thy, showing compassion and having a sense of the patient's perspective are effective ways to counter- act the impact of implicit bias. Surgical profession- als can also improve how they communicate with diverse patient groups. For example, surgeons can employ the shared decision-making model, which involves asking patients to tell their story, openly and honestly sharing the risks and benefits of surgi- cal procedures, making recommendations for treat- ment, asking patients for their preferred approach and arriving at a mutual decision about the best path forward. Moving forward It's challenging to definitively link implicit bias to adverse surgical outcomes, but patient care is neg- atively impacted if providers don't empathize with patients of all races, ethnicities, genders, sexuali- ties and other characteristics. Implicit bias could also negatively impact quality communication and the sharing of information among a diverse group of healthcare providers. Although this factor has not been definitively studied, it's deserving of fur- ther research. Discussions about racial and societal disparities in communities across the country have increased awareness about implicit bias and its impact on healthcare equality. The younger generation of healthcare providers is also pushing for change in established workplace cultures with respect to addressing implicit bias in the treatment of patients with various sociocultural backgrounds and grow- ing an emphasis on practicing cultural humility. Continuing to increase awareness of unconscious prejudices and attitudes among surgical profession- als will lead to improved access to care for all patients. OSM Dr. Santry (heena.santry@osumc.edu) is an acute care trauma surgeon at The Ohio State Wexner Medical Center in Columbus. D E C E M B E R 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 2 1 Leaders with implicit bias adversly impact the hiring of a diverse workforce.

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