Patient Safety Awareness Week (PSAW) 2021 (March 14-20) at MassGeneral Hospital for Children (MGHfC) hosted a virtual Pediatric Grand Rounds session that featured Ron Wyatt, MD, MHA, a fellow at the Institute for Healthcare Improvement and vice president and patient safety officer at MCIC Vermont.

Wyatt’s presentation, titled “No One is Safe Until All Are Safe: Eliminating Inequity” and sponsored by the Department of Pediatrics at MGHfC, detailed the four root causes of health inequity: implicit and explicit biases, structural competency, lack of trust in the health care system and racism.

Health equity relates to differences in health outcomes within a certain group or population that are systematic and unjust, as opposed to health disparities, which are differences in health outcomes that may or may not be unjust. With greater equity in health care, more people can access and receive the best health care they need and deserve.

“Until we eliminate inequity, we do not have safe health care, not only here in the United States, but around the globe,” said Wyatt.

To create more equitable health care, it is crucial to look at racism from a systematic perspective. It begins with recognizing what influences the structures, workflows, policies or environmental factors that affect the health of patients and their families. This is especially true in examining the effects of poverty on a person or population’s health. In doing so, a sense of trust develops between patients and providers.

Wyatt also touched on implicit biases, or stereotypes or prejudices that people unintentionally or unknowingly hold against a certain group or groups of people. Implicit biases are pervasive, but they do not necessarily align with beliefs or stances that people explicitly support or act upon. A silver lining, though, is that implicit biases can be changed through awareness, reflection and change on an individual and institutional level.

“Implicit biases are malleable, which means we can change to better serve our patients and families,” said Wyatt. “Implicit bias training is now beyond the idea of ‘nice to do.’ It is now a Must Do.”

Wyatt closed his presentation with a poignant message that captured the essence of the presentation. “My aunt always said you have to love people because love is what matters most,” he said. “It starts and ends with love.”

Other virtual PSAW events included: