Olivia Okereke, MD, MS, inaugural director of the newly established Massachusetts General Hospital Department of Psychiatry’s Center for Racial Equity and Justice, is leading anti-racism efforts in the department, the psychiatry field, psychiatric research and more.
Deborah Washington, PhD, RN, has had a long and distinguished career at Mass General. For more than 25 years, she served as director of Diversity for Patient Care Services at the hospital. With a lifelong passion for social justice and commitment to equity, her work and influence have been recognized locally and nationally. She has received numerous prestigious awards, notably the Lifetime Achievement Award from the National Black Nurses Association in 2019.
This past year, amidst the devastation of COVID-19 on communities of color and a global reckoning on race, Deb transitioned to a new role under the Mass General Equity & Community Health umbrella. She is now the Diversity, Equity and Inclusion (DE&I) community health partnerships manager. We sat down with Deb to get her historical perspective, her take on the current state of equity and community health efforts in our health system.
E&CH: Tell us a little about your role at Patient Care Services—the history and what early efforts in the DE&I space looked like.
DW: I became the first director of Diversity for Nursing and Patient Care Services over 25 years ago. I was chair of the first department-wide committee on diversity, and the strategic plan created by that inaugural committee was pretty ambitious and visionary. The launch was driven by the need and goal to educate staff and employees about the value of diversity and culturally competent care. That was the language of the times, and it reflected the starting point for organizations ready to start on that change in organizational life. We created a curriculum to explore the value added of a diverse workforce. We learned about the changing demographics of the country. We especially focused on the impact of what it meant to have a multilingual patient and family population who needed our care. Today it’s very common to describe those first steps of awareness as “fun, food and flags.”
E&CH: How have things at the hospital changed or evolved over the years?
DW: The focus continues to be on raising awareness. Current jargon articulates that state of being as “being woke or not yet woke.” COVID and social justice movements have certainly contributed a great deal of meaning and depth to issues that have been part of the diversity conversation for decades. The most significant change is personal ownership by those concerned about issues of justice, social equity and the elimination of disparities in all its forms. Of course, for Black people, that specifically means equal treatment when it comes to health care access, affordability and the quality of interpersonal interactions.
E&CH: What led you to transition from PCS to Equity and Community Health? Where do you see your experience thus far fitting into this new landscape?
DW: During COVID, my interactions with BIPOC communities started to dominate my workday. Phone calls, texts, emails from community contacts at the local and national level focused on what was happening in the community and how concerned people were. This outreach and the concerns were happening before things got sorted out and started appearing in headlines and on the news. The lived experience of disparities was more invisible at the beginning, except to the people who had questions about what they were seeing. Needless to say, the national dialogue about the health of the public continues to demand we keep at problem solving inequities.
This new landscape means that we move from addressing health as a crisis and more towards finding breakthroughs to something better that the system can deliver. Old paradigms need to be dropped. We’re in the process now of doing that. One example is our community care vans that bring services out of our brick and mortar walls of the hospital and health centers to mobilize care in new ways. We’re going to see more of that. Technology will help. New models of care that put the community-based patient in the driver’s seat of designing how care is delivered and care design that takes into account the social determinants of health are elements of new ways of thinking.
E&CH: What are your hopes for the future?
DM: My hope for the future is that as we redesign care delivery so that things like socioeconomic status, race, where a person lives, or any aspect of social status no longer have an outsized impact on to what extent any human being can get what they need when they’re not well. In a one-to-one situation, it is unimaginable that any person would turn their back on another person who needed help. Just because we systematize how we assist one another doesn’t mean that we change that sense of duty or obligation. Leaders operationalize what we mean by the concept of assistance. Helping one person at a time or helping social groups makes no difference.
E&CH: What is your advice to the new crop of leaders?
DM: Work with an eye to having personal impact. It takes time to change how a system operates. The problems before us cannot wait. For the time being, I believe that if each of us acts on our values while we hold positional influence, then small steps by individual people can keep collective change moving forward. I heard a speaker once say that the status quo is resilient. If nothing else, each of us can use our voice to point out when we are moving backward or standing still. The new crop of leaders is expected to bring something fresh to the table. I can’t wait to see what that looks like.
E&CH: What is the question that I didn’t ask that you’d like to answer?
DW: How do we stay close to the truth as we talk and strategize about what needs to be done moving forward? Every time I participate in a meeting, that’s my constant mantra. In what way are we staying close to the truth at this moment and in this conversation?
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