Unconscious Bias

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Unconscious Bias in Health Care

The Joint Commission (2016) has recommended safety actions health care organizations should consider to ensure threats of bias do not impact clinical care decisions and the best health care outcomes. In addition, clinicians and decision-makers must understand how bias and racial discrimination impact health outcomes of patients. Recommended actions include:
  • Evaluating the racial climate by evaluating employees' shared perceptions of the policies and practices that communicate the extent to which fostering diversity and eliminating discrimination are priorities in the organization.
  • Investigating reports of subtle or overt discrimination and unfair treatment.
  • Identifying and work to transform formal and informal norms that ignore and/or support racism.
  • Establishing monitoring systems in which processes and outcomes of care can be compared by patient race. Collecting data on race and other indicators of social position can be used to self-assess, monitor and evaluate the effectiveness of the organization's strategies for eradicating inequities in care.
  • Giving care units and, where appropriate, individual clinicians, equity-specific targeted feedback. When inequities are found, support creative solutions for remediation and create accountability for improvement.
  • Implementing work policies and clinical procedures that protect clinicians from high cognitive load and promote positive emotions. When clinicians' cognitive capacity is low or overtaxed, memory is biased toward information that is consistent with stereotypes. High cognitive load can be created by: productivity pressures, time pressure, high noise levels, inadequate staffing, poor feedback, inadequate supervision, inadequate training, high communication load and overcrowding.
  • Promoting racial diversity at all levels of the organizational hierarchy and support positive intergroup contact. Intergroup contact can reduce intergroup prejudice and help reduce feelings of interracial anxiety. Additionally, institutional support for interaction can increase the benefits of intergroup contact.
  • Implementing and evaluating training that ensures that clinicians have the knowledge and skills needed to prevent racial biases from affecting the quality of care they provide. The training should cover self-awareness regarding implicit biases, and skills related to perspective-taking, emotional regulation,= and partnership-building.
The Joint Commission, Division of Health Care Improvement. (2016). Quick safety: Implicit bias in health care, 23.