Why It Matters
Health care leaders from around the world seek advice from Ronald Wyatt, MD, MHA, the Chief Science Officer and Chief Medical Officer at the Society to Improve Diagnosis in Medicine and an Institute for Healthcare Improvement (IHI) Senior Fellow. A longtime anti-racism and equity champion, he has advised leaders for decades on how to make and sustain equitable, system-wide improvement. He is faculty for the IHI Leadership for Health Equity Professional Development Program and co-author of the IHI Achieving Health Equity: A Guide for Health Care Organizations. In a recent interview, Dr. Wyatt shared some of the straight talk and guidance for equity leaders for which he is known.
- Eliminate self-interest. First and foremost, the challenge for health equity leaders is to eliminate self-interest. This work is not for the position or title. It is not for rank, position, power, or authority. You must have the heart of a servant.
- Be proactive. This is not a role where you sit back and wait for everything to come to you. You will have to negotiate for the resources you will need. You may be the first designated equity leader your system has ever had. You will need to build a team. You will need to talk to the board, the C-suite, and people all the way through to the sharp end of a system.
- Build the business case for equity. You will need clinical data that you stratify as best you can by race, ethnicity, and language. You might start with post-surgical complications, falls with injuries, readmissions, or hospital-acquired pressure injuries since systems are required to collect and report this data. Avoid “analysis paralysis” and study just enough data so you and your chief financial officer can begin to understand not only patient harm, but also costs to the system.
- Do not sit around in your office. Equity work is not just inside-the-four-walls work. You have to get out into the community and learn how to build trusting relationships. Make sure you do things to invite people in so that you can be invited in. Go where people are and learn about the community’s perceptions of care. Conduct listening sessions or town halls. Listen carefully and respectfully and then show the community what you plan to do to improve people’s lives and the care they receive.
- Anticipate pushback with humility and empathy. There is plenty of fear in the system when we talk about disparities, inequities, racism, and bias. As a health equity leader, you must learn how to address pushback when you raise these issues. Getting to the root causes of those fears requires empathy. Meet with people who are responding unfavorably and say, “Tell me what you know about this. What is your perspective?” They might have ideas or perspectives you never considered.
There is no how-to guide on how to be an effective equity leader, but I hope this guidance is helpful. Whether you are new to the role or have years of experience, prioritize listening and learning. Persist.
Editor’s note: This interview has been edited for length and clarity.
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