Building a Better Workforce in Safer, More Welcoming Environments

One in a series of articles commemorating the two-year anniversary of Mass General Brigham’s United Against Racism initiative

As the largest private employer in Massachusetts, Mass General Brigham has an obligation to develop an inclusive culture. With 80,000 people working across our system, we have an extraordinary opportunity to educate and mobilize our workforce to be active in dismantling racism. We have begun that process across a number of areas. On the two-year anniversary of United Against Racism, we are proud to give updates on these initiatives:

• Recruitment of our most diverse medical residency class ever
• Supporting diverse candidates through workforce development
• Anti-racist employee programs
• Launching our patient Code of Conduct

Fostering diversity in our physician workforce

In an effort to receive more equitable care, patients may prefer to seek out providers of their own race or ethnicity. But data from the Association of American Medical Colleges (AAMC) shows that among active physicians, 56.2% identified as White, while only 5.8% identified as Hispanic and 5% identified as Black or African American. 

Recruitment initiatives led by the Mass General Brigham office of Graduate Medical Education aim to close this gap for candidates who are “Underrepresented in Medicine” (UiM), a term designated by the AAMC as racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population nationally, regionally, or locally. 

During the pandemic, Mass General Brigham (along with many teaching hospitals across the country) pivoted to remote residency match interviews. Prior to this period, a good turnout for an in-person reception might be about 40 people. With the switch to virtual platforms, hundreds of applicants were able to attend. Virtual recruitment added an equitable benefit for students who could not afford to travel, increasing the number of diverse applicant interviews.

Prior to 2021, UiM matches at Mass General Brigham ranged between 8-20%, depending on the program. But on Match Day 2021, we saw 25% UiM candidates overall. And on Match Day 2022, we saw 33% UiM candidates.

“I interviewed at 22 programs,” said Ikechukwu Amakiri, MD, MBA, Orthopaedic Surgery Resident, Harvard Combined Orthopaedic Surgery Resident Program. “I thought it was honestly unique to Mass General Brigham to see that many residents being interviewed who looked like me, sounded like me, and were underrepresented in medicine.”

Supporting diverse candidates through workforce development

Mass General Brigham Workforce Development programs serve everyone but focus on diverse populations — often from economically challenging circumstances. While there are many programs, some highlights from this year include:

• A $5 million Federal Good Jobs Grant offering accelerated training for candidates interested in Medical Assistant and Patient Care Tech (PCA) roles. Our plan is to place 1,000 people into high-demand direct care roles in years 2023-2025.

• A collaboration with African Bridge Network and the Boston Mayor’s office to provide internship and employment opportunities at higher levels to new Americans (foreign trained professionals) as part of the Immigrant Fellowship Program. Mass General Brigham also provides guidance and assistance to foreign-trained professionals to help secure employment with placement assistance and coaching.

• 20 Diverse Nursing Students from UMass Boston’s Manning College of Nursing and Health Sciences will be selected to enter the Clinical Leadership Collaborative for Diversity in Nursing (CLCDN) program, where they will receive Mass General Brigham clinical placements, one-to-one mentorship, and professional development opportunities.

Creating an equitable and thriving workplace culture

Racism has many impacts on patients and employees alike. Innovative courses, such as Stepping Stones and Ending Racism: Everyone’s Responsibility, are key elements of compliance training at Mass General Brigham.

To better support these learnings and foster an environment free from harassment, racism and discrimination, Mass General Brigham has created a Concern Management System for employees, patients, and visitors. This pathway allows anyone to report instances of inappropriate behavior so we can attend to these occurrences through strategies and tactics that will sustain a safe and engaging space for everyone

Mass General Brigham has also launched “Upstander” training, which allows for employees to understand how they can be active participants in stopping or responding to racism and other forms of bigotry. The goal is to equip staff with concrete tools for how to respond when they see or experience racism, discrimination, or mistreatment in their personal and professional lives.

Patient code of conduct

Just as we strive to provide the best clinical care and experience possible, Mass General Brigham aims to be a safe, welcoming environment for both our patients and our staff. In response to the national rise in violence and hostile behavior at healthcare facilities, Mass General Brigham has implemented a systemwide code of conduct for visitors and patients. The code outlines how words or actions that are disrespectful, racist, discriminatory, hostile, or harassing are not welcome. Several of our hospitals have previously implemented similar guidelines, but this is the first policy to be rolled out across the system.

This new code of conduct, which has been evaluated and refined over the course of the past year, has been shared with patients and staff. It will be physically posted in our hospitals, and it is also available to the public through our website.

The start of a long journey

By diversifying our workforce, training our staff, and holding everyone who enters our facilities accountable for their words and actions, we recognize the threat of disrespectful, racist or discriminatory words and actions on members of our community. This work is not immutable, but merely provides a starting point to build from, evaluate, and grow. These programs and policies help to define appropriate behaviors for our employees, our clinical staff, our patients, and other visitors to help create a welcoming and respectful environment for all.

This is just a small sample of all the incredible work happening across the system to combat racism and other inequities in our facilities and our workforce. For a deeper dive into this strategy, we recommend reading our interview with Rose Sheehan, Chief Human Resources Officer.

If you missed it, read our previous installment, a message from Dr. Anne Klibanski, Chief Executive Officer at Mass General Brigham, commemorating the two-year anniversary of our United Against Racism initiative.

In our next article, we’ll be looking at how we’re combatting inequalities in our clinical settings.