How to Measure Unconscious Bias

How to Measure Unconscious Bias

A children’s hospital reveals unconscious bias and inequities with a reporting system and culture change.

Quantifying events that breach an organization's diversity, equity, inclusion, and justice (DEIJ) norms is difficult. But an internal study at Riley Children’s Health made one thing clear: Black patients were two-and-a-half times more likely than white patients to be the subject of potential threat/behavioral alerts.

“That was really hard for our team to swallow,” said Elaine Cox, MD, chief physician executive at Riley Children’s Health in Indianapolis. “But it kicked off our strategic plan around what we are not seeing or doing, how we can make it clear that this is happening, and how we can train people to think and act differently.”

Recognizing that inequities exist is the first step of the hospital’s four-year DEIJ “road map.” Central to the goal is helping team members understand the prevalence of unconscious biases.

“A lot of times we don't recognize things are happening because of our own behaviors and actions,” said Shawnette Bellamy, manager of the health system’s DEIJ program. “But it’s hard to recognize without a method to measure it.”

The team developed a reporting mechanism patterned after the health system’s safety reporting framework. It quantifies the presence of unconscious biases and informs the DEIJ team’s response to events. So far, it has helped shine a light on unconscious bias across the organization. In a recent survey, 93% of staff said they became more aware of bias over the last year and 70% reported an increased comfort level with conversations around DEIJ.

Keys to success

Cox said drawing parallels to existing platforms — as Riley Children’s Health did with their safety reporting system — can ease the development of a respect and dignity event reporting framework. But it doesn’t guarantee a seamless transition; organizations shouldn’t underestimate the amount of socialization it will take for team members to feel comfortable using it.

“We had a little slower uptake than we expected, and I think it's because we could have done a little bit more implementation work,” Cox said.

Cox and Bellamy said it’s helpful to view incidents against respect and dignity as safety events — they are preventable harm to a person’s psychological safety. But it doesn’t require a new system to begin addressing the problem.

“The main thing is creating an atmosphere and culture where people are comfortable just talking about their differences and about the things happening in their culture,” Bellamy said. “Having a place where people can express how they’re feeling or what they’re seeing is the foundation of the work we do, and it provides an opportunity to start those harder conversations.”

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