Is Seattle Children's Living Up To Its Antiracist Pledge?

“This has been a journey, and Ben Danielson’s resignation is a point in time on that journey,” said Alicia Tieder, the hospital’s senior director of Health Equity, Diversity and Inclusion. “This work started before that. And we’ve been quite committed to the anti-racism work and framework and the EDI work at Seattle Children’s for some time. And I think we got some real results.”

This is part of a series updating our readers on some of our top stories from the past year.

Employees seem pleased with the progress they have seen the hospital make. Still, some complaints remain for those who want more from Seattle Children’s. Of the hospital temporary closure of Odessa Brown Central District Location – following the opening of the Othello clinic branch – added insult to injury for Danielson, who now works as a clinical professor of pediatrics at the University of Washington School of Medicine.

Staff continue to express concerns about what they consider a lack of transparency from management; the hospital’s failure to share the full version of a facility equity assessment; and her efforts to balance equity work with patient care.

“I feel like the hospital has been treating this like it’s a PR problem,” Danielson said, a sentiment he shared expressed in Crosscut last year. “And they’re relying on something that is, unfortunately, very, very effective in this society. Which is just waiting until people are distracted by other issues.”

Progress reports

The hospital took a massive reputational hit after Danielson left its ranks in 2020but some are still hopeful.

Seattle Children’s tracks its progress on health equity and anti-racism through quarterly reports, the most recent of which was released in September.

In it, the hospital described, for example, that it is currently meeting a goal of 40% racial and ethnic diversity of employees. And the facility is replacing Code Purple, the intercom call for security and a mental health professional that has historically been used with black patients at a disproportionate rate. (Seattle Children’s plans to launch the Behavioral Response Project, replacing Code Purple, in January, according to Tieder.)

The hospital also increased its score on a question in the Workforce Engagement Survey, which asks whether the organization values workforce members from diverse backgrounds. Tieder said the updated score exceeded the goal standard.

Survey responses from January 2021 to April 2022 also reflect a growing confidence among workers that their managers and senior leadership are addressing racism in the organization, although they routinely expressed greater trust in their managers.

From a nurse’s perspective, the hospital seems more open to talking about issues. The individual, who identifies as a person of color, asked not to be named for fear of professional repercussions.

“I don’t think before [Danielson] brought everything to light, that people knew who BIPOC are,” the individual said. “Who knew what microaggressions were.”

The hospital report also explores ongoing challenges, including lower than desired Family experience survey result and the disparity between its Latino patient population (19.1%) and its Latino employee population (7.7%).

In the report, Seattle Children’s specifically noted its struggle to recruit diverse nurses.

“Recruitment of Black/African American and Latino Hispanic nurses continues to be challenging for the organization, particularly given the limited availability of these diverse nursing groups in the Washington area,” the hospital wrote in the report. “Seattle Children’s is working on strategies to address this gap in its workforce.”

Seeking more transparency

Employees continue to struggle with what they consider a lack of transparency from management.

“It’s very strategic, it’s what they want you to hear,” said Edna Cortez, a Filipino nurse who has worked with Seattle Children’s for more than 30 years. “I wish for more transparency, as a person of color.”

For some, the push for progress has also been overshadowed by the fact that the hospital commissioned former US Attorney General Eric Holder to lead an investigation into the hospital, but only partially released the assessment. The rest remains under lock and key. Seattle Children’s initially withheld the results of the investigation, before partially releasing the findings amid mounting pressure in August 2021. The hospital says they are using their ongoing quarterly reports to update the community.

“We are making changes, but we still need to understand why we are making these changes,” said Therese Hill, a nurse. “We have an entire report and investigation that can be made available.”

Danielson finds it particularly troubling that the hospital retained Jeff Sperring as CEO. In September 2021, dozens of doctors and scientists in leadership roles participated in a survey about Seattle Children’s, confirmed by two people who participated.

Of the 50 who answered a question about whether they had confidence in Sperring as CEO, more than half said no. The results were provided to the Seattle Children’s Board of Trustees.

“There is the least amount of community visibility and transparency,” Danielson said. “They have their own people who make their own rules, their own approaches, their own changes. And I would challenge the idea that there’s community transparency in that.”

Research at the hospital this year showed that parents in the community think Children is doing well in several areas. survey tracked down the responses of 1,000 parents in the Washington, Alaska, Montana and Idaho (WAMI) region to statements about Seattle Children’s, including whether the hospital:

Communicates transparently: 33% agree, 31% strongly agree.
Take ownership when things don’t go right: 26% agree, 25% strongly agree.
Provides a welcoming environment and comprehensive care: 36% agree, 38% strongly agree.

More than 140 parents close to Odessa Brown Children’s Clinic answered the same questions, indicating whether the hospital:

Communicates transparently: 32% agree, 42% strongly agree.
Take ownership when things don’t go right: 32% agree, 34% strongly agree.
Provides a welcoming environment and comprehensive care: 36% agreed, 51% strongly agreed.

Nurses run it all

Hospital staff have struggled to balance efforts to reform the hospital system with their day-to-day duties, according to nurse Te’onna Adams, who is black.

“A lot of what’s been implemented has kind of come down to my direct leadership and then bedside nursing,” she said. “I know that the people I work with every day have to do a lot right now. At the forefront of patient care.”

Hospital nurses were created HEAL (Health Equity and Activism Through Learning) committees for their units during the aftermath of Danielson’s departure. Adams, a HEAL board leader, noticed committee turnover as people were spread too thin.

Tieder said he hadn’t heard of these concerns, though he thinks clinical staff in general have a different level of responsibility regarding equity because unequal care can cause harm. But she argued that equality is “work we have to do every day”.

“It has to be integrated and embedded into all the things we do and not really be seen as an extra project or an extra set of responsibilities,” she said, adding that this is the cultural change her team is trying to create in the organization. . “If we consider this work separate and apart, it feels like a burden.”

The nurse, who asked to remain anonymous, described their experience at a HEAL council as less than ideal, amid low staffing and high patient volumes.

“It existed to me, it seemed, in name only,” the individual said. “We never got to do as much of the work as I wanted to do. So I actually left.”

Recently, even the nurses in the hospital secured a new union contract. During the negotiations, Cortez did not feel respected.

“I remember the hospital literally saying, ‘You must be honored to be working at Seattle Children’s,'” she said. “It’s their honor that I work there… I’m the best PR for this hospital to bring in more nurses, to bring in nurses of different colors, different ages, different backgrounds, different experience, but really… It’s respect. It’s mainly the respect I deserve.”

Odessa Brown closes the Central District site

Earlier this year, Seattle Children’s opened Othello clinic page for patients forward temporarily closing its Central District branch for repairs, a move that frustrated Danielson.

“[They] it kind of made it sound like there were new construction problems that weren’t known in the past, which is really disingenuous,” he said. “These are not new problems. We had warped floors and different areas with water leaks and things like that for a long time.”

The hospital often acted like it was doing the Odessa Brown community a favor by keeping the clinic open, he said, adding that many people worked hard to open a second clinic so patients could more easily access services. He worried that because that community had been made to feel like it couldn’t ask for much, a new location could lead the hospital to permanently close its doors to the Central County area.

He also stressed the importance of not allowing the hospital to triangulate the clinic, its members and the story of Odessa Brown to distract from the issue of racism at Seattle Children’s.

“It’s a classic tactic to try to get black and brown people in the clinic to fight for the leadership in the hospital,” he said. “Or at least try to pit us against each other. To make sure the hospital doesn’t have to do anything.”

The hospital referred to the site’s temporary closure in its latest quarterly report.

“Seattle Children’s is strongly committed to the Central District community and plans to maintain a presence in the Central District, keeping families and workforce updated on the progress of the Central District building,” the institution wrote before detailing efforts to communicate with the community.

These efforts included sending postcards to clinic families in several languages; the reception of two municipalities around the closure; and the sharing of information in one piece by Dr. Shaquita Bell, the clinic’s senior medical director, at South Seattle’s Emerald.

It’s unclear when the Central District location will reopen, but Bell told Crosscut that Othello’s location, further south, appears to be more convenient for most patients, though the clinic is also working to minimize barriers to entry. transportation for families who have it more difficult. time to go to the site.

Bell, who described feeling extremely supported by the hospital, said it’s hard to have one person’s voice dictating what should happen now that Danielson is no longer running the clinic. She also disputed his feelings about the clinic’s ongoing structural issues, saying she was unaware of those complaints over the years.

“I have not seen bills from Dr. Danielson on how those issues escalated over the last 25 years,” she said. “I’ve only been in leadership for a year and a half and everything I’ve escalated has been addressed.”

Another year of pushing the hospital to change its culture — while the public watches — has passed. Tieder knows there is work ahead.

“It’s going to be an ongoing journey,” Tieder said. “I hope to see this change, not just in our health care system, but across the country in my lifetime. And most of us are aware, this is a marathon and we still have a lot of work to do. And I’m really proud of the work we’ve done so far.”