Explicit and an implicit bias in health care.

When we think of the health care delivery system and providing positive health care outcomes for patients it is important to consider cultural competency throughout the organization. Respecting the beliefs and cultural customs of patients helps to reduce patient anxiety, improves communications processes, and aids in relationship building processes between patients and their caregivers. Organizations that recognize the value and importance of cultural diversity also recognize that cultural competence reduces disparities that are often found within the health care delivery system (e.g., use of certain words in each language and hand gesture differences, medical biases, and individual norms and values). Benefits of cultural competency include aspects such as a greater understanding of patient expectations. When organizations have greater cultural competency, they gain a greater economic market share. Additionally, patients benefit through reduced medical error rates and enhanced preventative care programs. Lastly, communities benefit in terms of enhanced trust and a feeling of inclusion that promotes health care responsibility for self and the community.

The Joint Commission updated the cultural competency standards in 2010 to improve access to and quality of care for all patients. These standards are intended to provide guidance for organizations as they work to address the needs of all patients (The Joint Commission, 2011). Despite these very clear standards, health care organizations continue to see disparate outcomes due to implicit biases in health care workers. “Implicit bias refers to prejudicial attitudes towards and stereotypical beliefs about a particular social group or members therein. These prejudicial attitudes and stereotypical beliefs are activated spontaneously and effortlessly, which often result in discriminatory behaviors” (Hagiwara et al., 2020, para. 1).

· Give an example of an explicit and an implicit bias in health care. The example of systemic biases that may occur in policies (e.g., those held by insurance companies, federal and state mandates, etc.).

· Discuss the role biases have on patients’ perception of their access to and quality of health care.

· Identify three initiatives that can be taken to overcome implicit biases in a health care organization.

· Explain how your initiatives will reduce implicit bias.

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Sample Answer

Example of an explicit bias in healthcare:

  • A doctor may assume that a patient who is overweight or obese is lazy and not motivated to improve their health.
  • A nurse may use a patronizing tone of voice when speaking to a patient who is not fluent in English.
  • A receptionist may be less likely to schedule an appointment for a patient who is dressed in ragged clothes.

Example of an implicit bias in healthcare:

  • A doctor may prescribe fewer pain medications to a Black patient than to a white patient with the same symptoms.
  • A nurse may be less likely to explain a medical procedure to a patient who is from a low-income neighborhood.
  • A receptionist may be more likely to make a patient with a disability wait longer to be seen.

Full Answer Section

Example of systemic bias in healthcare:

  • Insurance companies may charge higher premiums or deny coverage to people with certain chronic conditions.
  • Federal and state mandates may make it difficult for people in rural areas to access healthcare.
  • Language barriers may prevent patients from getting the information and care they need.

Role of biases on patients’ perception of their access to and quality of healthcare:

Biases can have a significant impact on patients’ perception of their access to and quality of healthcare. Patients who experience bias may feel that they are not being treated with respect or that they are not getting the care they need. This can lead to anxiety, distrust, and avoidance of healthcare services.

Initiatives to overcome implicit biases in a healthcare organization:

  • Unconscious bias training: This type of training can help healthcare workers to identify and understand their own implicit biases. It can also teach them strategies for overcoming these biases.
  • Diversity and inclusion initiatives: Healthcare organizations can promote diversity and inclusion by hiring a diverse workforce and creating a welcoming and inclusive environment for all patients and staff.
  • Culturally competent care: Healthcare organizations can provide culturally competent care by learning about the cultural needs of their patients and adapting their services to meet those needs.

How my initiatives will reduce implicit bias:

My initiatives will reduce implicit bias by:

  • Helping healthcare workers to identify and understand their own implicit biases.
  • Teaching healthcare workers strategies for overcoming their implicit biases.
  • Promoting diversity and inclusion in the healthcare workforce.
  • Creating a welcoming and inclusive environment for all patients and staff.
  • Providing culturally competent care.

By implementing these initiatives, healthcare organizations can create a more equitable and inclusive healthcare system for all patients.

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