Readiness:
- Staff/provider education beyond Implicit and Explicit Bias with a goal of cultural humility
- Review all patient forms and education materials with community/patient advisors
- Share definitions of key equity terms to create a common language
- Perform a baseline equity needs assessment for the unit/organization
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Recognition/Prevention:
- Actively solicit and share a social history to appropriately prioritize emotional, psychological, medical interventions
- Create a shared understanding: What are your goals? What is important to you for labor and birth? What are your concerns regarding your birth experience
- Explicitly support Informed/Shared Decision Making
- Actively engage support persons and/or Doula as part of the team
- Value personal boundaries: Respect modesty at all times and ask permission before touching all patients
- Practice “Active Listening”—ensure that the patient/family is heard and verify all care instructions are understood (e.g. CDC “Hear Her” campaign)
- Post a list of these principles of care and share with birthing persons
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Response:
- Train staff in the art of “Active Upstanding” to respond to microaggressions
- Collect and share brief stories (1-2 minutes) about microaggression observations on the unit
- Identify “champions” of the same race/ethnicity who can hear and help address concerns
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- Advancing the Mission: Tools for Equity, Diversity and Inclusion (The Annie E. Casey Foundation)
- Dear anti-racist allies: Here's how to respond to microaggressions (CNN)
- Disarming Racial Microaggressions: Microintervention Strategies for Targets, White Allies, and Bystanders (Sue DW, Alsaidi S, Awad MN, Glaeser E, Calle CZ, Mendez N, American Psychological Association)
- Equity vs Equality Tool (Robert Wood Johnson Foundation)
- Guide to Allyship (Amélie Lamont)
- Protecting Your Birth: A Guide for Black Mothers (Erica Chidi and Erica P. Cahill, M.D.)
- Staff education:
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Reporting/System Learning:
- Stratify quality measures by race and ethnicity with interpretation guidance
- Collect Patient Reported Experience Surveys that reflect equitable and respectful care
- Share data and patient feedback with staff in huddles and department meetings
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- Maternal Data Center Birth Equity Dashboard/PDF reports
- Patient Reported Experience Measure Response Reports
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