Good Morning Colleagues,

Onward. Upward. Beyond. These are the three words that came to mind as I contemplated this update to you.  

You will recall that when I wrote to you last month commemorating Juneteenth, I promised to keep you informed of the specific actions we are taking at Duke Health to combat the social pandemic of systemic racism and injustice that plague our country. We have begun the important work of learning from and reconciling moments of inequity across Duke Health and are now audaciously driving a movement for real change that makes our organization and community stronger, healthier and more just. We’re calling this endeavor Moments to Movement, and below outline how we are approaching this work.

Onward
We are taking action today.

Our people and environment are our top priority. Through Moments to Movement, we are beginning the critical work of learning from our history, understanding our present and planning for a bolder, more diverse and inclusive future.

We’ve created workgroups to lay the foundation of deep, interdisciplinary change throughout the Duke University Health System, the School of Medicine and the School of Nursing. These workgroups are pursuing their charges to:

• Form strategies to transform our culture and ensure our mission, vision and values promote an environment where everyone thrives and feels valued. To do this well, we must and we will engage the voices of our people.  
• Provide professional development for faculty and staff in the areas of racial equity, cultural intelligence and ways to improve education for diverse student populations. In addition, a new Equity, Anti-Bias and Anti-Racism Core is being developed that will focus on establishing curricula and standards, as well as providing consultations, for all researchers within Duke Health.  
• Eliminate systemic racism in the guise of health inequity. All of our quality measures and clinical outcomes are now viewed through the lens of health equity. When we identify disparities, we are now determining the root causes and actively working to address them, inside and outside of our walls.
• Delineate best approaches for understanding and managing implicit bias, reporting racial injustices and ensuring accountability.

These are merely illustrative examples of how we are working to learn, commit, transform and sustain this movement. We are creating a future with increased racial diversity, greater equity and a sense of belonging not only at Duke Health but also within the communities we serve.

Upward
We are broadening our traditional view of diversity and inclusion to address systemic racism, inequity and injustice.

To be a better, stronger organization, we now more clearly understand that we must take on these larger underlying causes. This requires us to step outside of our comfort zone and engage in honest and candid conversations. We must create safe and brave places that allow us to advance these discussions about race relations to better understand how the unfolding events in our nation impact us as individuals, as an organization and as a community.

Admittedly, this will all take time. It would not behoove us to rush towards a solution or a finish line as we so often do as part of our competitive spirit at Duke. While we feel the urgency of this moment, we have to be thoughtful about the importance of quality and not be distracted by the propensity for speed. This work needs to be intentional, deliberate and embedded in our cultural DNA. True transformation will require the tenacity and resolve to endure the marathon ahead.  

Our process for change will be enriched by collecting personal stories, experiences and feedback from our team members through formal and informal listening sessions, particularly at the front lines. And we have been doing just this throughout the summer. We are grateful to the many individuals from around Duke Health who have engaged with colleagues in frank conversations, and the dialogue must continue.

To deepen our knowledge and elevate our thinking, we are also currently seeking the right external partners to serve as expert advisors. These outside advisors will help us refine our framework and plans for Moments to Movement and help us achieve the strategic priorities that will create the culture we desire.  

Beyond
We will aim to achieve impact heretofore unimaginable.  

To transform our culture and sustain our movement, we will pose this persistent question to ourselves: what does radical change really look and feel like? The answer lies in our collective, rigorous imaginations.

Imagine a workplace where everyone feels a sense of value and belonging.

Imagine health professions education based on a core principle of social justice.

Imagine a healthcare and biomedical research workforce that is intentionally anti-racist.

Imagine population health programs judged by and accountable to the imperative that Black lives, and the lives of other vulnerable communities, matter.

When you think of radical change, what do you imagine?

In reimagining ourselves we gain the power to open new frontiers in our quest for racial, social and health equity.

Yes - Onward. Upward. Beyond. The work we are setting out to do is hard, complex and overdue. And achieving the future we can imagine must live in the hearts and minds of all at Duke Health. Your voice matters. I encourage you to speak up. I, along with other Duke Health leaders, am listening, learning and acting. Please don’t hesitate to contact me directly at chancellorhealth@duke.edu.

A. Eugene Washington, M.D.
Chancellor for Health Affairs, Duke University
President and CEO, Duke University Health System