It’s Duke Health’s collective stand against systemic racism and injustice. The name signifies going beyond passive moments of reflection and becoming more active as we build a movement to make lasting change for our patients, their loved ones, and each other. Moments to Movement is our pledge to stand against racism in all its forms, to be self-aware, and to make equitable choices daily. That is how we create a community that is stronger, healthier, and more just.  

Quality care cannot happen without equity, and equitably healing minds and bodies means overcoming the painful separations that divide us. To deliver excellent care, we must ensure equal access to treatments, equal patient experiences, and equal results and outcomes. We know that this equity is not yet a reality for all, which is why we say that racism is a public health crisis.

As an institution and an anchor in our community, we’ve pledged to stand against racism in all its forms and to stand up for civil and human rights, as well as access to the factors that influence good health, such as education, transportation, healthy food, and of course, health care.  In addition, now is the time to put our mission and values into action. If we truly believe in diversity, and in our core value of “caring for each other,” we will stand up for human rights.

In order to advance these changes in a sustainable way—that we’ve truly gone from Moments to Movement—we are going to partner with outside resources that have expertise in this space and will help us with our journey.  And given the importance of this work, our Board is also committed and walking alongside us and will keep us accountable on our goals.

In a big organization like ours, differences in thought are a given. We know there are places where our Duke Health family will disagree, but we also know we share common values. For instance, all of us care for human life, or we wouldn’t be here. So we’re using that shared value as a starting place. We’re approaching it as a conversation because we want everyone along with us in this work, with no one left behind.

All of us joined the healthcare profession because we have a heart for other people. And this is why we keep having open conversations to call out systemic racism – because its existence harms human lives, and hinders our ability to give excellent care. And that is something we can all agree is not OK.   

They do! (Working in health care, we know that better than anyone.) But in order for all lives to matter, Black lives must also matter. And Black lives are the ones in particular danger right now. Our Duke culture is to save lives, and to stand by others, especially those in need, and that’s why many team members are showing their support by saying affirmatively that Black lives matter.

Duke is a multicultural organization, and diversity is one of our core values. Some of the ways we have honored human difference include education and training on cultural competence and human difference, and the establishment of affinity groups.

Yet part of Moments to Movement is acknowledging that, despite our efforts to respect all human difference and create a culture where everyone feels they belong, we have not yet “arrived” in terms of true equity, and there is much more still to be done. The work we are doing now for Black lives will also help others who may be feeling disenfranchised, because equity is not a zero-sum game – it’s not an “either/or,” but a “both/and.”  

As Duke continues to transform to create an ever more inclusive environment, we want to hear the voices of all people about how to respect their communities – and we look to you to co-create what would make you feel more included and seen. That said, if you feel you are experiencing discrimination or have been treated unjustly, you can contact the Office for Institutional Equity, your HR department, or your leader. We do have channels to protect everyone.

This is an area where we look to make tangible progress.

Unfortunately, underrepresentation in leadership is not a problem that’s unique to Duke—many organizations have the same dilemma. To improve diversity at the leadership level, we’re going to have to evolve our existing processes and systems, and the way we make decisions. The way we’ve always done things will not work. We have to be more diligent about developing our talent and creating pipelines for growth. We need to be more intentional in our hiring, mentoring and sponsorships.

As we have new openings, or can forecast growth assignments, we need to look more broadly, both internally and externally, to tap very diverse talent. We also need a culture that attracts people from all backgrounds, and makes them want to stay and grow their careers at Duke. It comes down to building, developing and advancing diverse talent, and providing equal opportunity for all.

We are a multicultural organization. We honor human and cultural differences in a lot of different ways—education, training, and affinity groups (which gather those with like interests and identifies, and their advocates, to work together and give back to the community).

That said, we know we haven’t arrived yet. We know there are other groups that we need to learn about, and we realize that diversity is diverse, and everyone matters. Right now we ae focusing on Black lives, but our work here blazes a trail for others who may feel disenfranchised or discriminated against—ultimately leading us to a place of greater equity and opportunity for all.  

We agree! Duke’s Population Health Management Office continues to look for ways to meet our community members where they are. There is always more we can do in this regard, but expanding our reach in new and more convenient ways is a strategic priority for us, and we are already making progress:
 

• DIHI, in partnership with PHMO, ID, Critical Care and Cardiology, established the Pandemic Response Network Community Watch Program. This program helps communities stay safe via community-level symptom monitoring for COVID-19. It also helps connect people in need with specific community resources and services. This program also brings together a large number of local and national community partners engaged in addressing the health needs of people, and resources are offered in English and Spanish.
• We’ve also used digital means to expand our reach. While telehealth solutions do rely on connectivity and other prerequisites, they are a way to make Duke Health care much more accessible and convenient. In addition to telehealth appointments, we’re also exploring technologies for remote patient monitoring in support of chronic disease management, as well as technology to supplement telehealth visits with data, such as vitals, that providers review during face to face visits.
• Duke HomeCare & Hospice delivers home health care, infusion, hospice, and bereavement services right to the front doors of patients over an extremely wide service area, and offers remote monitoring of vitals.
• Duke offers preventive wellness opportunities such as diabetes support groups.
• Finally, PHMO partners with community-based organizations in Duke’s primary service area to help connect patients to social services support and needs.

 Efforts like these are only the start. Duke Health is committed to expanding our reach and find new ways to meet patients where they live and work.