By Dr Amy Ireson (September 2023)
Here we will discuss the steps that we have taken at Homerton Healthcare to start thinking about Equality, Diversity, and Inclusion (EDI) within our simulation team, to hopefully help other centres feel empowered to do the same. This is currently very much a work in progress at the Homerton, and we hope to be able to update more in the coming months on projects we have going.
Main Drivers: There have been influences both locally, regionally, and nationally that have caused us to reflect and focus on EDI as a priority.
– Homerton Healthcare trust has recently added ‘Inclusive’ as its 5th core value
– London Simulation Network sharing information about the Sim EDI tool
– ASPiH including EDI as a core value in their draft standards for 2023
How we have gone about this:
– Reaching out to our EDI lead, Victoria Beckwith – we sent a copy of the EDI Sim tool to our trust’s EDI lead and met up to unpick the terminology and concepts within this.
– Training sessions – We followed this up with 2 training sessions led by Vicky, which were attended by our full sim team, including all our fellows, and our technicians.
– Automatic Bias and microaggressions – As a team we found the amount of bias that potentially exists within each of us personally and healthcare eye-opening.
– Bystander intervention – We focussed on how we might be able to positively intervene in a scenario. We came up with ideas as to how situations may present themselves within simulation; we broke this down into design, delivery and debrief, and worked with Vicky to create scenarios that our team could reflect upon and practice techniques with each other.
– Gaining further viewpoints: Through our reflections during this training, we recognised the limitations we might have in identifying themes to help bring out EDI related reflections within our scenarios, because of our limited experiences or positions of privilege, for example our gender, ethnicity, sexuality etc. We decided to approach both workforce and patient groups to be able to understand better real-life stories that are happening in our trust and the themes associated with these.
– We have plans to attend the ‘Homerton patient voices’ forum, in person, to be able to speak to patients.
– We have also met with our Freedom to speak up Guardian to be able to talk about real life staff stories and themes that we can learn from.
Thinking about EDI in practice: One area of inequality we noticed, was regarding access to simulation based education, with community vs acute healthcare providers. We have worked with Homerton Transitional Neurological Rehabilitation Unit based in the community to deliver a course, and design scenarios specific to a community setting. We hope to branch out further with other community links over the next year.
Another area we hope to focus on is within our maternity department – MBRRACE (2022) reported a 3.7x increased mortality for Black women giving birth. We are currently building links with our trusts Equity and Inclusion midwife who has been collecting local data on outcomes and hope that this is a project that we can develop to start to open-up more conversation about why outcomes like this exist, using real-life patient scenarios.