Being welcome, included and valued is a basic human need and essential to health and well-being. It’s why eliminating inequities is key to creating healthy communities. As an organization dedicated to the health and well-being of every person, HealthPartners is committed to building an anti-racist culture. President and CEO Andrea Walsh discusses the organization’s journey and why calling out racism is critically important to being an anti-racist culture. She also talks with hosts Dr. Kari Haley and Dr. Steven Jackson about how the expertise, passion and lived experiences of colleagues is helping to build a stronger organization where inequity and racism have no place.
Being welcome, included and valued is a basic human need and essential to health and well-being. It’s why eliminating inequities is key to creating healthy communities. As an organization dedicated to the health and well-being of every person, HealthPartners is committed to building an anti-racist culture.
President and CEO Andrea Walsh discusses the organization’s journey and why calling out racism is critically important to being an anti-racist culture. She also talks with hosts Dr. Kari Haley and Dr. Steven Jackson about how the expertise, passion and lived experiences of colleagues is helping to build a stronger organization where inequity and racism have no place.
Hosts: Kari Haley, MD, and Steven Jackson, MD
Guest: Andrea Walsh
HealthPartners website: Off the Charts podcast
Got an idea? Have thoughts to share? We want to hear from you. Email us at offthecharts@healthpartners.com.
Kari Haley:
He's a rehab doctor from Chicago.
Steven Jackson:
She's an emergency medicine doctor from the Twin Cities.
Kari Haley:
Together, we're examining the health equity emergency.
Steven Jackson:
Inviting voices for change without the cue cards.
Kari Haley:
I'm Dr. Kari Haley.
Steven Jackson:
I'm Dr. Steven Jackson.
Both, together:
And this is Off the Charts.
Steven Jackson:
Well, I just want to welcome everybody to our show. We have a very special guest with us. And on the day and time of this recording, we are actually commemorating the two-year anniversary of the murder of George Floyd. And it just so happens that today we have our president and CEO of HealthPartners, Andrea Walsh, with us today to talk a lot and a little about the vision of our organization and get into a few things here as it relates to where we want to be and where we want to go. So, Andrea, want to say welcome.
Andrea Walsh:
Thank you, Steve. It's so great to be here and special to be here on this day in particular.
Steven Jackson:
Absolutely. Who is Andrea Walsh? Where did you come from? And what is it that you would like, in general, people to know about you that maybe they don't know?
Andrea Walsh:
Sure. That's a great question. So, I am a mom and a grandmother. I've married my college sweetheart and I've been married now since 1986. So, for a few years. I grew up in Rochester, Minnesota. My dad and my grandfather and my great-grandfather actually were physicians. So, come from a family that was really centered around health care and health. I have been at HealthPartners since 1994. So, for quite a long time.
Steven Jackson:
So, a few years.
Andrea Walsh:
A few years, a little bit. And what's kept me at the organization, I love working in an organization that has a mission of health and well-being and truly the opportunity to work and be surrounded by and with people who share that passion around, how do we make our community healthier and how do we provide exceptional care and health insurance and health support for people. That's really what motivates me.
Kari Haley:
Well, thank you for a nice summary of a little bit of the "Who is Andrea Walsh?" As we acknowledged on this date of recording, this is the two-year anniversary of George Floyd's murder. And about that two years ago, we came out and you publicly came out with HealthPartners being an anti-racist organization. What does an anti-racist organization, what did it mean then? What does it mean now? And what do you think it means in the future?
Andrea Walsh:
There's a lot in that question and I think it's a great one because as an organization with a mission around health and well-being, there is no question that racism impacts health. And we aspire to be an organization where everyone is welcomed, included and valued. And as we look at the people in our organization, our patients, our members and the broader community, we've got to live and work in a place where everyone is able to achieve their very best health. And that can't happen when there's racism and when there's sexism. Name the ism. But frankly, calling out racism in particular is so important because that is in the house of isms, the one that has just been on fire.
Steven Jackson:
When you think about the term anti-racism or anti-racist or even just the part of that word is racist. It's pretty jarring for some. It's pretty bold. It's pretty, fill in the blank. And it's a pretty big stance that we, as an organization, is making. Has it been difficult making that stance as an organization?
Andrea Walsh:
Honestly, we have so much work to do that calling it out boldly is really important. You have to know where you want to end up to be able to ever get there. I would say the difficult part about it is "anti" feels negative. And I think part of what we really need to do to be a place where everyone is welcomed, included and valued is to create and foster better relationship, better kinship with each other. We need to address bias. We need to address the underlying things that result in people being excluded. And so, I think declaring our aspiration to be an anti-racist organization is important because we can't tackle bias. We can't work on inclusion without being clear that where we're at today is not OK.
Kari Haley:
I think between the stance of anti-racism forming the [HealthPartners Equity, Inclusion and Anti-Racism] Cabinet, that within our organization, we have done things and done a good amount of things. What do you hope for in the next year within our organization? And then thinking about outside with our community partners, with our patients who are out in the communities and how can we influence that?
Andrea Walsh:
Two years ago, when we formed the cabinet, I think part of the realization we had within the organization and within the broader community is while we were doing many things to address health inequities, while we were doing many things to create a more diverse and inclusive work environment, we were dabbling. We were doing lots of little things but nothing at scale. And to really be able to achieve better equity and inclusion, we needed to scale it up. And so, that was really about creating a cabinet across HealthPartners where we could draw on the expertise and the lived experiences of the people in our organization who live and work in our communities and saying, "How can we collectively guide our work?" And so, we set the cabinet in place and we began to look across the organization at all of the work underway and set some really aggressive goals. So, that in the next five years, we're clear about what success looks like.
Andrea Walsh:
And I think the pandemic actually gave us the opportunity to learn and grow in some really important ways and it is a place where we've made progress. And one of the things that we will do moving forward is take some of our lessons around vaccine equity, as an example, and apply that to how do we close maternal and infant health care gaps? How do we do a better job at preventive screenings?
Steven Jackson:
I'm a firm believer in timing and a firm believer that now is a time for us to be doing a lot of the things that we are doing. Some of you may know out there in listening land that I serve on the cabinet with Andrea and it's been a great experience. And I feel like that we are making headway in some of the work that we're involved in. And as President and CEO, there are 26,000-plus individuals in our organization. Sometimes you hear, "Well, we're not doing enough," or, "When is the work going to speed up," or, "When are we going to see evidence that we're making headway?" How do we reconcile that, when you know and I know, because we work together on a lot of things. You know that we're up late and we come in early whether thinking about it or doing something about what we're talking about. How do you reconcile that?
Andrea Walsh:
Well, in part I can completely appreciate the impatience and it's warranted, right? We all want to move farther faster and we can only do it together. Steve, actually, as I think about it, I want to tell a story on you.
Steven Jackson:
Uh-oh. I didn't do it.
Andrea Walsh:
And it was just fairly immediately after George Floyd's murder, we were thinking about as an organization, "What can we possibly do to create space in our organization for people to grieve and mourn, to just express the incredible pain and tragedy that his death caused in the community." And I remember actually talking to you on the phone and we just had, what I will always remember as a conversation, where you were so helpful. Just your insights into how to help people move through pain and grief and tragedy. I feel like you helped me tap into something important for other leaders at HealthPartners as well, which is, it led to a conclusion. We need to create some listening sessions. We need to create space and we subsequently then held 16 listening sessions over the course of that first summer and created the opportunity for just conversation and dialogue, kind of like this, but more along the lines of, "How am I feeling? How am I doing?"
Andrea Walsh:
And it just, to me, is something I will always remember as a precursor really to the cabinet because at that point we really needed to listen to our people and to really reflect on what is our role as an organization to get there? And one of the things I've taken away from our work over the last couple of years is it requires each and every one of us to do our level best as an individual. And then it requires each and every team to do their level best. And then within each team, then you broaden it out to the organization and then more broadly into the community. And unless you get everybody in, we can't make the progress. And that's the frustrating part, which is, what can feel so obvious lots of times doesn't move as fast as you would want it to.
Kari Haley:
Steve and I were just chatting a little bit right before you came and talking about those frustrations that people are having. Probably not seeing the impatience, not seeing the big results that they're maybe envisioning but what are some of the things that we can do as a person, day to day, just to improve small interactions, the small ways that we can treat each other and our patients and our communities?
Andrea Walsh:
I think that's a great question and something for all of us to reflect on. You think about, if you want to be a place where everyone is welcomed, included and valued, how do you show up as an individual? And how do we foster cultural humility because none of us can know and appreciate someone else's lived experience but if we're not open to learning and understanding and accepting of others beliefs, accepting of others values and preferences, it's like we have to quit othering others. It needs that's right to be, "We're all in this together." And I think reading, for me, reading is a good way at it but more than that is just it's the human interaction. And I think one of the blessings in the cabinet has been the opportunity to work with leaders across the organization that you may not work with day to day. And I think it's fostered some connection.
Andrea Walsh:
For instance, our physicians have formed three different affinity groups to get together as clinicians to talk about what it's like to practice at HealthPartners as a Black physician, a Black female physician. What's health and well-being look like at HealthPartners from a clinician's view? Likewise, we've got some colleague resource groups that have formed as well. And I think this human connection is really important. And one of the things that each of us can do is figure out how do we better connect?
Kari Haley:
Absolutely. I love that.
Steven Jackson:
And Andrea, with the depth of work that we're all involved in and standing on our declaration to be an anti-racist organization... What are some of the things that we can do to support you and to make sure that you're on your A game as we continue in this work?
Andrea Walsh:
Oh, gosh. I, one, I appreciate that question. Being honest about where we're at and where we need to make more progress is really important. I think the other thing that's really important is taking ownership for helping make things happen. I think that in space when things are hard, it's easy to say, "I wish more would happen here or there," but the best way I think people can support each other, support the organization and support me is take ownership. Do what you can, where you are, to make a difference and create that culture of inclusiveness and welcome-ness. I think that we're in such a divisive time and the polarization outside our organization sadly sometimes comes within the organization. And so, help me stop the finger pointing and the blame game. Help set the tenor and tone and the clear expectation that we're a place that lives our values, the accountability to be in our best.
Steven Jackson:
That's awesome.
Kari Haley:
That is awesome.
Steven Jackson:
Well, there's a lot of layers to what we're talking about and this would be probably the longest podcast in history if we were we to unpack, or should I say, peel back all of the layers to our conversation. I'm sure over the past two and a half years, whether it be George Floyd or the pandemic and everything else in between, there's so much going on right now, which is crazy. What would you say has been maybe the most impactful story that you've heard, positive or negative, that really sticks with you during this time period?
Andrea Walsh:
Boy, there's a lot. The listening sessions and just hearing individual colleagues stories about what it's like to experience racism at work and also what it's like to experience feeling the support when something bad has happened. And I think some of those stories of interventions and support, if you will, stories of a colleague backing up and supporting another when a patient shows up unwilling to be cared for by an exceptional colleague clinician. To be in a place where your colleagues and your team has your back and says, "Hey, wait a minute. That's not OK."
Andrea Walsh:
I can back up and probably tell that story better but I think as I think about one of the stories that sits with me, it was a colleague who vividly described what it was like to have a patient say, "Don't touch me. I don't want you to touch me. I don't want you to care for me," and how much it meant to have a colleague say, "Hey, this is one of our best on the team, and that's not how it works here. This is who should provide your care. This is how it works." And, one, it's a tragedy that anybody should ever be subject to that to begin with. Patients show up, they're sick. They show up with their own lived experience. Our job is to take care of them but our job is also to create an environment where our people are emotionally supported, aren't subjected to behavior that is hurtful and harmful. And so, creating a healing environment, lots of stories like that.
Steven Jackson:
Well, I have sipped the Kool-Aid, the HealthPartners Kool-Aid, should I say. When I look at our plaques that talk about our mission and our visions and our values, they really speak to me because I think they align with my personal values. And so, when I think about excellence and partnership and integrity and compassion, I think, "Well, that's kind of how things should be anyway," in my opinion. So, they make sense and they really align. And if you can speak about expectation when it comes to a person that works here or works for the organization. What is the expectation? And I probably talked about it already but what is the expectation when a person says, "I want to work for HealthPartners?"
Andrea Walsh:
I always think first and foremost, it's a team sport. So, living those values, being committed to excellence, partnership, compassion and integrity. Those are just foundational must haves. I think being committed to fostering an inclusive environment where people are truly welcomed, included and valued, that is also mission critical. And another example of where I've seen our organization step up and a story of what it looks like when we're at our best, the work around vaccine equity. When we had those months where we had precious little vaccine and a lot of people who wanted to get vaccinated and unfortunately many people who didn't know they needed to be vaccinated or were hesitant to get vaccinated and our ability as an organization to say, "Hey, we need an equitable distribution of vaccine."
Andrea Walsh:
We need to make sure as we turned on the ability to schedule your vaccine appointment online and shot out emails, we quickly noticed as we looked at the data that our White patient populations were doing a great job of getting those appointments, scheduling in and getting appointments made. And we weren't reaching our communities of color. Our patients of color weren't scheduling at the same rate. And so, we needed to take extra steps to really figure out what do we do from an outreach standpoint? How do we meet our patients where they're at? We discovered texting was a better method than an email. Well, that's awesome because that also applies beyond. I feel like some of our early lessons in vaccine equity remind me of some of what we learned in mammography screening, which is like, gosh. If you can have a woman in for a preventive screening counsel on, "You should get a mammogram," and walk down the hall and get it the same day, you've just solved and are able to close some health care disparity gaps by virtue of making it simple and convenient.
Andrea Walsh:
And so, I think that some of those lessons, that's what I think about like, "What's the HealthPartners team like?" It's like, "Hey, we're all in it to make sure that our patients and our members get the very best care and we recognize and appreciate the diversity of the patients and populations and communities we serve.
Kari Haley:
And to almost segue then, I have a question relating to, how do we measure this? So, how do we know that we are doing some of the right things, and even maybe more importantly, that we're doing for the right reasons?
Andrea Walsh:
Great question. When I think about measurement, it's so important because if you can't measure it, you don't know. For instance, I've been at HealthPartners long enough to remember the early boardroom conversations where, believe it or not, we weren't even collecting race data on our patients. And we had many who would have said, "Well, is that appropriate to ask and will we offend somebody if we ask?" And we had a really rich and robust conversation in our boardroom at the time.
Andrea Walsh:
And I'll never forget, Willie Mae Wilson, an African American community leader for the St. Paul Urban League. She was on our board at the time. And she was like, "Absolutely, we should be collecting race data. We need to know and understand if we have health care disparities gaps." And in that day, which was some 20-plus years ago, we really thought, "Well, we don't because it's equal treatment. We're doing the same thing for everybody. We're not going to have any health care disparities gaps." And now today, you think, "How could we have thought that?" But we we really did and it was only through collection of race data that then we were able to look at clinical outcomes data, and know and appreciate, who were we missing and what were those gaps? And once you see those gaps, then of course you can address them more effectively.
Kari Haley:
It's hard to know what you don't know. And if you're not looking at the data, it's hard to know whether or not. And I think it's really important then too, thinking about those targeted things. So, we're being so specific now on some of the goals and that we have for anti-racism is because we have looked at the data. We have looked at what we have done historically and that we can be specific about what we're doing.
Andrea Walsh:
Yeah. And it's nice because we have enough history in clinical quality gap closure to know when we focus on colorectal cancer screening, we could see in our data that African American and Indigenous men over 50 weren't coming in for colorectal cancer screenings at the same rate. And so, as our, "White over 50." And so, we had quite a big gap. We took a targeted approach to figure out how could we close that gap? And you've got to try a lot of different things to figure it out but you're able to figure it out when you have a team that is committed to understanding values and preferences and really meeting patients where they're at and knowing and understanding, what are some of the cultural norms that might get into the way of coming in for a screening? And using the fit test, the mail-home fecal test really made health care way more approachable for many men who, frankly, wouldn't like the idea of the prep and the procedure. But boy, if you do an at home test and it comes back saying, "You need a colonoscopy," it sounds a little more like you should get one than just you should because you should.
Kari Haley:
Yes.
Steven Jackson:
Well, this work is hard. How do you keep your personal tank full? Because obviously this is a long journey and we won't fix it in five years and 10 years. How do you keep your tank full?
Andrea Walsh:
What inspires me without a doubt is watching the people in our organization and the difference that we get to make in the lives of the people that we serve. We have the opportunity to help people in some of their highest moments of their life and their lowest moments of life. And what inspires me every day is just the teamwork and the commitment that I see across our organization in people really wanting to live out that mission of improving health and well-being.
Steven Jackson:
Yeah.
Kari Haley:
To think about the future and I always like to think about hopeful things when we have so many things in the world that can get you down. What is your hopes? Maybe let's say in the next couple years here in the race towards anti-racism.
Andrea Walsh:
I love how you frame that question because I do feel like we have just been in this incredibly challenging time where so many things have happened and it feels like we just get over one thing and another thing comes. And I think we've got the dual pandemic. And then on top of that, now we have global conflict. On top of that, we have the human tragedy of so many kids being lost to gun violence. We have the tragedy of school shootings and we have a lot of work to do as a society to make this a better place for our kids. I think what gives me hope is people, is the power of each and every one of us deciding we are going to get up and make it a better day today than it was yesterday. And I think my hope and aspiration is, a year from now within HealthPartners, the people who come to work at HealthPartners feel the alignment between our purpose and an individual's purpose and feel they are supported to be able to bring their best to work and really make a difference.
Steven Jackson:
Well, I want to say that change takes time but it's written that without a vision, the people perish. And I'm very thankful that, as our leader, there is a vision and we're not just flailing our arms, hoping that we make some kind of magical change and magical improvements but I feel that where we want to go is clearly spelled out. And I think that we have the people in the wherewithal to be the change that we want to see. And so, we just want to say, thank you for what you're doing.
Andrea Walsh:
And I want to say thank you back to both of you because I fundamentally believe it's we work. It's the ability that we have to come together and make a difference. And I feel we're making progress. You can see the progress being made. It isn't necessarily coming as fast as all would like but you know what? Good work and making progress, sometimes it does take some time but the right things ultimately happen with the commitment. So, thank you both for your work to help raise voice and keep things off the charts.
Steven Jackson:
I like it.
Kari Haley:
I like it. I think we have to end that way.
Steven Jackson:
I think so.
Andrea Walsh:
Perfect.
Steven Jackson:
Off the Charts is a production of HealthPartners and Park Nicollet.
Kari Haley:
It is recorded by Jimmy Bellamy with creative by Peggy Arnson, Tina Long, Tim Myers and Jeff Jondahl.
Steven Jackson:
Production services provided by Matriarch Digital Media.
Kari Haley:
Our theme music is by Ryan Ike.