The Bias Time Out: A practical tool for advancing DEIB in the healthcare space

Abstract

‘I know my own mind. I am able to assess others in a fair and accurate way’. In the book Blindspot: Hidden Biases of Good People, the authors (Banaji and Greenwald) challenge us to accept the reality that bias is universal (Banaji, M. R., Greenwald, A. G., (2013), ‘Blindspot: Hidden Biases of Good People’, Delacorte Press, Excerpt on book cover, 272 pp). Even when fully aware of our biases, they cannot be eliminated. This paper posits that the focus is less about eliminating bias and more about increasing self-awareness and learning about ourselves and the biases we hold but cannot see. Addressing negative bias in healthcare is about adapting our behaviours and decisions to minimise and control the harmful consequences of bias. In this paper, the authors provide examples and scenarios demonstrating bias and strategies to increase self-awareness and focus on behaviours, institutional practices, policies, systems and structures that perpetuate and reinforce bias and its adverse effects. They discuss how to mitigate and manage these biases by utilising the Bias Time Out. The Bias Time Out is a framework that provides a stepwise method that lends itself to easy adoption, application and translation while establishing a process to manage and control bias in real time. Healthcare organisations, systems and oversight bodies all play an important and central role in improving and transforming health, equity and the lives of patients, communities and the nation. Recognising and accepting this role is crucial in managing the negative and deleterious outcomes of bias and the structural and institutional forms of discrimination lurking just beneath the surface.