After more than a week of facing public outcry and accusations of a lack of transparency, Seattle Children’s has released the findings and recommendations from former U.S. Attorney General Eric Holder’s investigation into systemic racism at the hospital.

The hospital’s board of trustees voted to release the findings, which were completed in July, after it heard “feedback that this was needed to realize Seattle Children’s vision of becoming an anti-racist organization,” Seattle Children’s CEO Dr. Jeff Sperring said in a statement Monday.

“From a place of great humility, we thank everyone who spoke up,” board chair Susan Betcher said in a statement. “We heard from many of you that our initial adoption and release of the Summary of Recommendations did not provide the clarity you expected and instead added to the pain our community is feeling/experiencing. For that, we profoundly apologize.”

The investigation began last year after Dr. Ben Danielson resigned, citing institutional racism at the hospital as one of his reasons for stepping down. In the face of public pressure over the beloved pediatrician’s departure, the hospital hired Holder and his Washington, D.C.-based law firm, Covington & Burling, in January. The firm heard from more than 1,000 people in the months since.

In a summary of the 11 findings, Covington found that while Seattle Children’s had improved its racial and ethnic diversity, “racial disparities persist in leadership positions, promotions and voluntary terminations.”

According to the summary, some of the disparities are evident in a decline in employee engagement from 2015 to 2020, particularly among Hispanic and Latino employees and those who work at Odessa Brown Children’s Clinic (OBCC), a community clinic located in Seattle’s Central District.


The summary also described the hospital’s “culture of conflict avoidance and failure to address microaggressions.”

Covington found the hospital did not adequately investigate a 2009 allegation that another doctor used a racist epithet to refer to Danielson. The investigation also found that Seattle Children’s has not met its goals related to interpretation and translation services, and lacks the accountability, infrastructure and culture to successfully address racial disparities in patient treatment.

In addition, the firm noted a “widespread perception” among hospital employees that patients receive disparate treatment based on race or ethnicity, “exacerbated by the hospital’s inadequate reporting and feedback mechanisms.”

In its detailed list of recommendations and possible approaches, Covington urged Seattle Children’s leaders to make an “unequivocal” commitment to anti-racism, increase diversity in hiring, build a culture of inclusion in the workplace, include patients in conversations about equity, and communicate transparently, among other actions.

“Seattle Children’s should take up this challenge by making itself a learning laboratory for health equity initiatives, testing actions against changes, sharing its lessons learned and leading the field in health equity internally, in research and in the broader community,” the report says.

Among some of its more detailed recommendations: Conduct an organizational structure audit to determine roles and responsibilities related to health and workplace equity. Develop formal career mentorship and sponsorship programs to accelerate the advancement of underrepresented employees. Track diversity metrics in hiring, performance evaluations, promotion, compensation, discipline, retention and attrition. And schedule regular visits and support leadership at the OBCC, which it notes is a “unique and vital facility for Seattle’s BIPOC communities,” referring to Black, Indigenous and people of color. 


Another large source of contention among Seattle Children’s patients was focused on the hospital’s use of “Code Purple,” in which staff call for security and a mental health professional when they feel there is unsafe or threatening behavior. According to a Seattle Times analysis of data from the hospital’s inpatient and observation units, the hospital called security on Black patients at twice the rate of white patients since late 2014.

The new report addressed the “significant racial disparities” in Code Purple calls and said that even though the hospital had been aware of the issues since at least 2013, senior leadership didn’t work to address them until 2020.

Sperring on Monday also drew attention to the hospital’s new internal task force, which includes members nominated to work with the executive leadership team to create an action plan addressing Covington’s findings.

The leadership team plans to share more details about the action plan by September 1, Sperring said.

Former Washington Gov. Gary Locke, who served on the hospital’s assessment committee, said Monday that now that the hospital has released the findings, it can “begin a new chapter.”

“I am confident that the organization will emerge from this assessment armed with the information needed to address current shortcomings and do the necessary work to become a leader in health equity,” Locke said.

Seattle Times staff reporter Asia Fields contributed to this story.