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Toward a More Equitable, Inclusive Healthcare Environment

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While Diversity, Equity, and Inclusion programs have a long history of prominence in the corporate world, healthcare has largely operated on the margins of the conversation. While the industry has traditionally prided itself on its meritocratic principles, research continues to show massive gaps in health outcomes among the poor, the LGBTQA community, people of color and especially, women of color; this reality has forced providers to reevaluate their core beliefs through a more critical lens. Transformational change is never easy, particularly when it requires pushing back against broad societal trends. And it is perhaps doubly challenging for healthcare providers, because they need to think about DEI from the perspective of two equally important stakeholder groups: patients and staff.

This change is being driven by a number of factors. On one hand, the healthcare industry has never been more focused on care delivery outcomes; population health is a critical driver of revenue capture and growth potential, and years of risk analysis have placed the social determinants of health in sharp relief. And, the broader national conversation has necessitated a clear-eyed accounting of stark racial disparities among physicians and healthcare leadership.

Sustainable transformation requires organizations to build a more diverse, more inclusive, and more welcoming environment into everything from succession planning to the onboarding process for new clinical and administrative staff. This must include the development of cultural competencies, designed to foster an appreciation for the unique characteristics and challenges of staff members and the communities they serve. In order to achieve a workable baseline for meaningful change, leadership must implement surveys and engagement initiatives designed to answer key questions:

  • What are the core barriers to increased diversity, equity, and inclusion, both in terms of staff development and serving our patients?
  • What is preventing the organization from building a more diverse, representative workforce, particularly at the leadership level? Where are the shortcomings or gaps in the way people are heard and listened to?
  • Are the concerns of marginalized communities reflected in the standards, processes, and policies of the organization?

These are uncomfortable questions, and leaders need to be prepared to have difficult conversations that focus on overcoming biases, particularly those that are more nuanced, deeply rooted, and insidious. Taking a lesson learned from the HCM world, it is also important that providers focus as much effort on the middle tier of management as on the executive team – while it is incumbent on the top levels of leadership to establish DEI as a guiding principle, middle management is where the rubber meets the road. This is because managers at this level have the most regular, impactful touchpoints with the largest number of staff members. In a healthcare environment, this same emphasis must extend to physician leadership development and training programs.

What is equity…and how do we build it?

Perhaps the newest element in the national conversation is the concept of “Equity” which prioritizes holistic, contextualized empowerment, giving people the tools they need to excel no matter what role they perform. This is reflected in the Institute of Medicine’s decision to include Equity as one of the six aims for American healthcare. One recent Connex Virtual Think Tank attendee recounted that their organization has established an Equity test as part of all policy making, as it pertains to COVID and anything else: “Who could this policy adversely affect, and who’s not represented in the room when we made the decision?”

In order to build equity and ensure that all voices are uplifted, providers must focus on building internal networks – mentorships, sponsors, employee resource groups, mental health support – that are designed specifically to help women, LGBTQA, and people of color succeed and excel within the organization. This is a multifaceted challenge in the best of times but in the context of the current pandemic it becomes more complex; providers must determine how to achieve these goals within a healthcare environment that is increasingly remote, increasingly fragmented, and under significant financial pressure. Moving to online modules must be done carefully and intentionally to ensure that the quality and impact of good DEI programming is not lost without the peer-to-peer element.

Conclusion

Decades of check-the-box diversity training and development programs in the corporate world have taught us that focusing solely on the number of diverse staff member in an organization is insufficient to producing sustainably inclusive, welcoming, and open-minded organizations. More than a century of disproportionately negative outcomes for underrepresented minorities and marginalized communities in the American healthcare system has proven that the status quo is insufficient. We are experiencing a social revolution in terms of the way we think about the importance of diverse perspectives and the innate value this represents for business performance and service quality. It is crucial that healthcare providers across the country seize this opportunity to begin the hard, necessary work that will result in lasting change. As one recent Connex Virtual Panelist recently commented, DEI transformation is “a marathon, not a sprint.”


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