Too few hospitals, ambulatory facilities and health systems have strategies that are robust enough to ensure diversity in their leadership and to establish their position as an employer of choice. Executives and board members may question whether it's even necessary to create a "strategy." They say, "We are already diverse. We reflect our community and we receive plenty of praise for our outreach."
It takes astute leaders to respond, "Every major company needs to have a diversity strategy—not just because it's the right or popular thing to do—but because they want to be an employer of choice." A multiyear plan to expand diversity and inclusion is as essential a business priority as implementing financial controls and managing quality improvement. Like all best practices, a successful program requires transparency, data and shared accountability.
Healthcare executives recognize that differences are not always apparent, especially in communities that seem homogeneous. Veterans, women returning to the workforce, members of the LGBTQ community and people with disabilities are among the diverse constituencies with varied needs and desires as employees, patients and vendors.
Just as employee surveys across all departments and salary levels reveal staff concerns about issues like scheduling or night-time parking, ongoing attention to inclusion will indicate ways to be more culturally responsive. Perhaps the cafeteria food should include more choices that fit Hindu or Muslim dietary observances. Or Latino staff may request a Hispanic business resource group be established.
Conduct an inventory of the C-suite, administrative staff and department directors. Do you have diversity in leadership? Is it similar to your workforce and community? Armed with that data and a gap analysis, you can add a filter for minority candidates for promotion and hiring. Reject applicant pools that are not sufficiently diverse. "No one applied," is not an acceptable answer.
Board buy-in is essential. Talk with board members directly about the hospital's goal to be a best place to work and take advantage of their expertise. Their companies may already have started on the journey to diversity and inclusion. Local bankers, retailers and college administrators can share insights about best practices in your community.
There must also be a frank discussion about diversity on the board. Have the board establish criteria for optimal inclusion of talent and representation, then do a gap analysis and create a three-year plan. Adding diverse, nonboard members to committees is a good way to build a board that more closely mirrors the community.
Earlier this year the American Hospital Association honored five hospital systems for their comprehensive diversity strategies. Navicent Health of Macon, Ga., received the AHA's 2018 Equity of Care Award for minimizing disparities systemwide over the past three years. One of Navicent's enhancements was implementing an annual assessment tool for board recruitment and re-appointment. The result: they increased the diversity of their board to 35.3% and of their board committee leadership to 41.6%.
The board and C-suite executives must hold each other accountable to be an employer of choice and to prioritize equity of care at the strategic level of budget and operations. It can be a cost-effective business decision if you require concrete action plans and honest use of data. Meaningful outcomes may include fewer patient readmissions, less staff turnover, increased savings and improved social determinants of health.
We do many things well without a long-range program, but demonstrating respect for the diversity of our staff, patients and community is complicated. There is no one-size-fits-all plan defined by check boxes of race, gender and ethnicity. Whether you run a 25-bed hospital or an academic medical center, your strategy must address the complexity of your own community.
Begin with transparent self-assessment and plenty of employee input, then create responsive, actionable, multiyear plans with ongoing measurement. As you add differing perspectives you will experience improved problem-solving from the bedside to the boardroom and beyond. Most importantly, if you become a diverse, inclusive employer of choice, your organization will grow stronger and more resilient in today's difficult healthcare environment.
Stephen K. Jones, former president and CEO of Robert Wood Johnson University Hospital and Health System in New Jersey, is an executive in residence at the Edward J. Bloustein School of Planning and Public Policy at Rutgers University.