Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’

“Organizations that do not have significant racial and ethnic minority representation in senior leadership are less likely to make racial health inequities a priority.” I had to look at the publication date of the article that was part of Modern Healthcare’s In Depth series late this summer. I read the same thing 20 years ago.

How long have healthcare organizations had initiatives to create a more diverse and inclusive culture and workforce? A diversity and inclusion imperative has been on deck for at least 20 years. Workforce 2000 (Hudson Institute) came out in 1987. It was a bombshell. The data showed that the net new entrants coming into the workforce between 1987 and 2000 would be women, minorities and immigrants.

Laid bare was the truth that to attract, retain and create a robust pipeline for advancement and promotion, leadership had to represent the cultural values of incoming workers and be reflective of the community. Decades later, ignorance of the need to diversify healthcare leadership is exacting its toll.

We’ve seen the disparities between a local community’s Black population and the percentage of COVID-19 patients from that community who are Black. You’ve heard governors warn local healthcare providers not to discriminate in their care for COVID-19 patients based on patients’ race, ethnicity, religion, gender, age, physical disability or mental disability.

To be an effective creator of a culturally diverse healthcare management team, you need to move the needle of your accountability mindset for diversity. Research consistently shows that healthcare management teams whose rosters reflect the diversity of their patients and staff perform better on virtually every measure of clinical, financial and operational performance. You are your patients. You are your staff.

Building a culturally integrated leadership team must be deliberate and organic at the same time. It must be deliberate, in that you want to change the status quo, and you want to change it now. It must be organic, in that you naturally attract diverse leaders because you value diversity and you attract leaders who reflect the diversity of your patient population and your staff.

All manner of programs for “breaking bias” haven’t been working. If you do what you’ve always done, you’ll get what you’ve always got.

Linda Galindo
President
Galindo Consulting
Half Moon Bay, Calif.

The article “CommonSpirit pushes back cost savings timeline” notes the health system “has stretched the timeline from four to five years to meet a number of performance improvement goals, including a plan to cut $2 billion in costs.” Supply costs were cited among the issues.

Meeting anticipated post-merger savings and process improvement goals can be very difficult. This is especially the case in the area of supply chain, where reductions in costs and improvement in efficiency, which should be rapid, frequently do not materialize for three to five years. Why is this the case for both private organizations as well as within government—where there is a congressional mandate to integrate the medical supply chains across the military services?

Undoubtedly moving forward is challenging, especially as post-merger organizational supply chain cultures clash and there is frequently an absence of a vision and governance, beyond “mere savings,” to advance a post-merger system to become a “fully integrated supply chain organization.” Medical supply chains have been slow to learn from other sectors, where fundamental problems, common in the health sector, have been long-ago put to rest. A good example is medical-device and pharmaceutical recall management—a perplexing problem for many in the health sector, but recalls have been mastered by organizations such as Costco, GM and, for medical devices, Philips.

Post-merger activities must transcend their tendency to adopt what they have perceived to be the best practices of one of the partners. It is time to surmount the “if it wasn’t invented here” belief and to consider cross-industry best practices.

Eugene S. Schneller, Ph.D.
Professor of supply chain management
Arizona State University