The Advisory Board, a division of Eden Prairie, Minn.-headquartered Optum—a health services company that is part of United Health Group, has extended its submission date for the Innovation Showcase: Strategies to Advance Diversity to Oct. 15. The showcase celebrates strategies used to increase the diversity of the workforce to better reflect a community’s demographic makeup or labor pool, focusing on the clinical workforce, senior leadership, or career pathways for entry-level roles.
At the event, taking place on Nov. 18, voting by attendees and a judging panel will determine the winner among the presenting finalists, based on four criteria:
- Impact - the innovation demonstrates a measurable and positive impact on workforce diversity and retention of underrepresented staff
- Creativity - the innovation is a new way to increase representation or applies new elements to an old approach
- Design - the design process meaningfully involved marginalized stakeholders whom the innovation is targeting
- Sustainability - the strategy includes a plan to sustain and expand the positive impacts over time
Optum will award the winning organization $10,000 toward investing in Diversity, Equity, and Inclusion (DEI) work.
A press release on the showcase states that “Many health care organizations have ample opportunity to improve representation within their senior leadership and clinical workforce. About 80 percent of the healthcare workforce is made up of women but only 19 percent of hospitals and four percent of healthcare companies are led by women, according to a Korn Ferry study. Up to 98 percent of senior management in healthcare organizations is White, a study in The Health Care Manager found. And only 5.8 percent of active physicians identify as Hispanic and five percent as Black or African American, while only 34 percent of physicians are women, according to the Association of American of Medical Colleges.”
Healthcare Innovation had the opportunity to speak with two leaders of the Advisory Board, Micha'le Simmons, managing director, and Rachel Zuckerman, research consultant, about the importance of DEI in healthcare organizations.
Can you tell me about the Innovation Showcase?
Micha’le Simmons: We are doing this Innovation Showcase because we wanted to allow our members and those that lead diversity efforts to tell their own story of how they are making progress on increasing representation within their respective organizations. We wanted to encourage people to share progress specifically on roles where we see a lack of diversity. And I want to note that diversity is very context dependent. So right now, we're using it more broadly. But if we're working with an organization, we encourage them to be very specific about what that means for them and their community and context. With the Showcase, we wanted to focus on having people share stories of how they're increasing diversity within clinical roles and within leadership positions, and how these are truly viable career paths. Also, for the leadership side, these are places where decisions are made within the healthcare industry. We know how sometimes few women and people of color are in some of the senior leadership roles within the health system.
Rachel Zuckerman: Encouraging organizations to share strategies that have worked for them and where they're making progress, really in an effort to share that learning across the industry. Because we know this is an area where organizations, to make progress alone, it really has to be an industry wide collaboration. So, just bringing leaders together to share that learning and share inspiration with one another.
How can leaders understand the tradeoffs necessary to advance structural transformational change toward a more equitable workplace?
Simmons: First, organizations need to be clear about what diversity means for them and to be willing to pursue such an initiative. One of the first tradeoffs is that we are going to prioritize specific groups of people. Whether that could be that we need to see more women in leadership or that could mean that we need to see more Black leaders within our organization. But choosing to be specific, and that often can create a lot of conversation among the team, because that means that we are taking a stance as an organization, and we may investment in those specific groups and having rationale for that.
Often we can look to the data and see where certain groups may be having an inequitable experience and that is responsibility of the leaders. If we are committed to diversity, equity, and inclusion, to look for ways to mitigate those inequities. So, one of the very first tradeoffs that you have to make is it actually getting clear about where are we willing to prioritize our investments and what groups of our staff are marginalized and are not being promoted at the same rate as others. And so on.
What are some of the challenges about having those kinds of conversations with leadership?
Simmons: The big thing that will come back, is that it's very personal. Also, if I say that I'm going to make investments in one group over the other, there can be a certain sense of if I am not someone who represents that particular group. If I am, for example, a White leader, we're talking about increasing representation of Latinx leaders in the organization. What does that say about me and people who look like me? There is definitely a challenge of identity. And whether or not I feel like, do I still have a place in this organization?
As leaders who are making these decisions and making investments, that's a question that you have to ask for yourself personally. But you also need to account for the fact that other people within my organization are also going to be asking the same questions. How are we going to tell this story and help the organization understand why we are making the choices that we're making.
Zuckerman: I think I would just add, there's a level of discomfort when explicitly talking about diversity. The way that we're talking about, even just explicitly naming what you mean when you say diversity or representation, and what that looks like for our organization. I think there's also some discomfort we’re wrestling with when we look at the data. What does that mean when we look at our organization, and where we have been falling short, and it can be hard to confront that as leaders.
Simmons: The other thing that comes up is some of the deeply held beliefs that we might have, like are we lowering the bar, and that is absolutely not true. If anything, the bar hasn’t been clearly defined about who gets to be a leader and how we are making those selection decisions. This is one of the tradeoffs that leaders need to think more deeply about because some of those decisions are made too much by default, rather than clear intention, and ruling some people out because of that.
Some organizations that have been more successful in increasing in diversity and hiring have had to go back to the drawing board to look at their evaluation criteria and make sure that this is actually reflective, and hopefully in some way predictive, of whether or not someone will be successful in that role, but not in a way that's allowing our inherent biases to show up when we're selecting who gets to join our organization. Or, I think, even harder decisions are who will be a good leader or who should be a leader here.
Let’s talk about education and training. Do you have any methods or strategies to reduce workplace inequities in an existing organization?
Simmons: One of the things about training that we always have to add on is the caveat that you can't really train away the inherent bias that we have. If you have a brain, you’re biased, and we're always prone to that no matter how much we educate ourselves. In addition to using education to help us increase our sense of cultural humility, understanding of other people's perspectives, and a bit of holding a mirror up for us to know where our inherent biases may crop up, depending on our areas of privilege. But also at the same time, you need to pair that with how will I do the job differently? What are the processes where I am more prone to make biased decisions that are going to have an impact or consequences?
So, again, going back to the example of hiring, if I want to do the training with an organization, we want to not only talk about here are the types of things, but also stereotypes might show up, we're making hiring decisions, or some of the neurocognitive biases that might show up like confirmation bias, which are all familiar with. But then I want you to think about when I am in the moment of hiring, what are some things that I will do differently, so that we're using or thinking about this in a way that actually allows us to apply it.
I think when you would go back to the original question that you asked about, how do we make structural or transformative changes, it's making sure that we're combining this education, increasing our awareness with disrupting and changing the structures that got us there in the first place. How are we revisiting—talking about the evaluation criteria—how are we revisiting that so that our leaders aren't making those decisions just based on their whims? For example, the interview guide they made up, which might be okay, is likely going to a weed out some people by design.
Do patients have better outcomes when they have a provider who shares an identity with them? For example, would a Black patient relate better to a Black physician?
Simmons: There is definitely data that shows that patients tend to have better care outcomes and experiences when they're interacting with providers and clinicians that share identities with them. I think that comes back to how important it is to have that representation within your clinical workforce that represents the community that you're living in. I think that especially in the physician workforce, there is a real lack, particularly racial diversity, and gender diversity as well, actually. That's why part of the focus of the Innovation Showcase is really bringing forward those examples and stories of how organizations have increased diversity, not only in leadership roles but in clinical roles as well. Exactly for the reason that you said, because it is so important in patient outcomes and health outcomes.
How can a workplace foster team members from underrepresented groups, so they feel included and valued?
Simmons: With that, it starts with norms that are set by leaders and needing to openly have conversations with the team. Whenever we’re bringing new people into a team, which is a practice that could benefit anyone, is coming back to [the question] what are we trying to accomplish together? And what are the things that are unique? About even what you need from this group to feel like you can contribute your most or your best to the team. One of the other things that we also explore as a team of this research is looking for tools to be able to provide new leaders to have better conversations with people on the team. Whether that’s a conversation about performance and actually having your leader acknowledge directly as I'm giving feedback that I'm coming from this particular perspective. I might not understand some of the challenges that you might face, [but] openly talking about those things, instead of separating them, we're now moving through realizing the professional is not separate from the personal, we’re whole human beings and we have to acknowledge all of those different facets. So, it's partly not ignoring that those things are there.
Zuckerman: In addition to the leader’s role, there's work to do in shifting the culture of the organization and all employees in the organization to kind of be advocates for this safe culture that we want to create. If you think about it in healthcare, employees are all accountable for reporting adverse patient outcomes or safety errors that they notice. If you think about creating a culture like that around equity and inclusion, where people really stand up and speak up for to acts of exclusion that they notice or language that doesn't feel inclusive, you're really spreading the responsibility and accountability.