In some ways, it appears that diversity in health care organizations has improved recently. According to "The State of Health Care Diversity Disparities," a 2008-2009 benchmarking study from the Institute for Diversity in Health Management conducted by HR Solutions Inc., the demographics of full-time health care employees now tend to mirror that of their patients, with 72 percent of both patients and full-time employees identified as Caucasian.
Yet, when we compare these data against previous studies by the institute, we still see a lack of minority representation on the boards of trustees and executive teams, of which 90 percent of members are Caucasian. The disparity is even greater in rural areas, where minority populations often are unrepresented.
Why Increase Diversity?
The primary argument for increasing diversity among the executive and governing teams is that it improves patient care. Different racial and ethnic groups have genetic predispositions that make them more susceptible to certain diseases.
For example, while diabetes is a major concern in African-American communities, Asian-Americans are more likely to be diagnosed with stomach cancer. By having the racial diversity of the board of directors and executive teams mirror that of their patients, specific health issues are made more prominent, which leads to better awareness, early diagnosis and increased funding.
A diverse executive team also can create a more inclusive environment for patients, helping them trust staff members because they feel they are being heard and not being discriminated. Trust leads to fewer misdiagnoses and improved quality of care.
Greater minority representation at the executive and governing levels may seem like a daunting task, since the goal in hiring is not specifically to hire a candidate of a certain race or ethnicity, but to hire the best possible candidate. But there are several tactical approaches that organizations can take to increase the diversity among their organization’s leaders:
- creating an action plan for diversity;
- widening the candidate pool;
- engaging recruitment firms;
- promoting leaders to executive positions within the organization;
- ensuring accountability for diversity goals; and
- encouraging future generations to pursue careers in health care.
Creating an Action Plan for Diversity
While many organizations want to increase their minority representation, few have a strategic plan to do so. Of the 182 participants in the study, 108 organizations (59 percent) did not have a documented action plan for providing opportunities to underrepresented racial and ethnic minority professionals to serve on boards or in executive positions. Yet action plans can be an excellent way to increase minority representation, because they set clear goals for the organization and determine ownership for each step of the process.
"Achieving diversity within the ranks of health care executives and trustees requires the same level of precise planning that is used to achieve other organizational goals, such as increasing scores in patient satisfaction or reducing medical errors," says Fred Hobby, president and CEO of the Institute for Diversity in Health Management.
"The ability to identify and align the appropriate human resources with opportunities for process improvement is the key," adds Hobby. "Organizations should anticipate future needs (retirement, relocation, term limits) and begin the process of identifying the desired talent well in advance. The competition for minority talent in senior management and governance is increasing. Success is enhanced by action plans that can be measured by outcomes."
Widening the Candidate Pool
The 43 organizations (24 percent) that have a documented plan for increasing minority representation in both the governing body and in executive positions employed a variety of methods, including recruitment, retention and succession-planning efforts, and connection with local and professional organizations. These methods work because they typically widen the pool of available candidates.
Engaging Recruitment Firms
At Alameda County Medical Center in Northern California, which has an extremely diverse executive team and governing body, the human resources department uses strategic recruiting when searching for executive team candidates. "We can provide better care to our patients if we have a better understanding of their culture," says Jeanette Louden-Corbett, chief human resources officer for ACMC.
ACMC human resources staff ensure that the candidates they find for executive positions understand the culture of the medical center’s patients by working with an outside recruiting agency. When recruiting for an executive, they typically prepare a profile of ACMC and of the community, which is incorporated into the job description the recruitment firm uses to seek candidates. This profile includes the racial and socioeconomic demographics of their patients, allowing ACMC to attract candidates who are a good fit for both the community and the organization.
Another way to ensure that organizations have a diverse group of candidates is to require contracted search firms to present a diverse slate of candidates for open positions. Only 40 percent of organizations surveyed said they currently have this type of requirement.
Promoting from Within
The use of outside search firms is not the best option for every organization. Memorial Sloan-Kettering Cancer Center in metropolitan New York uses a slightly different strategy to realize its goal of increased minority representation.
"We tend to promote from within to ensure that our diverse population has the chance to move up in our organization," says Dennis Dowdell Jr., vice president of human resources for Memorial Sloan-Kettering. This process also removes bias from the interview process, allowing candidates of any race or ethnicity a chance to be considered for executive positions.
Holding a party accountable for increasing diversity within the top tiers of the organization is another best practice. To ensure accountability, consider building diversity requirements into performance expectations. Only 19 percent of organizations reported that their hiring managers have diversity goals included in their performance requirements.
Encouraging Future Generations
To establish a diverse pipeline of candidates in the future, organizations also should foster a culture with a focus on health care awareness to create interest among the youth in their communities.
Providing opportunities for grade school or high school students to see how a health system operates—through programs such as career days when physicians discuss what they love about their field, or through job fairs, or even job shadowing for older students—can show youth that a career in health care is something they may want to pursue.
Additionally, offering summer internships or fellowship programs to college students can help lead to permanent placements at an organization. For example, the Institute for Diversity has provided a summer enrichment program since 1996. It is a widely used tool and highly acclaimed model program for recruiting emerging leaders from multicultural backgrounds.
About the study: A total of 182 U.S. health care organizations participated in the Institute for Diversity in Health Management’s 2008-2009 study, which collected data and measured attitudes on diversity and disparities in the health care arena. The goal of the study was fourfold: (1) establish diversity benchmarks, (2) measure future progress, (3) educate organizations regarding diversity and disparities, and (4) recognize organizations embracing diversity and leading the way in addressing patient care disparities.
Kristina Anderson is an associate marketing project manager at HR Solutions Inc., Chicago.