PARKER: Too much is often put into the chief diversity officer position, so the moment the funding dries up, or the individual in the position leaves, all of the programming goes with it. To be successful, we need to integrate shared accountability horizontally, across all departments. We need to leverage the horizontal opportunities to work with department heads and others to embed diversity and inclusion into the organization. To establish alignment, the goals of the chief diversity officer should align with other units, so that diversity and inclusion can take hold in those areas. We’ve found that once it’s in the goals, it sticks.

BOLTON: To me, it’s about institutional ownership. If there’s institutional ownership, it’s built into the organization’s values and goals. We have a dashboard that tracks our performance in everything from board-level engagement to community engagement. It’s about creating ownership across all levels of the organization. A head count showing workforce diversity does not equal ownership. Inclusion means that it is embedded into everything we do. Everyone has ownership and feels as though he or she is part of an inclusive organization.

SMITH: Diversity is always something that comes up when talking with my clients about executive placement. Rarely do we talk about inclusion. Inclusion takes diversity to a deeper level. However, it also brings additional challenges. One of the challenges that I see is the fact that hospitals and health systems are being pulled in so many different directions. The focus today is the shift toward value-based care and remaining solvent during the transition. Those challenges make it easy to lose sight of diversity and inclusion efforts. I’ve seen diversity come and go as an organizational priority. With the rise of population health management, leadership diversity is gaining greater importance across the board.

GARCIA-THOMAS: The way to improve margins is by developing an inclusive environment where people can bring their unique characteristics to the table. We need to change the conversation to get people to think about diversity and inclusion in different ways.

PARKER: When we started this journey, one of the first things we set out to do was to expand the discussion beyond what we traditionally think about in terms of diversity. It’s about tapping into every dimension of difference that every employee brings to the organization and creating an inclusive culture where all of it can be put on the table. It’s a much broader definition. As chief diversity and chief inclusion officers, we should spend more time educating everyone about what diversity really is and discussing the broader definition.

REEDE: There are still segments of the population that, historically, have been systematically excluded. We cannot lose sight of that fact. But we do need to build an understanding that everyone represents diversity.
One of the barriers that I see is a lack of metrics. Yes, we collect patient demographic and ethnicity data. But we have been somewhat lax in developing metrics, ways of understanding the workforce. What does inclusion look like? Is inclusion a feel-good term, or can we develop metrics to understand how people are included or excluded? We need to build an evidence base.

MODERATOR: Let’s narrow the focus. How do we build diversity in leadership and governance? Are there different barriers to attaining diversity in leadership and governance?

GUNN: We get strong resistance from potential clinical leaders, because time is always an issue. Asking them to sit down and have a conversation around diversity may not seem like the best use of their time. That’s a big challenge.

Time is also a significant barrier for senior leadership. But it’s also more of an internal issue. Senior leaders need to recognize their shortcomings and put together a team of leaders with the skills and attributes to run a successful organization. Senior leaders also should ask how they can continue to build self-awareness and self-actualization of the need to have people on their team to solve problems they can’t see. That’s not unique to health care. But, in health care, I see a huge deficiency around how diversity plays into the whole conversation. Of course, you want the smartest CFO, or the best person for the position. You want skilled individuals working for you. But there’s a huge blind spot on how diversity and inclusion augments those things. For me, it’s a leadership competency that often is lacking.

As a leader, I’ve always prided myself in recognizing that I may not be the smartest person in the room. I’m only as smart as the information I’m given. So, I continue to evaluate, fact-check and verify until I’m sure I have the best information. That’s what all health care leaders need to do if they are to overcome the blind spot that often exists around diversity and inclusion. Leaders need to continue to be critical and recognize what they know and what they don’t know.

MODERATOR: How will we change that? What are some of the practices that can help us move in that direction?

BOLTON: One way is by attracting people to your board who already get it. They get it because they’re running businesses and understand and have dealt with the same issues. Once they are on your board, ask them to apply the same practices that made them successful in the Hispanic community or the African-American community, to your organization. You want them to bring that same knowledge and skill to the governance of your organization.

Pipeline development is another important piece. All hospitals and health systems should have a process in place to identify and grow potential leaders. We can tap our board members to help get an effective process in place, because there are successful models from outside health care. It has to be part of the fabric of the organization. If an organization lacks diversity and does not have diversity as part of its values, it’s a reflection of the governance of the organization.

It’s not just the nice thing to do; it’s good business. If you can make a business case for doing this, then you’re going to be more successful in getting buy-in from the entire organization.