REEDE: Developing the pipeline is also important. Training the next generation of leaders, preparing that queue to move on to the next stage is an essential business function. If you look at the leadership pipeline within your organization, and you don’t see diversity, then you have a problem.

SMITH: One of the challenges is that it’s hard to find great board members. It requires a great deal of work and commitment. It’s hard getting gender balance, let alone diversity. And, as Linda mentioned, if you can get people who have been successful in building a diverse, inclusive workforce, they can help make that a priority within your organization. But it’s a big challenge.

As for the C-suite, it’s equally hard to find a great group of diverse candidates. It’s a real challenge. There’s a supply issue for one. But there’s also an unwillingness to look beyond candidates who have the top résumés, to those who have the best skills and knowledge for the organization and who can bring diversity to the table.

PARKER: I recently spoke with someone about the challenges of achieving board diversity. I asked what they look for when searching for board members and the answer was that they look for CEOs or other board chairs. I explained that that approach perpetuates the problem, because of the existing lack of diversity on boards and in leadership positions. If you don’t have a pool of diverse candidates, how are you going to increase diversity? Again, it’s not about looking at résumés and who is best on paper. We need to look beyond that to cultural fit and what he or she can bring to the organization. Medical schools already have made the shift. They’ve moved from looking for the top grade point average to the total candidate’s profile.

To be honest, if people say they cannot find a diverse candidate for a position, they simply aren’t looking hard enough. The talent is there, but organizations have just not committed to getting the talent. I’m not talking about affirmative action, or achieving certain numbers, but rather about making diversity and inclusion a core value of the organization. Building a diverse board — one that understands the value of diversity — will go a long way toward building accountability and elevating the importance of diversity within the organization.

GARCIA-THOMAS: We have to be purposeful to make change. I report directly to the CEO. I’m a part of the executive team that works with the board, and when we do board recruitment, we are purposeful about how we recruit. We are purposeful in defining the skill sets that we need. We need someone who has a retail background, someone who understands the technology. And as we’re doing that, we also define the makeup of our board. Our board is extremely diverse today versus the type of health care board we had 10 years ago, but it took a great deal of effort. It won’t happen unless we’re intentional and have focus.

SMITH: Senior leadership has to demand it. It’s easy to say there are no diverse candidates for the job, and it’s not just about the candidate pool. It’s about who gets the job. We can have a diverse pool of candidates for a position, but if they never get a job offer, the organization isn’t there yet. In my many years of executive search work, the organizations that I’ve seen most successful at building diversity demand it and push harder to get it.

MODERATOR: How can hospitals and health systems begin the shift from searching for job titles to focusing on competencies?

BOLTON: Organizations need to start with the board. If you’re saying you are an inclusive organization, then analyze what each board member brings to the table — what competencies they have. One of the phrases we’ve used in nursing is that diversity is a pathway to wholeness. The whole journey to become an inclusive organization is about getting to wholeness, and that allows the organization to be much more effective. And I’ll come back to the fact that it’s good for business. You want someone at the table who has a good relationship with the community. They may not be a physician or nurse, a banker or an educator, but he or she has a great relationship with the community. You want the person at the table who has a great relationship with vendors, and has a track record of being inclusive in managing those relationships. Looking for those competencies will help get the job done, and it will help the organization to accomplish its mission.

SMITH: About 30 percent of the boards test the competencies of their members, so this is not something that’s deeply embedded in the hospital field. There’s a great deal of room for improvement in that regard.

GARCIA-THOMAS: The industry is changing dramatically, too. The type of business we were 20 years ago had a very different board. We look at it this way: If we can hire someone who has the skills we need, we’ll bring him or her into the organization. If we can’t hire the person, but we could benefit from his or her skills and expertise, then we appoint him or her to the board. We want people on the board who can help to move the organization into the future.

GUNN: The board is important. We have a unique situation: Our board members are appointed by the state legislature. We have absolutely no control over who gets on our board, or how long they stay, or how many times they get reappointed. It’s stipulated that half of the board members have to be medical leaders and the other half lay leaders. So, that’s why I can’t dismiss the belief that accountability has to be on the CEO to make sure the C-suite is just as complementary and diverse as the board. And, again, it comes back to the competency of the CEO and how intentional and deliberate he or she is in building a team that has it all.

It’s incumbent upon C-suite leaders, particularly CEOs, to recognize that and take deliberate, affirmative steps toward those goals. And I don’t see enough of their being deliberate. It’s important for C-suite executives to take advantage of continuing education to help them learn how to be intentional in building the right team for the organization.