Advancing Cultural Diversity in Health Care

By Howard T. Jessamy, Diversity Practice Leader, Witt/Kieffer

Two world views on diversity emerged from a national survey of 464 health-care leaders sponsored by Witt/Kieffer during 2011. For Caucasian respondents, the No. 1 barrier to success in achieving their diversity goals was a lack of access to diverse candidates. For minority respondents, the No. 1 barrier was a lack of commitment by top management. Whose perspective is correct? I contend they both are, and these two issues need to be faced head-on by today’s CEOs and board members.

Health care is facing a raging talent war, with organizations vying to attract and retain proven leaders adept at strategy, technology, quality, and other drivers within the post-reform landscape. Diversity is part of this equation, as confirmed by survey respondents who perceive diverse leadership as a valuable business builder. Successful examples of diversity results include improved patient satisfaction and clinical outcomes, successful decision-making, and a stronger bottom line.

Yet survey respondents lament that minority representation is still slim, with only one-quarter reporting that minority executives are well-represented in their organizations’ management teams and only 22 percent believing their management teams reflect patient demographics. This disconnect seriously endangers culturally competent care. As one CEO survey respondent explained, “Cultural competence and diversity drive quality. It is good business.”

Cultural diversity in health care is not strictly a staffing issue involving people who care for patients. It needs to permeate the entire institution, including a more inclusive approach to board appointments. As a Hispanic CEO survey respondent noted, “When I first started here, the board was made of mostly majority members. Now it is more diverse. We have Latino, African-American, and Asian board members. You need cultural competence on your board to deal with staff.”

Fixing the Pipeline Problem

So how can CEOs and board members address the gap between vision and reality? Let’s first focus on the perceived lack of access to diverse candidates or, as I call it, “a less-than-robust” talent pipeline. There is no question that more minorities need to be attracted to health-care careers, beginning with students in junior high and high school. Programs such as Medical Explorers have been effective in exposing teens to an array of medical careers, from pharmacy and diagnostics to surgery and emergency responders. I was encouraged to pursue a career in hospital administration at a young age and have reached out to young people over the years to do the same.

A “wait-and-see” attitude about the pipeline isn’t good enough if health-care CEOs and board members are serious about attracting minority candidates to their organizations. Bridges need to be built with young people now to ensure that health care remains a magnet area for bright leaders and their career development. Young people need to see hospitals and other health-care organizations as mega-businesses where they can thrive.

To-do items: I suggest every CEO can strengthen the minority talent pipeline within his or her organization or system by:

1. Providing internship opportunities within the institution.
2. Partnering with local colleges and universities to provide on-site experience for students.
3. Networking with the Institute for Diversity in Health Management, Asian Health-Care Leaders Association, National Association of Health Services Executives, National Forum for Latino Healthcare Executives, and other organizations with insights and solutions for more inclusion.
4. Identifying minority up-and-comers within your organization and maximize their leadership development opportunities.

Driving from the Top

Now let’s focus on the No. 1 issue for the survey’s minority respondents: commitment from top management. In my work with national health-care executive searches, I see commitment backed by action, as well as the exact opposite. For example, I consulted with a health-care association searching for a C-suite executive with a high priority to fill the position with a diversity candidate. Initially, the search stalled as the search committee screened out diverse candidates. The CEO noticed the pattern, objected to it, and insisted that a refreshed slate of diverse candidates be assembled because they were serious about their inclusive search. The net result: A female African-American executive was recruited and is effective in her assignment.

The commitment can’t stop at the recruitment stage. It must be carried through onboarding and sustained mentoring to ensure minority executives feel they will be productive and effective in their roles. Sometimes I see a “brain drain” occurring with high-performing minority talent leaving their positions due to a lack of career development. If individuals don’t feel welcome and able to use critical skill sets, they will seek greener pastures in other organizations and other industries. On the other hand, I have seen great examples of diversity success with CEOs serving decisively to attract and nurture talent. One national health system successfully recruited and retained minority individuals to serve as the chief operations officer, chief human resources office, and a senior vice president through the concerted efforts of the African-American CEO.

 To-do items: CEOs and board members must drive from the top. This means:

1. Embedding diversity goals into the strategic framework.
2. Encouraging accountability by tying compensation into diversity achievement.
3. Building an authentic welcoming culture.
4. Communicating diversity initiatives to all employees.
5. Ensuring that minority leaders have effective and sustained mentoring.

These activities cannot be siloed or passed off to middle managers; they must be visibly advocated by the top echelon of leaders as a sign of commitment. If diversity is not treated as an organizational and strategic priority, it will languish and potentially diminish culturally competent care.

When working with health-care organizations, I hear a significant shift in language: from “diversity” to “inclusion” as leaders embrace a rich diversity of thought, gender, race, ethnicity, and age to achieve a representative and robust board, C-suite, and workforce. These expanded dimensions of diversity are helpful as the most successful organizations establish inclusion as a strategic priority. When their demonstrated commitment to cultural diversity in health care becomes known regionally and nationally, these organizations are in even stronger positions to serve as magnets for talented leaders. In effect, they are winning the talent war by opening their arms.

Howard T. Jessamy is a Diversity Practice leader at Witt/Kieffer, an executive search firm devoted to health care, life sciences, higher education, and nonprofit industries. For more information, visit http://www.wittkieffer.com.