Friday, August 15, 2008

So, when do we really address diversity in the healthcare workforce?

It has been known for a long time that diversity in the health professions is not only the so-called "right thing to do" but it is also evident that it is the thing we need to do healthcare right.



In December of 1995 The Pew Health Professions Commission (Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century) stated:

There is a substantial body of literature which concludes that culturally sensitive care is good care. This means two things for all health professional schools. First, they must continue their commitment to ensure that the students they train represent the rich ethnic diversity of our society. Important investments and many successes have been achieved, but this is an obligation that must be continued at each institution until it is no longer an issue. Second, diversifying the entering class is not sufficient to ensure understanding and appreciation of diversity. Cultural sensitivity must be a part of the educational experience that touches the life of every student.



About 10 years later, the Sullivan Commission on Diversity on Diversity in the Healthcare Workforce published Missing Persons: Minorities in the Health Professions stating:

Diversity in the health workforce will strengthen cultural competence throughout the health
system. Cultural competence profoundly influences how health professionals deliver health
care. Language is a critical component, with two out of ten Americans speaking a language at home other than English. The cultural challenges posed by a shifting patient demographic can
best be addressed by health professionals educated and trained in a culturally dynamic environment. . .



The business community has long recognized that workforce diversity is essential to success
and maintaining competitiveness in the marketplace. Corporate executives as well as local
chambers of commerce describe the economic benefits of developing a workforce that reflects the customer base.



After publication #1 (Pew) we were left with a greater understanding of the issue. In between the Pew report and the Sullivan (publication #2 above) report, there were myriad reports on this issue and related issues such as health disparities, other workforce-related studies examining diversity, numerous conferences, and a lot of conversation about the importance of it, how it is affecting health outcomes, etc. There have been other subsequent to Sullivan, too.

What I personally have not seen a great deal of is a publication of best practices: How to diversify and expand the healthcare pipeline?; "Where do we go from here in healthcare workforce diversity?"; and so on and so forth--in essence, action!

Now, my not seeing this much does not mean that it is not happening. So if it is, and you happen to pass by this blog and read some of it, please share your success with me and I will do my best to share it with my network, my clients, etc.

In the meantime, when do we really address diversity in the health professions; in the healthcare workforce? There are many steps that have been taken in states and by cutting edge foundations like the California Endowment. Check out what they are up to:

http://www.calendow.org/article.aspx?id=1382&ItemID=1382

You may also find programs taking place through educational institutions like the Summer Enrichment Program at the University of Michigan as well as another such program run by the Institute for Diversity in Health Management.

These programs are great, the question lies in the details and in the measurement of what is coming from them. I would say there are positive outcomes anecdotally, and I actually believe anecdote is measurable. However, we generally are not even capturing the stories that these programs produce in aggregate. As a result, the funding for them is usually sparse, running low, running out, and has already run away with little hope hope for renewal.

Don't get me wrong, I am confident that we can make continued and bigger strides towards understanding pipeline building in the healthcare workforce. To me it lies in moving towards a clear understanding that this is not "initiative-based". Initiatives come to an end. Diversity in the healthcare workforce is not something that some do and others don't if they want success long-term and it has no ending. Diversity recruitment is recruitment, period. If diversity is not being considered, quite frankly you are not really recruiting. You are selecting some folks that will meet your needs for the next few years, but you are not building the workforce that will add to bottom-line growth in the future of your organization, hospital, institution, etc. It simply won't lead to the innovation, connection with patients, market share growth, or any other aspect that you are looking to advance including cultural competency.

So, when do we really address diversity in the healthcare workforce? We are doing it now, but not nearly to the extent we need to. Do we understand the implications? I doubt it. Right now they are theoretical and not practical.

I am in search of a healthcare organization that has focused on diversity and has documented how it has positively affected them. If you hear of any, let me know, I would be thrilled to do an interview with them.

If you are interested in an interview talking about your talent management efforts, drop me a line at amrijohnson@gmail.com. We are in the process of creating our interview and publication schedule for Diversity HealthWorks. I am sure the world would love to hear about the great things you are doing. . .

Sunday, August 10, 2008

New Mexico Taking a Lead In Healthcare Cultural Competency

Below is a link to a very nice article that speaks to the fact that cultural competency in healthcare is an issue that every state needs to be engaged. Looks like New Mexico is really engaged in the conversation. Other states like New Jersey and California have implemented similar legislation as it relates to culturally and linguistically appropriate care.

What state is next to push this to their healthcare workforce?

http://www.cnn.com/2008/HEALTH/08/08/cultural.medicine.ap/

Friday, August 8, 2008

You maybe want the Hot and Sour Soup

A few weeks ago, I was having dinner at one of our favorite vegetarian restaurants outside of D.C. My friend and I asked about the soup choices, in particular the Won Ton Soup. The waitress whom I have seen quite a bit, described the Won Ton Soup. She said, "Won Ton soup, the Won Tons are made of flour." She then paused. Not fully understanding what she was tying to convey I then asked, if it was good. She did not respond directly to the question, but she did make a suggestion, "You maybe want the Hot and Sour Soup." We looked at one another chuckled and the Hot and Sour Soup it was!

The conversation points to the dynamics that we see in cross-cultural interchanges everyday within healthcare institutions. Perhaps an American wait staff would have said, "I don't really like the Won Ton soup." However, she chose to not be critical of the food, the restaurant, the chef and instead suggested that we choose one that she felt we would like through experience. A very highly contextual response.

Consider the many times we encounter communication styles that are not in alignment with our world view. Are we even aware enough to know that our selective listening begins? Imagine how this could happen with a staff person, a physician, or a patient. We often emphasize language because of CLAS standards or simply because we have so many reminders of language barriers as the diversity of our organizations grow.

While we are aware of the fact that culture matters beyond language, and clarity in communication comes from context, and that we all have both. However, we don't necessarily examine our biases and how our context consistently occurs to others.

How do we begin this process?
  1. My experience is first to begin to learn about cross-cultural communication. Generate an awareness of the nuances of how we relate to one another in communication and what types of questions ask.
  2. Knowledge of all archetypal generalizations of cultures outside is not necessary (or possible) but it without doubt can help with our understanding of how we might be occurring to others based on their cultural lens.
  3. Lastly, get engaged in the process of learning about effective communication. Any education in this topic should inherently include a module related to culture.

Our new healthcare diversity and cultural competency wiki Health Culture Depot is coming soon. If you have topics you would like to write about regularly, let us know. We are building our list authors as I write.

Thursday, August 7, 2008

Cultural Competency and Diversity in Healthcare: A Healthcare Diversity Consortium

Cultural Competency and Diversity in Healthcare: A Healthcare Diversity Consortium

A Healthcare Diversity Consortium

There are a lot of people doing great work in the diversity and cultural competency space where healthcare is concerned. One organization (the whole team!) that is doing outstanding work is Trinity Health under the leadership of VeLois Bowers, Sr. VP. of Diversity.

They are hosting an event that is going to be awesome! It is not too late to RSVP although the note below says different. Reach out to Toni Green and be there. If you are in healthcare and have a diversity responsibility in any capacity, you have to be there!
________________________________________________
Greetings,

Today, diversity executives and practitioners in health care are faced with many factors impacting our diversity efforts. Recently, there has been an expressed interest in health care diversity professionals coming together to address initiatives in an industry where the diversity journey is just beginning. In this light, Trinity Health is pleased to host a health care diversity consortium to benchmark and share best practices from the industry across the nation. We will focus not only on recruitment, retention, and talent management but how diversity and inclusion initiatives impact responsive and respectful patient centered care.

Trinity Health's Office of Diversity and Inclusion would like to invite you to join us September 30 and October 1, 2008 at the Dearborn Inn located across from Henry Ford's historic Greenfield Village located near the Detroit metropolitan airport. The hotel logistics and an agenda will arrive under separate cover. We are planning a robust agenda that will include guest speakers and topics to stimulate dialogue and share best practices.

Please RSVP with your, or your designee's availability by Monday, July 28, 2008.

If you know of other healthcare diversity colleagues who may be interested in attending, please forward this invitation. Please contact me if you would like additional information.
I look forward to our meeting.

Best Regards,
Antoinette Green PHR
Director, Diversity & Inclusion
Trinity Health
34605 W. 12 Mile Rd, Ste 127
Farmington Hills, MI 48331
248-489-6371