Health systems and hospitals are in the business of taking care of people – all different types of people. One of the challenges hospital executives face today is how to approach diversity and inclusion in their organizations as strategic business imperatives and as a way to fulfill the organization’s mission.
For healthcare systems, health equity is a key component of diversity and inclusion. Health equity is defined as everyone having the same opportunity to be healthier, no matter their circumstances; whether it is financial status, gender, race/ethnicity, age, language, housing, etc.
We sat down with Tanya Stewart Blackmon the Executive Vice President and Chief Diversity, Inclusion and Equity Officer (CDIEO) for Novant Health, to discuss the importance of diversity, inclusion and health equity in health systems.
Diversity & Health equity is more than a program but part of the culture.
Novant Health defines diversity as the similarities and differences of people found in our workforce and communities we serve. Diversity includes many characteristics that may be visible, such as race, age, gender or appearance and it also includes less visible characteristics such as personality, ethnicity, religion, job function, life experience, sexual orientation, gender identity, geography, ability, regional differences, work experience and family situation – all of which make us similar to and different from one another. Novant Health’s definition of inclusion is intentionally engaging human differences and viewing such differences as strengths in both patients and team members. The key to inclusion is that we value the perspectives and life experiences of each person. These actions build an environment that fosters mutual respect, trust and commitment.
When Blackmon transitioned into her role as CDIEO, she understood that for Novant Health to be a truly diverse organization that achieves health equity, these concepts could not just be part of a program but embedded in the culture of Novant Health. Diversity and inclusion needed to be a clearly stated and a measurable goal.
“One of the biggest challenges of considering diversity and inclusion as a program is that it can be easily dropped due to funding. For Novant Health, embedding diversity, inclusion and health equity is a culture change strategy to effectively live one of its five core values,” Blackmon explained.
Blackmon needed to learn more about Novant Health team members. She conducted a listening tour across the Novant Health footprint. She listened to over 700 people, which helped clarify the current state and provide input to a strategic plan. She quickly learned that 99 percent of Novant Health’s employees were committed to the organization’s vision, “the Novant Health team, will deliver the most remarkable patient experience, in every dimension, every time.” She also discovered there were some overall misconceptions about the true meaning of diversity and inclusion.
An interesting insight from her listening tour was discovering that the board of trustees, the executive team and leaders from different levels of authority wanted to be held accountable as a leader for all of the organization’s core values of compassion, personal excellence, courage, teamwork, diversity and inclusion.
“This was crucial because how a company presents itself to the world should be rooted in its core values. It impacts the success of the business,” said Blackmon.
Health Equity Matters
Healthcare is about taking care of people. Health equity is ensuring the highest level of health for all people (source: Healthy People 2020).
“One of the main questions leaders should ask is, how do we get to know our patients more and how do we understand them in a deeper way so that we can meet their needs?”
Asking the tough questions requires the leadership team to know the hospital’s data related to patients, team members and the community. Leaders should look at quality scores, gaps in the population, etc. Once the data is collected, it should be segmented. Novant Health segments their data by REAL-GAPS (race, ethnicity, language, gender, age and pay source).
Novant Health has worked with their team members to identify and address healthcare disparities in their facilities. A few years ago, they observed a high rate of pneumonia readmissions after discharge in the Black/African American population. Novant Health assembled an interdisciplinary team to review the cases, examining medical records and conducting telephone interviews with every patient, and family member about their visit and their follow-up appointment. Over the course of a year, they closed the readmission rate gap between Blacks/African Americans and Whites/Caucasians and reduced the overall readmission rate for both groups.
“It was important for the team to focus on the fact that we don’t want to treat everyone the same, we want to provide personalized care for each patient,” said Blackmon. “This goes back to health equity, diversity and inclusion all being embedded in the organization’s culture.”
Surprisingly, working with competitors is important when it comes to health equity. “In health equity, there isn’t competition because as health systems we are all working for the greater good of our communities. Novant Health has partnerships with Atrium Health and Wake Forest Baptist Health to improve care in underrepresented populations.
A journey to an organization’s excellence includes diversity and inclusion.
Blackmon understands the business side of healthcare and the people side. She explains that diversity is about representation and having a workforce that, reflects the community you serve. Blackmon stresses the need to be intentional when you want a diverse workforce and an inclusive environment. “Diversity and inclusion must go together. You can have representation but never include people,” she said, “When we conducted our team member engagement survey, one of the most important inclusion questions was ‘I feel like I belong in this organization.’ If people are not feeling included, then you might need to revisit your organization’s strategy of both diversity and inclusion. People who feel included are innovative, efficient and provide better service.”
For 2019, Novant Health will continue to embed diversity and inclusion into its culture and will leverage the success thus far. Holding itself accountable to the culture it’s creating, Novant Health measures progress through a team member engagement survey. When asked “This organization values team members from different backgrounds, ” Novant Health has moved from 69th percentile in 2016 to the 94th percentile in 2018. For the inclusion question, ‘I feel like I belong in this organization’ (a key driver for Novant Health), the organization improved from 55th percentile ranking to the 92nd percentile ranking in the same time period.
Blackmon’s accomplishments can be credited to her willingness to listen to Novant Health’s team members and the communities they serve aligns with the organization’s strategic business imperatives. She implemented strategies that allow everyone that steps into Novant Health to feel appreciated, included and confident they will be treated with respect, dignity and receive personalized care.
“It’s about intention. You must learn in this space (healthcare) that embedding diversity and inclusion requires long-term and intentional focus. What is it that we are trying to do? We (at Novant Health) want to be the healthcare provider of choice, the employer of choice and the leader on health equity. A commitment to our patients, team members and the community as well as seeing progress – changes in our system, behaviors and mindsets gives Blackmon the strength to keep moving the organization forward.
Note: Responses have been edited lightly for length and style.