DiversityNursing Blog

Why Should Healthcare Be Committed to Diversity in their Workforce? 

Diversity within healthcare is essential in delivering competent and inclusive patient care. Individuals from all walks of life enter hospitals and clinics daily to seek medical care. To provide these individuals with the best medical care possible, we must be able to relate to them properly. The best way to ensure we can connect and communicate effectively with patients is to ensure that the healthcare staff is well diversified. 

What is Diversity in Healthcare? 

Diversity is reflected in healthcare by employing individuals from different backgrounds and walks of life. There are many ways healthcare staff can be diversified. A diversified workforce includes hiring persons of multiple races, ages, genders, ethnicities, religious beliefs, political beliefs, education levels, languages, and sexual orientations. Military service is also a unique quality that can often be overlooked to add to the diverse population of healthcare workers. 

Is Healthcare Committed to Diversity in their Workforce?

Although there is much evidence to support that diversity within the healthcare workforce is beneficial for employees and the community, there is still a gap in healthcare diversity. The majority of Physicians are white males. Nurses tend to be predominately female. 

Benefits of Diversity in Healthcare 

There are many benefits to having a diverse workforce for the healthcare staff and patients. Some of those benefits include:

• Individualized Patient Care for Diverse Populations: When you have a patient seeking care and there is diversity within your healthcare staff, there is always someone on the healthcare team who can communicate and identify with them to ensure their needs are met. 
• Increased Patient Trust: Patients seek medical care for a variety of reasons. Often, the reason for seeking care comes with a sense of anxiety. Studies have shown when patients can easily relate to their healthcare provider, there is better overall communication and better patient outcomes. It’s also been shown that when patients relate better to healthcare staff, they are more likely to continue with follow-up care and take part in preventative care measures.
• Improved Problem Solving: A wide range of perspectives from individuals of different backgrounds allows for better problem solving and creative solutions to problems. When creative minds come together from various perspectives, new ideas and innovations can be produced. 
• Better Employee Retention and Morale: Employing a diverse community of healthcare workers can improve employee morale and make the workplace more enjoyable. Working for a company that takes pride in people of diverse populations positively impacts the workplace and the community. 

Disadvantages of a Lack of Diversity

The disadvantages of a lack of diversity within healthcare can pose significant risks to healthcare delivery and result in poor patient outcomes. Some disadvantages include:

• Impaired Communication: Impaired communication occurs when there is a language barrier. Healthcare staff may not fully understand what a patient is trying to convey, and patients may be confused about the plan of care, leading to patient dissatisfaction and potential medical errors. 
• Limited Perspectives: When healthcare staff lacks diversity, implicit bias can affect how healthcare is delivered to those of different backgrounds. Implicit bias is when healthcare workers unintentionally judge patients based on their different beliefs, customs, or cultures. Although implicit bias is not intentional, it can cause significant harm. Having a diverse healthcare staff decreases implicit biases by allowing for different perspectives while implementing care.

How can we Promote Diversity in Healthcare? 

The only way to truly diversify healthcare professionals is to make medical education more attainable for people of all races, ethnicities, and backgrounds. People seeking healthcare education should have access to feasible and affordable education. 

Many students seeking medical education are not of the traditional college age. College students can range from working parents, people changing careers, or single parents seeking education on weekends or nights. Many people cannot dedicate days to a classroom setting. A great way to achieve a more diverse workforce is to improve upon and offer more online learning programs that are more accessible and affordable to various and diverse people. 

Conclusion 

The importance of diversity within the healthcare workforce is evident. When healthcare is more diversified, medicine itself becomes more culturally competent. All healthcare workplaces should strive to provide a diverse population of workers to improve overall patient outcomes and acquire better patient satisfaction.

Major health care giants like Dana-Farber Cancer Institute and Massachusetts General Hospital have pledged to improve diversity recruitment of health workers. Reports showed a lack of diversity in hospitals and care discrepancies among patients. The hospitals plan to increase resources, hire executives focused on improving diversity and inclusion in their organizations, and more.

The lack of diversity in the healthcare workforce can impact patient care. Minority patients are more likely to seek out and follow advice from health professionals who look, sound, eat, worship and share the same cultural customs and values like they do. 

The U.S. population overall is changing and quite rapidly. In 2010, the number of residents age 5 and older speaking a language other than English at home had climbed 158% to 59.5 million from 23.1 million in 1980, according to the U.S. Census Bureau. By 2044, more than half the nation is expected to be made up of minority races or groups, according to a 2015 Census Bureau report.

Yet, statistics show healthcare isn't keeping pace with population changes. Minorities made up just 14% of hospital boards and only 11% of executive leadership positions in 2015, according to a survey from the American Hospital Association's Institute for Diversity in Health Management. This disparity exists even though minorities represent roughly 30% to 35% of patients in hospitals.

Dana-Farber Cancer Institute officials told Becker's Hospital Review they plan to hire a leader for diversity programs, and will require all faculty and administration to complete a bias awareness workshop, among other initiatives, as part of the institution's 2018 strategic plan.

Dianne Austin, workforce diversity program manager at Massachusetts General Hospital, told Healthcare Dive, "Mass General has an orientation where new employees attend a program on diversity and inclusion and learn about various resources available to employees, such as a citizenship program, careers days and school admissions officers. There are also multiple staff committees focused on improving diversity and inclusion."

Akron Children's Hospital supports a program that aims to improve Nursing diversity. The program's plan is to increase the number of interns in the program and provide tuition support during their senior year of college. The hope is that program participants will return to Akron Children's after graduation to begin their Nursing career.

 "Nursing diversity is vital to ensuring a positive experience for our patients," said William Considine, CEO of Akron Children's Hospital. "Not only does this program provide a valuable educational experience, it also helps Akron Children's recruit more prepared Nurses and helps our workforce reflect the diversity of the patients, families and communities we serve."

UC Health intends to contribute $1.5 million to create University of Cincinnati scholarships designed to diversify the medical profession. The hospital system hopes the scholarships will help all local health systems diversify their workforce when hiring doctors, Nurses, pharmacists and medical technicians. 

“We know through recent research that underrepresented adults in Cincinnati believe their race negatively impacts their treatment from medical professionals,” said Dr. Rick Lofgren, CEO of UC Health. “This investment is a step to improve health care for all of our patients and to foster a health care workforce that reflects the diversity of our population.”

Diversity & Inclusion initiatives can be difficult to sustain, but commitment to increasing D&I at all levels of your organization will bring new perspectives and values to your hospital/health system, which can help decrease health disparities across the board. Bravo to the healthcare leaders that are seriously acting on their D&I initiatives! Do you see progress in this area where you work or teach?

Healthcare organizations must know in order to be successful, you need a diverse workforce. The key to success in this area is retaining that staff and knowing how to defuse conflicts. This is especially true in settings like hospitals, where mistakes can mean life or death.

Poor communication is one of the leading causes of medical errors, according to the Joint Commission. Medical errors are the 3^rd leading cause of death in the United States—right after heart disease and cancer, and it’s more prevalent than respiratory ailments, stroke and Alzheimer's disease—according to a study out this year from The BMJ. Author Martin Makary, MD, of Johns Hopkins University, and colleagues estimate that 251,000 Americans die each year from such mistakes. Some instances have nothing to do with interpersonal conflict, but employees at odds with one another are less likely to spend time making sure they understand each other during crucial events like a patient hand-off.

Dianne Austin, workforce diversity program manager at Massachusetts General Hospital, told Healthcare Dive, creating robust support networks is key to helping employees identify and deal with tension or potential discrimination from other employees. They also need to be able to talk freely with others who may be in similar situations. “There’s a lot that we do to really try to help employees feel that they have a voice and that they’re important,” she said.

How conflict happens

Susan Woods, a workplace consultant, says there are a few major dynamics in diversity-related conflict, including respect and disrespect, as well as recognition and identity.

1) Respect and Disrespect

Disrespect may be gross and blatant, but it is also subtle, communicated in the little

ways someone is told they don’t belong, are not good enough, are not expected to

achieve, or that they can be overlooked and don’t count.

Remarks like the ones below convey messages about respect.

“Not a bad job, for a woman.”

“You don’t have to worry about your appointment. You’re a minority.”

“That company is very traditional. I’m surprised they even hired you.”

A reasonable person could interpret disrespect in each of these messages. The

harmful message may be unintended and unrecognized by the offending party, even

as it is deeply felt by the offended party.

When disrespect is communicated in unintended and unconscious ways, bringing

this perspective to the surface creates an opening for learning and improved

relations. Regardless of how the incident in question is settled, failure to understand

the dynamics of respect and disrespect from more than one perspective perpetuates

the underlying conflict.

2) Recognition and Identity

A second dynamic often present in diversity-related conflict resolution is

recognition and identity. Recognition and identity are complicated dynamics, full of

opportunity for misunderstanding and tension. These may have a negative effect,

but may not have been communicated with consciously malicious intent.

We hear it below:

“I’m always asked to be in the photo or meet with visitors because I’m one of the few people of color

they have. It has nothing to do with my accomplishments.”

“I hope you’re not asking me to take the minutes because I’m the only woman in the group.”

“You’re not like the others. I feel I can talk with you.”

“Those people …”

The old days of the “great melting pot,” where everyone was expected to conform

to the dominate group, are gone. Hopefully, we’ve moved past assimilation to

realize that inclusion is about recognizing diverse identity. It’s about understanding

individuals as unique persons and, at the same time, as members of groups.

Either/or logic is misleading. This is a both/and phenomenon. The ambiguity can

be unsettling, especially when the challenge is so deeply personal and emotional as

with identity.

Research shows that conflict can be frequent in healthcare organizations because of the high workload volumes, pressures to move quickly and the importance of decisions being made. These conflicts can affect companies in many ways, including high staff turnover rates, reduced productivity and litigation costs.

Dealing with conflicts

The best processes start early and attempt to prevent conflict. Austin said Massachusetts General has an orientation where new employees attend a program on diversity and inclusion and learn about various resources available to employees, such as a citizenship program, careers days and school admissions officers. There are also multiple staff committees focused on improving diversity and inclusion.

Healthcare managers can help ease conflict by listening carefully to employees, quickly addressing the source of the problem, instituting strict and clear policies and educating staff about those policies, she wrote.

Massachusetts General has multiple ways for an employee to bring any concerns to light, including an anonymous hotline, Austin said. The HR department will review whatever is submitted and the relevant department head is told the details. “We really try to pull managers and the appropriate people in so we can get to the bottom of it based on the information provided,” she said.

Sometimes, the problem starts with a patient who refuses to be cared for by a certain nurse or doctor, and may use racial slurs or other inappropriate language. The nurse manager will respond and tell the patient all providers are equally trained and capable. The patient is then told they can go to another hospital if they will not be respectful to all employees. The affected employee can decide whether or not to continue working with the patient.

Diversity is needed at higher ranks

Diversity and inclusion efforts should reach all the way up the ranks to the executives, making sure their C-suites and boardrooms are also diverse and reflective of the surrounding community.

The American Hospital Association's Institute for Diversity in Health Management released a comprehensive report titled Diversity and Disparities: A Benchmarking Study of U.S. Hospitals in 2015. The results of the survey were not exactly positive. In fact, the survey found that minority representation on healthcare boards across this nation stood at just 14%—precisely the same percentage reported in a similar survey two years earlier and a similar study conducted in 2011.

Deborah Bowen, president of the American College of Healthcare Executives said the best ways to remedy poor diversity in C-suites is to start cultivating a diverse group of people who have an interest in leadership early on in their careers. Post-graduate fellowship programs and scholarship for mid-level executives can be helpful. Hospitals should provide leadership development and training as well as other career resources, she said.

“It’s a matter of finding mentors, for example,” she said. “Have a mentorship network to find somebody who has gone through something similar.”

The diversity of people in the US has changed considerably. As stated at the beginning of this article, our hospital and healthcare system employees need to reflect their patient population at all levels within their organization(s). Sensitivity to language, cultural, sexual, and physical differences in both your staff and patients is critical for a harmonious and productive environment.