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3 ways health care executives can build a more inclusive culture

By Rachel Zuckerman

August 20, 2020

    This is the third instalment in our 'Global perspectives on racism in health care' series. Read the first instalment here and second instalment here.

    We recently discussed the importance of supporting staff members of colour—including Black and Indigenous staff—as a critical step health care organisations can take to fight racism and create more equitable communities.

    Discussion guide: Diversity, equity, and inclusion conversation starters

    Building a genuinely inclusive culture is hard work. It requires leaders to actively change existing systems to amplify underrepresented voices and eliminate policies that invite bias.

    Further, while it's crucial to support the individuals leading diversity and inclusion efforts, every executive must demonstrate clear and continuous commitment to build a more inclusive workforce.

    The ultimate goal is for diversity and inclusion (D&I) efforts to be owned by all levels and functions across the organisation—not just the D&I lead and not just by underrepresented groups.

    Just to get started, leaders should demonstrate their ongoing commitment by publicising funding for affinity groups, hiring and retention data for Black employees, immigrant assistance programmes, community partnerships, and purchasing agreements with minority-owned businesses. Transparency reinforces accountability and inspires others to action.

    Below, we share three actionable steps executives should take to create a more inclusive culture.

    1. Seek to understand disparities in the employee experience

    Dig into existing workforce data to understand the unique challenges that Black, Indigenous, and people of colour (BIPOC) staff face at the organisation. Analyse recent engagement survey results, promotion rates, as well as turnover data and exit interviews.

    To get started, consider calculating these metrics:

    • Promotion rate of racial/ethnic minority staff compared to all staff;

    • Retention data for racial/ethnic minority staff compared to all staff, including qualitative evidence from exit interviews;

    • Compare the aggregate responses of racial/ethnic minority staff to all staff on the engagement survey, including breaking results down by individual survey questions or engagement drivers; and

    • Data on grievances or complaints submitted by racial/ethnic minority staff.

    In addition to data, provide safe forums—including anonymous ones—for staff to share their experiences and feedback. Check out our guide to group facilitation to help you convene productive conversations.

    Once you have a baseline understanding of inclusion, establish measurable and time-bound goals. Articulate what metrics you'll track, how you'll share them, what your goal metrics are, and how you plan to reach them. Provide frequent updates to all employees on how you're tracking.

    2. Elevate and invest in internal communities for staff of colour

    Employee resource groups (ERGs) or affinity groups can be powerful vehicles to drive employee engagement, business outcomes, and strategic priorities. ERGs are voluntary, employee-led groups that bring together employees with a shared identity, and their success heavily depends on how much power they're given.

    Ensure BIPOC affinity groups have a formal direct line to leadership, potentially with an executive leader or sponsor. Before making strategic decisions, especially those related to talent management, executives should consider soliciting input from these groups or involving representatives in conversations about organisational strategy.

    Executive-level commitment also means allocating adequate budget dollars to ERG programmes. While no budget amount is necessarily best practice, it's vital that ERGs have the resources to pursue their goals. When ERGs operate effectively, organisations view this budget allocation as an investment in pushing forward critical strategy.

    3. Lean into hard conversations about identity and inequity—and train all leaders and managers to do the same

    It's easy to believe that issues that have been politicised, such as police brutality, shouldn't be discussed in the workplace. In actuality, staff are already discussing these issues with each other and would appreciate an employer who openly acknowledges that staff might be affected by these events or circumstances, invites conversation, and supports employees who speak up.

    Leaders tend to shy away from these conversations for fear of saying the wrong thing or having an incomplete perspective. However, conversations about race must be prioritised by every senior leader, especially considering the direct impact of structural racism on health inequities.

    From the start, leaders should set a tone of empathy and openness. Acknowledge that these conversations will be uncomfortable but worth it if colleagues engage with compassion and a willingness to learn.

    To help facilitate conversations, consider sharing how you're educating yourself or leading regular conversations on how the organisation is combatting structural racism. Book clubs or other organisation-wide forums can be a powerful way to build cultural humility at scale.

    Then, translate these conversations into concrete organisational changes, and consistently reinforce your willingness to be held accountable to taking action over time.

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