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Advancing equity for your workforce, patients, and community

Diversity, equity, and inclusion are increasingly top priorities for health care organizations. Success will require dedicated leaders, resources, measurement, and a multifaceted approach that covers workforce, patients, and community.

By Micha'le SimmonsDarby Sullivan

Updated -

August 28, 2020

    Diversity, equity, and inclusion is increasingly a priority for provider organizations nationwide. Many hospitals and health systems already have initiatives underway, but these efforts are often short-term pilots implemented ad hoc. To make real headway, senior leaders must designate diversity, equity, and inclusion as part of both the organization’s mission and strategy, with dedicated leaders, staff, resources, and metrics to advance the vision. This complex journey requires a comprehensive and multi-tiered approach that covers three key areas: your workforce, your patients, and your community.

    Read Advisory Board’s statement on why racism is a health care issue.


    Workforce: How can we support diversity, equity, and inclusion among our staff and leaders?

    Organizations with a diverse workforce (across race, ethnicity, gender, sexuality, gender identity, culture, language, ability, and more) and an inclusive culture are stronger businesses. Research indicates that these organizations are more profitable, better performers, make better decisions, and have greater team collaboration. When frontline staff represent the community they serve, patients experience better outcomes. Further, diverse leadership perspectives can help organizations become market leaders with innovative strategies to advance equity. But most organizations have a long way to go.

    How Advisory Board can help

    In order to move the dial on workforce diversity and inclusion, first identify where your organization sits on the D&I maturity model with our tool How to Embed Diversity and Inclusion in Your Workforce Strategy. Set clear goals to guide progress. If you haven’t already, dedicate resources to building diverse pipelines for frontline staff and leaders:

    Hiring a diverse workforce is only the first step. Cultivate an inclusive culture that improves retention with tactics like employee resources groups and in-depth, regular D&I training:


    Patients: How can we offer equitable biopsychosocial care to all patients?

    Inequities in care delivery and patient outcomes is a moral issue. It can also impact the functioning and outcomes of hospitals and health systems. Health disparities among a provider’s patient population can lead to legal risks, accreditation failures, lower quality and HCAHPS scores, avoidable utilization, and increased total cost of care. Further, these inequities can damage consumer confidence and the organization’s brand.

    Health disparities typically result from two factors: inequitable care delivery and the impact of unmet social needs. Maintaining a diverse workforce and an inclusive culture is a key first step to improving equitable care delivery, but it’s not enough. All staff need to be able to care for all patients regardless of background, and all are at risk of relying on cognitive shortcuts in high stress situations. And even if staff are able to build trusting, patient-centered relationships, they can’t make much clinical headway if patients face non-clinical barriers to health, which can account for up to 50% of health outcomes.

    How Advisory Board can help

    The first step to offering equitable care to all patients is to engender organization-wide cultural humility. Culturally-responsive care builds trust with marginalized patients and enables care teams to meet the range of diverse and intersectional needs. Cultural humility requires an in-depth understanding of structural inequities and how they manifest in the patient/provider relationships:

    In addition, staff must also have patient engagement basics down pat:

    Once staff can build strong patient relationships and design person-centered care plans, they also must be prepared to meet the range of needs they surface. Often, non-clinical needs interfere with clinical improvement and most impact patients from historically marginalized communities. To get started, make sure you understand the basics:

    Then, develop a plan of action for meeting these needs. Provider organizations select high quality community partners and create seamless referral processes. To do so, design investments with sustainability in mind and ensure you have comprehensive data on the range of patient needs to prioritize next steps:

    Then, design targeted interventions to address the most pressing social needs among your patients:


    Community: How can we address community-wide social determinants of health and their root causes—intergenerational poverty and structural inequity?

    Provider organizations must address the inequities they see among their patient population, but that approach alone is insufficient. Efforts that end at the patient level serve as a Band-Aid approach and don’t address the community-wide social determinants of health or their root causes—intergenerational poverty and structural inequity.

    How Advisory Board can help

    To advance health equity in the long term, leaders need to address these community-level factors that impact historically marginalized groups at disproportionate rates. To start, leaders need to understand structural inequities and why provider organizations have a role to play:

    Then, leaders must collect data to understand the full scope of the problem, strengthen partnerships with community leaders, and design a long-term strategy for addressing structural inequities:

    Spotlight: Nationwide health inequity crises

    For guidance on national inequity crises:

    Covid-19

    Maternal health

    Rural health

    LGBTQ health

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