|Diversity, Inclusion, and Cultural Competence – A Review of the Hawaii-Pacific Chapter of ACHE Panel Discussion|
|Kelly Wheeler, Health System Specialist, Hawaii Military Health System|
Diversity, inclusion, and cultural competence are words that are being heard more and more often in all sectors of business, including healthcare. In Witt/Kieffer’s 2011 national survey report “Building the Business Case. Healthcare Diversity Leadership” (Gauss, J., Jessamy, H., 2012) key findings included:
Many experts believe that embracing diversity, inclusion, and cultural competency will lead to increased access to quality care for all patient populations and can be a business strategy to attract new patients and market share. Jim Gauss, Chairman of Board Services for Witt/Kieffer, served as the moderator for the recent Hawaii-Pacific Chapter of the American College of Healthcare Executives (ACHE) panel discussion on diversity and inclusion. He explained that organizations that have an active interest and strategy for diversity and inclusion become magnet organizations that attract talent. He also shared that cultural competency aligns with recent and emerging reimbursement and incentives.
Pictured above: Mr. Jim Gauss, Witt/Kieffer, Panel Moderator
As part of the Hawaii-Pacific ACHE panel discussion on diversity and inclusion, Ms. Diana Paloma, director of Native Hawaiian Health Program for The Queen’s Health System in Hawaii began by stating there is not a direct translation of the word diversity in the Hawaiian language but that the best translation is “kauaka like ‘ole,” or, people are not alike. As Hawaii was settled and developed, the racial diversity of the population has evolved much differently than the mainland United States. Today’s demographics of the islands make Hawaii the most racially diverse state in the US. Due to introduced diseases from foreigners and settlers, the Native Hawaiian population plummeted from 350,000 in 1778, to 70,000 in 1853, with extinction a possibility. Queen Emma and King Kamehameha IV's vision in 1859 in response to the plummeting Native Hawaiian population had a lasting impact on healthcare in Hawaii with the establishment of The Queen’s Hospital. Present day, The Queen’s Health System Native Hawaiian Health Program was developed to address the specific health needs of Native Hawaiians. What makes Queen’s Health System even more unique is that the race distribution in staff is quite similar to that of the population in Hawaii, enabling the system to mirror the diversity of its staff to patients and provide more culturally competent care.
The second speaker for the panel, Ms. Velois Bowers, Senior Vice President for Diversity and Inclusion for CHRISTUS Health, emphasized that diversity and inclusion have to be a strategic concern. As part of her experience at Trinity Health System, also working in the field of Diversity and Inclusion, the leadership was serious about diversity. She noted that the CEO drove the strategy by tying strategy to financial incentives for individuals. In one particular year, if there was even one leader throughout the organization that did nothing in the year to improve inclusion and diversity, no one that year would get a bonus. This created a tangible incentive for all levels of leadership to ensure that they promoted diversity throughout the organization at all levels. Now working for CHRISTUS Health, Ms. Bowers works for an organization that defines diversity as "everyone and everything with no one and nothing left out” (Diversity and Inclusion, 2014). Key to the diversity and inclusion at CHRISTUS is training and development including its executive fellow program. This two-year program is an integral part of the health system's mission to better reflect the communities it serves. According to Ms. Bowers, it is programs like these that develop a pipeline of future executives by matching fellows with a diverse group of mentors (Selvam, 2013). The next stage for CHRISTUS is developing and promoting supplier diversity.
The final speaker for the evening was the Commanding General (similar to Chief Executive Officer) of the Army Pacific Regional Medical Command, Brigadier General Patrick Sargent. He explained that diversity and inclusion are weaved into the fabric of the military culture through various programs including the Equal Opportunity, Equal Employment Opportunity, various policies and training including the Army’s Sexual Harassment /Assault Response Training, and various other Command policies. Through his personal experiences, he has become “comfortable through uncomfortable conversations and relationships.” Literature that he recommended included “Fierce Conversations” and “The Anatomy of Peace.”
Pictured above: Brigadier General Patrick Sargent
Cultural competency as defined in a 2002 field report for The Commonwealth Fund, “describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs” (Betancourt, J., Green, A., Carrillo, J., 2002). This study also cited that barriers to a culturally competent care include: lack of diversity in healthcare’s leadership and workforce; systems of care are poorly designed to meet the needs of diverse patient populations; and poor communication between providers and patients of different racial, ethnic, or cultural backgrounds. Having diversity and inclusion a part of the strategy of healthcare organizations is and will continue to be a key success factor.
Pictured left to right: Brigadier General Patrick Sargent, Ms. Velois Bowers, and Ms. Diana Paloma
The American Hospital Association, in conjunction with other healthcare organizations such as ACHE, has several tools available, including a diversity assessment tool, how to conduct a cultural competence self-assessment, and a toolkit for collecting race, ethnicity, and primary language information from patients on its website at http://www.aha.org/advocacy-issues/disparities/assessment-planning.shtml.
As the professional membership society for healthcare executives, ACHE embraces diversity within the healthcare management field and formally recognizes that priority as both an ethical and business imperative. In general, diversity and initiatives that promote diversity improve the quality of the organization's workforce. ACHE also embraces diversity through the Thomas C. Dolan Executive Diversity Program. This year-long program was established to address the gap between diversity in the C-suite versus the diversity of communities being served by preparing mid- and senior-level careerists for C-suite jobs.
The Hawaii-Pacific Chapter of ACHE has recently established a Diversity Committee. Interested members can contact the Committee Chair, Ms. Charlotte Hildebrand for more information at email@example.com.
Betancourt, J., Green, A., Carrillo, J. (2002). Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches. Common Wealth Fund. Retrieved on 18 December 2014 from http://www.commonwealthfund.org.
“Diversity and Inclusion,” CHRISTUS Health, accessed 18 December 2014, http://www.christushealth.org/diversity-and-inclusion.
Gauss, J., Jessamy, H. (2012). “New Research: The Importance of Cultural Diversity in Healthcare Leadership,” Witt and Wisdom (blog), April 5, 2012, http://blog.wittkieffer.com/2012/04/05/advancing-leadership-diversity-why-it%E2%80%99s-critical-in-2012/
Selvam, A. (2013). “Making Progress: Sustained Efforts to Increase Minority Representation in Healthcare Executive Ranks are Delivering Results, but Barriers Still Remain,” Modern Healthcare. Retrieved on 18 December 2014 from http://www.modernhealthcare.com/article/20130518/MAGAZINE/305189958
US Census Bureau. (2014). State & County QuickFacts. Last revised 4 December 2014. Retrieved on 18 December 2014 from http://quickfacts.census.gov/qfd/states/15000.html