19 Mar The Drive for Culturally Responsive Health Care

You might think the drive for culturally sensitive health care delivery was tied directly to the exponential increase in immigrant populations happening in cities of all sizes across the US. Indeed, there were a record 43.7 million immigrants, or 13.5% of the total population, living in the U.S. in 2016. Certainly, that diversification in the population would imply a need for a respective diversity in health care delivery.

On the other hand, that’s still lower than the record 14.8% share of immigrants in 1890, when 9.2 million immigrants lived in the U.S. The top issue back then, related to quality of health care, was cleanliness. We’ve come a long way since hand washing was considered an innovation in the mid-1800s. So what’s driving the call for culturally sensitive health care delivery today?

(Read this article in the National Diversity  Council Newsletter here: http://ndcnews.org/2019/03/15/the-drive-for-culturally-responsive-health-care/)

TODAY’S HEALTH CARE ENVIRONMENT IS EXTREMELY COMPETITIVE.

Mark Grach, Health Policy Consultant and Vice President of the Institute of Medicine of Chicago, says the desire to deliver culturally responsive healthcare cannot be separated from the financial model of health care in general. For Grach, the money model for state reimbursement as prescribed in the current Affordable Care Act is behind all decisions. “One way to get cultural competence is to buy up smaller organizations,” says Grach. The idea being to buy local health care delivery organizations that already mirror their local community. “The current environment makes ‘bigger’ a better way to get scale and keep care affordable,” he adds. It also can be a strategy toward cultural responsiveness for the ‘home’ office.

Grach sees an increasing opportunity for larger organizations in the current environment. People, meaning professionals, “go where the pay is.” In this environment, bigger organizations can better thrive, but they need the local connection to build trust in the community. “Nurses and lab assistants, people who interact with patients more often, are a good place to start,” says Grach. Doctors, less so, because of the need to hire for specific expertise and competition for salary takes precedent. “It’s more about economics,” says Grach.

TODAY’S CONSUMERS WANT TO KNOW WHAT YOU STAND FOR.

While Baby Boomers (born 1946-1964) are the largest generational segment of the population today, in a few more years it will be Millennials and GenZ. Guess what? Millennials and GenZ are more and more choosing to consume products and services from companies whose values align with their personal values, whatever they may be. On top of providing the best product or services, organizations are increasingly being asked to articulate their core values.

FROM GOOD TO GREAT: CULTURALLY RESPONSIVE HEALTH CARE AT HOUSTON METHODIST

Houston Methodist is a great example of that. Houston Methodist is already the number one hospital system in Texas for Patient Care, according to US World and News Report on Best Hospitals. They also rank in the 97% on employee engagement on employer studies. So why are they engaging in a new Diversity and Inclusion Strategy?

Carole Hackett, Senior Vice President of Human Resources at Houston Methodist acknowledges that they already have a formal D&I program. “The populations Houston Methodist serves have long been diverse,” says Hackett. “Population shifts due to increased immigration is not something new for Houston, as it might be for other communities across the US.”

“We have received awards recognizing our commitment to diversity,” she adds. “Our culture is something that we are very proud of.” Which makes it all the more significant that they are embarking on a program, with help from Executive Diversity Services,” to drive Diversity and Inclusion and cultural responsive healthcare across the organization.

While recognizing the success of the system, Hackett is poising them to go to the next level. “Just because you have a diverse workforce, it doesn’t mean you are inclusive,” said Hackett. In particular, Hackett was focused on aligning internal and external messaging and building in measurement for success. “We want to have clear and consistent messaging across the organization, from leadership to frontline service delivery. And we want to measure our success from inclusion and training to community engagement.”

Deepening the Diversity and Inclusion strategy at Houston Methodist “will only make us stronger and more successful to care for our patients,” says Hackett. “It’s all about giving the best care for our patients, and also about caring for each other—our patients, our employees, our community. It’s all about making us better.”

HOW EXECUTIVE DIVERSITY SERVICES HELPED

Elmer Dixon, President of Executive Diversity Services (EDS) outlined how EDS worked with Houston Methodist.

EDS initially met with Houston Methodist’s top 75 leaders, including the president of the organization. This was to secure executive support for the organization-wide initiative, to help them build a business case and identify best practices for diversity and inclusion at Houston Methodist. This initial session also included presentations on unconscious bias and on developing intercultural sensitivity in health care.

We then met with 400 directors to secure this next level of commitment to Houston Methodist’s D&I strategy and tactics, and to engage Directors in understanding their role in the program’s success. We helped them look at paradigms of unconscious bias, definitions of D&I, and developing an intercultural sensitivity model. Together we looked at the path to creating greater cultural sensitivity in the health care field.

With solid leadership commitment, we then moved onto  training for Human Resource (HR) Directors and HR Generalists. There were three full-day training sessions, each with 20 to 25 people. Content focused on understanding and identifying the paradigms of unconscious bias and how that is critical to creating inclusion and more culturally responsive health care.

KISS… NOT SO MUCH

As with most issues, it’s not always easy to keep it super simple (KISS). It starts with a desire to be the best, to be inclusive and to provide services that respond to those that you serve.

In the day of the Internet, people can get exactly what they want. And that has to be realized in real life as well.

With large organizations, change always takes more time. It takes leadership from the top. And then it takes instilling strategy and adopting tactics across the organization and down to people delivering services on the front line.

There’s a phrase in management that says “your day is your week is your month is your year. It means that what you do in the moment is where you’re going to be in the long run. So if you want to be the best healthcare system providing the best service to the people you serve, then what you do in your day-to-day interactions is what will lead you to that result.

A system-wide strategy on Diversity and Inclusion, broken down into measurable tactics, is a path toward success. Says Hackett, “It’s all about making us the number one healthcare provider.”