External collaborative strategy to recruit can foster diversity and inclusion in health care workforce
For U.S. health systems, valuing diversity and inclusion (D&I) in the workforce is vital to serving the emerging needs of a diverse patient population. The much-aspired patient-centered care is feasible when the approach and focus are shifted to enable health systems to improve care quality and the patient experience of diverse patients.
Published in JMIR Formative Research, the study titled "Valuing Diversity and Inclusion in Health Care to Equip the Workforce: Survey Study and Pathway Analysis" asks the following questions:
- Can the health care workforce leverage the educational pipeline to fulfill diversity needs and address workforce shortages?
- How do the alternative pathways of improving, recruiting, and collaborating compare in this process?
The study finds that improving the current workforce through upskilling or returnships around diversity and inclusion needs is more effective than recruiting or collaborating with universities to find fresh talent. The most important contribution of this study has been to compare and contrast the three alternative pathways and their associations with benefits. The findings suggest that health systems that value only a D&I strategy may not rely on collaboration with universities to equip their workforces. However, health systems that adopt a recruiting strategy will look externally to find new workers and seek collaboration with universities. Moreover, these pathway effects go hand in hand with a talent-improvement strategy, indicating that talent and diversity strategies must be aligned to achieve the best results for a health system.
The study was authored by Jiban Khuntia, Ph.D., associate professor of information systems and director of the Health Administration Research Consortium (HARC) at the University of Colorado Denver (CU Denver); Xue Ning, Ph.D., assistant professor of management of information systems at the University of Wisconsin-Parkside and HARC research fellow; Rulon Stacey, Ph.D., director of programs in health administration, CU Denver, and chair of the CEO Circle of the International Hospital Federation; and Dr. Wayne Cascio, emeritus distinguished university professor of management at CU Denver.
The recent workforce shortage issue in health care, along with the lack of diversity, is a matter of concern for health systems leadership. Giving voice and committing resources to diversity and inclusion initiatives will fail unless leaders instill a process inside their organizations through education and training. Good intentions will not be enough. Just recognizing or appreciating the concept of diversity is not enough. Leaders need to implement actionable plans within their systems to improve inclusiveness. "Improve" here reflects something like making in contrast to the process of buying through recruiting or collaborating to achieve desired outcomes. Also, the study reveals that diversity and inclusion strategies are essential to accrue business benefits and service benefits, aligning with the concept of patient-centered care envisioned by health systems. To date, approximately 50% of health systems have a sound strategy around diversity and inclusion; others need to catch up, as reflected in the summary statistics of the study.
The 124 health systems represented in this survey varied from 1 to 18 hospitals and from 176 to 75,000 employees. In 2020, the annual revenue of these health systems ranged from US $0.7 million to US $12 billion. The health systems represented US $300 billion in revenue and 1.1 million employees across the United States.
Dr. Wayne Cascio, a coauthor of the paper, has been discussing diversity and inclusion in his books and in the Society for Human Resource Management for the last several decades. He observed the following: "The U. S. will become even more diverse over the next several decades. Asians are projected to become the largest immigrant group, surpassing Hispanics as a percentage of the immigrant population, and organizations are adopting business strategies that require more teamwork. Unless health systems emphasize that diversity is an important part of their business strategies, they are less likely to be able to meet the needs of a more diverse patient population."
Dr. Khuntia believes that investigating health systems' workforce diversity-related research is timely. This study is the first in that direction. Subject to resources, several questions need to be investigated to inform both academics and practice.
Dr. Rulon Stacey was the CEO of health systems earlier and has consulted them as a partner at Guidehouse. He notes: "In my travels across three continents in the past many months, I am convinced that addressing the issues of the workforce remains the #1 issue healthcare administrators are working to solve. While there is no quick solution, incremental improvements can be made, and this research and its conclusions are a very meaningful start to that process."
Dr. Xue Ning, another coauthor of the paper and assistant professor at the University of Wisconsin Parkside, views the opportunity further to promote D&I in education and research. Higher education institutions, including health care education and research institutions, are making efforts to advance diversity and inclusion through collaborative initiatives. Through collaborations with universities, health systems can equip both clinical and nonclinical workforce with D&I for more significant success in health care.
The end of the COVID-19 pandemic will undeniably help mitigate some of the drivers of a declining health care workforce, but it will be challenging to recover what has already been lost. The silver lining lies in the opportunity this creates for the development of initiatives to improve the state of the workforce. Some health systems may attempt to improve workplace culture to increase retention, while others focus on recruiting a new pipeline of health care workers. Whichever way they go, looking inside the organization to instill inclusiveness through training and upskilling remains a top priority. On that note, the study concludes the following:
"A notable point is the importance of professional and executive training programs and further education for instilling a D&I mindset, strategy, and pathways in a health system. This 'improvement' pathway is beneficial; however, diversity and talent-acquisition efforts must be aligned with recruitment to yield multiple benefits for health systems. Following these findings, our recommendations will help health systems establish a more diverse health care workforce and improve outcomes for a diverse population of patients."
More information: Jiban Khuntia et al, Valuing Diversity and Inclusion in Health Care to Equip the Workforce: Survey Study and Pathway Analysis, JMIR Formative Research (2022). DOI: 10.2196/34808