Embracing Diversity, Equity, and Inclusion: Executive and Leadership DEI Hiring Practices

The current state of Diversity, Equity, and Inclusion (DEI) in healthcare leadership is a blend of encouraging strides and persistent hurdles. As of 2023, healthcare organizations have gradually begun to recognize the value of DEI and its role in promoting better patient outcomes and enhancing employee engagement. Despite this progress, disparities remain evident, with minorities and women still underrepresented in key leadership positions.

Efforts to improve DEI have proliferated in recent years. Various organizations have implemented programs to mentor and support diverse talent, creating pipelines for leadership roles. Some hospitals and health systems have made notable strides, with leaders from diverse backgrounds taking the helm and making meaningful impacts on their organizations and communities.

However, while these initiatives are commendable, they represent the tip of the iceberg in the industry-wide commitment needed to effect substantial change. A 2019 AAMC report found that among Deans and Department Chairs in academic medicine, only 18% were women, and a mere 13% were from underrepresented minority groups. Similarly, in hospitals, according to a 2020 American Hospital Association report, only 11% of executive leadership roles were held by racial and ethnic minorities. Although it is possible that these percentages have increased slightly since then, the pace of change remains slow. Moreover, the gender disparity is similarly significant, with women, especially women of color, facing a glass ceiling in healthcare leadership.

The current state of DEI in healthcare leadership also reflects systemic issues in the wider society. Implicit biases, lack of access to quality education and opportunities, and societal norms all contribute to the existing disparities. Addressing these issues requires a holistic approach that extends beyond the healthcare sector and encompasses broader social policies and practices. 

Benefits of DEI in Healthcare Leadership

It’s crucial that the leadership in healthcare organizations reflects the diversity of the communities they serve and the teams they lead. Embracing DEI in your healthcare leadership also offers numerous benefits for hospitals and healthcare organizations.

Enhanced Patient Care

Diverse healthcare leadership is better equipped to understand and address the unique needs of a diverse patient population. Cultural competence, the ability to interact effectively with people of different cultures, is a key element in delivering quality healthcare. Leaders who are diverse in terms of race, ethnicity, gender, age, or socioeconomic background can provide valuable insights and perspectives that may otherwise be overlooked. This diversity leads to more inclusive decision-making, which can result in more comprehensive and equitable healthcare policies and practices. It can help eliminate health disparities, improve patient satisfaction, and ultimately, lead to better patient outcomes.

Innovation and Problem-Solving

A diverse leadership team brings a variety of perspectives, experiences, and ideas to the table. This diversity of thought fosters creativity and drives innovation, as different viewpoints can challenge traditional approaches and spur novel solutions to complex healthcare and business issues. Research has demonstrated that diverse teams are more effective at problem-solving, as they are less prone to groupthink and more likely to critically evaluate different options. This is particularly important in healthcare, a field that is constantly evolving and where the ability to adapt and innovate can directly impact patient care and outcomes.

Workforce Retention and Engagement

DEI initiatives can have a positive impact on staff retention and engagement. Employees who feel valued and included are more likely to be engaged in their work and less likely to leave the organization. This is particularly important in healthcare, where high levels of employee engagement are associated with improved patient satisfaction and outcomes. Additionally, healthcare organizations that prioritize DEI are more likely to attract a diverse range of job applicants, contributing to a richer talent pool and fostering a more inclusive and representative workforce.

Economic Sustainability

Beyond the moral and ethical imperative, there is a strong business case for DEI in healthcare leadership. Healthcare organizations that serve a diverse patient population need to understand and meet the needs of these different groups to be economically sustainable. A diverse leadership team can better anticipate and respond to market changes and can help the organization connect with diverse patient groups, thereby expanding its customer base. Additionally, organizations that prioritize DEI are more likely to avoid costly lawsuits related to discrimination or inequity.

In addition to understanding the customer base, a diverse team has been proven to create more innovative solutions to business problems as mentioned above. Whether it be simply innovating to provide a new service or close a gap in the market, or taking a creative approach to economic challenges, these solutions have been shown to have a significant impact on the economic stability of an organization. 

The Challenges of DEI Recruiting in Hospital Leadership

Achieving DEI in the recruitment process for executive leadership is not without its challenges. Let’s delve into some of the common obstacles hospitals and health systems face when attempting to diversify their leadership.

Implicit Bias

Inherent biases, both unconscious and systemic, are one of the most significant hurdles in DEI recruiting. These biases can subtly influence the recruitment process in ways that disadvantage candidates from diverse backgrounds. Unconscious bias, for instance, can impact the assessment of a candidate's fit, qualifications, or potential. Systemic bias, on the other hand, can be embedded in the structure of the organization or industry and may impact the availability of opportunities for individuals from underrepresented groups.

It is impossible to completely eliminate bias, but with training and awareness, we can certainly mitigate it. 

Pipeline Issue

The pipeline problem is another significant challenge. Historically, hospital and physician leadership roles have been occupied by individuals fitting a certain demographic profile. This pattern has perpetuated a cycle where potential candidates from diverse backgrounds may not see themselves represented in these roles, leading to a lack of interest or perceived barriers to entry. For instance, individuals from underrepresented groups might not pursue leadership roles due to a lack of role models or mentors, or because they perceive that the system is stacked against them.

Retaining Diverse Talent

A less frequently discussed, but equally important challenge is the retention of diverse talent. Even when successful in recruiting diverse leaders, hospitals can face challenges in creating an inclusive environment that supports these leaders. This can include providing equal opportunities for growth, addressing microaggressions, and ensuring that diverse voices are heard and valued in decision-making processes. Without these supportive environments, hospitals risk losing their diverse talent, negating their recruitment efforts.

These challenges make DEI recruiting for hospital leadership a complex task, requiring dedicated effort, resources, and a commitment to long-term change. But the potential benefits - in terms of enhanced decision-making, better patient outcomes, economic success, and a more equitable healthcare system - make this a challenge worth tackling.

Strategies for Improving DEI in Your Executive Leadership

By implementing DEI strategies, hospitals can tap into a wider pool of talent and perspectives, reflecting the diverse patient populations and teams that they serve. Let’s delve into a few strategies that hospitals can implement to improve DEI hiring of their healthcare leadership.

Comprehensive DEI Training for Hiring Teams

Understanding the value of DEI in healthcare starts with the hiring process. Ensuring that all members of the hiring team are well-versed in DEI principles is the first step towards creating a more inclusive workforce. This involves comprehensive training that focuses not only on the understanding of DEI but also on the identification and elimination of unconscious biases, and the implementation of equitable candidate evaluation practices. A key component of this training involves the understanding of legal and ethical considerations in recruitment to prevent discriminatory practices. In addition, fostering a culture of respect and understanding for all candidates, regardless of their background, is also essential. 

One helpful resource is the Harvard Implicit Bias Test which is available online for free. This quick survey will help hiring teams identify their unconscious bias and create awareness during the review, interview, and offer processes.

Holistic Assessment of Candidates

Traditionally, hiring processes have often emphasized formal education and previous experiences. However, this can unintentionally exclude candidates from diverse backgrounds who may not have had the same opportunities but bring valuable skills and perspectives. Hospitals should consider widening their requirements and parameters only to include the skills and education absolutely necessary to do the job. A more holistic assessment approach, which takes into account a candidate's potential and track record of progressive responsibility and interpersonal skills, such as their ability to work in a team, leadership qualities, and empathy, can attract a more diverse candidate pool. 

The Cleveland Clinic, for example, uses a behavior-based interviewing process to evaluate candidates' interpersonal skills, decision-making abilities, and potential for cultural fit, in addition to their technical expertise. This approach helps to reduce bias and ensures that they hire individuals who can contribute to a diverse and inclusive environment.

Evaluation and Interview Process

Within the candidate evaluation and interview process itself, a few steps can be taken to mitigate bias and increase diversity. 

The use of a selection panel or committee will bring multiple perspectives to the table when evaluating candidates. The entire committee should have had bias and DEI training, and a committee Chair can be appointed to facilitate discussions. 

As candidates are being reviewed (both at the application and interview stages), the Chair and other committee members should be empowered to ask probing questions as to why members have made certain conclusions or assumptions about each candidate - is this due to something objective or subjective? Additionally, a scoring rubric can be used at both the application and interview stages, where an agreed-upon ranking system is utilized across a predetermined set of criteria (in alignment with the job requirements mentioned above). These rankings should be completed and collected before discussions occur, to eliminate groupthink, but discussion should occur after the data is aggregated. 

Mentorship and Sponsorship Programs

Mentorship and sponsorship programs can help underrepresented individuals navigate their careers within the healthcare system. A mentor can offer advice, share experiences, and provide emotional support, while a sponsor can advocate for an individual’s promotion and open up opportunities. Hospitals should provide these programs to help diverse talent advance to leadership positions. They also need to ensure that mentors and sponsors are trained and committed to fostering an inclusive culture.

The Mount Sinai Health System in New York City has a Diversity and Inclusion team that oversees various programs aimed at fostering leadership development among underrepresented groups. One such program is their Diversity Council, which provides mentoring and sponsorship opportunities.

Be Honest - Walk the Walk

DEI is a journey, not a destination. Candidates do not expect any organization to be perfect. But they do expect you to know your strengths and weaknesses, and to have a proactive strategy to continue down the path towards your DEI goals. Have a public statement both on your website and in your job postings about your values, mission, etc as it pertains to DEI and recruiting/retention. 

Don’t hide or deny your faults. Candidates will see them for themselves in the interview. But do celebrate your wins, and show candidates your aspirations. 

Improve Your DEI Efforts with Curative Executive & Academic Search

Curative Executive & Academic Search understands the importance of having a diverse leadership team. Your job is providing high-quality care to patients, ours is providing high-quality, diverse talent to your organization. This blog's intent is not to provide an exhaustive list of challenges and strategies, rather, we hope to highlight some considerations and potentially spark a conversation.

We have partners on our team with certifications in DEI Recruiting, ensuring an understanding of current best practices. We know where to find these candidates, but also how to shepherd you and your candidates through the recruitment process. It’s one of the many reasons we have a successful track record in diversity placements – in fact, 63% of our placements are female, and 34% of our placements come from underrepresented backgrounds, as compared to 25% and 11% industry benchmarks, respectively. 

To learn more about how Curative Executive & Academic Search can help your hospital with their DEI leadership efforts, please contact executivesearch@curativetalent.com, or fill out the form below.