On Monday, October 30, HC3 in collaboration with HC3 Member IHA (Illinois Health and Hospital Association) hosted the latest installment of HC3’s Future of Work Series focused on on DEI – featuring leaders and practitioners working to address workplace diversity amidst increased scrutiny from employees, stakeholders, regulators, policymakers, and the public.
Moderator:
Lisa Harries, AVP, Health Equity and Policy, IHA (Illinois Health and Hospital Association)
Featured Speakers:
Shannon Andrews, Chief Equity and Inclusion Officer, Cook County Health
Xan Daniels, Vice President, Inclusion and Diversity, Alight Solutions
James Williams, Jr., VP, Diversity, Equity and Inclusion, University of Chicago Medicine
Watch the Webinar:
Event Recap
Please note: This discussion has been summarized and edited for clarity and brevity.
Moderator’s Introduction
Lisa Harries (LH): I am assistant vice president of health equity and policy at the Illinois Health and Hospital Association (IHA). My role is to develop, evaluate, and implement policy proposals and advocacy strategies to address health care disparities and inequities in Illinois and work directly with our hospitals across the state on their health equity strategies. Our broader role at IHA is to advocate for over 200 hospitals and nearly 50 health systems across the state. We advocate for a vision for Illinois health care, where all individuals and communities can access high-quality health care at the right time in the right setting. We strive to be the trusted voice in resources for our hospitals as they deliver care to each of their communities, which is our mission.
Panelist Introductions
Shannon Andrews (SA): I'm the Chief Equity and Inclusion Officer at Cook County Health. It is an inaugural role that I’ve been in for a little over two and a half years. Cook County Health is one of the country's largest safety net hospitals. Many people are surprised that my role is new, but the hospital has a rich history of work in equity and inclusion. Before coming into this role, I was the chief procurement officer for the City of Chicago, and before that, I was a chief procurement officer for Cook County. In both of those phases, I also held responsibilities related to the organization's Minority and Women Enterprise Business Enterprise program. I’ve had unique experiences relating to inclusion and ensuring that everyone has a voice and a seat at the table regarding providing fair and equitable opportunities. At Cook County Health, I am responsible for all our equity and inclusion work as well as supply chain management, materials management, or sponsored programs work here at the organization, as well as language services.
James Williams (JW): I serve as the Vice President for diversity, equity, and inclusion at UChicago Medicine. Our department is structured under the Urban Health Initiative, which was launched by Michelle Obama and is now led by our senior vice president for Community Health Transformation, Chief Equity Officer Brenda Battle. In that body of work, I focus on creating a more equitable organization that reflects our patients and our community and is agile enough to provide culturally responsive care to those we have the privilege of serving. In the DEI department, we help to build cultural responsiveness within the organization. Over a decade ago, we launched a cultural competence training strategy. Then, we recently folded in our spiritual care department to attend to the spiritual needs of the patients we have the privilege of serving. We have a body of work around health literacy and becoming a more health-literate organization so that patients and the community have information to self-manage their care. All of our work is grounded in critical theory. We want to equip people to understand and illuminate social structures by critically analyzing power and how that plays out in relationships.
Xan Daniels (XD): I am the chief diversity officer for Alight Solutions. For the last 25 years, we've focused on being a human capital and business partner to many of the world's most influential companies. I work with our integrated talent teams to help develop strategies that help us attract and retain diverse talent. I also work with our talent teams to help deliver and develop learning opportunities that build and reinforce inclusive behaviors, cultural humility, and cultural awareness. I am also responsible for infusing our culture into the community through strategic partnerships.
Panel Discussion
LH: How are your organizations establishing clear accountability for DEI goals in the workplace?
JW: At UChicago, we created an equity strategy, Equity Plan 2025, that is aligned with our broader strategic plan. It includes pillars relating to community, climate, the core business of health care delivery and service, and community engagement. We have goals that help us with accountability. For example, we aim to have 35 percent of our senior leadership be Black, Indigenous, or people of color by the fiscal year 2025. To set these kinds of goals, we pulled together a multidisciplinary group and looked at the demographics of our community, patients, and our teams.
XD: As James said, first, you need a strategy, and then there are goals you can execute on based on that strategy. The measurements are important, and it is also important to include outcomes and impact. What are the outcomes you hope to attain by setting specific goals? It’s also important to be able to articulate the impact of that outcome. If you have increased representation as a goal, how will that impact your clients and how they engage with you as an organization? Our identified goals were similar to those James mentioned around representation. We asked why is that important and how will it help us be more profitable and better engaged with our customers. It has also helped with the adoption of our strategies because customers understand the why.
SA: At Cook County, we are in a unique position because of the population we serve. For us, metrics matter, but in a very micro way. While there are clear data and metric points, we have made an effort to also engage with employees and the workforce. Given the vastness of our suburban communities, we have found it’s important to take the data we have for the county as a whole and then work with communities to benchmark what is important in that more micro population. We’ve had to be creative and intentional to ensure it’s not a one-size-fits-all all – because our footprint is so large. In terms of building talent, it’s important to have an ear to what people are saying is needed and what is important to them.
LH: What strategies and best practices are you using to implement unbiased recruitment and hiring practices to ensure you're attracting a diverse talent pool of people in the workplace?
JW: We have done targeted recruitment, specifically going to the community where people are in order to help strengthen the diversity of the recruitment pathway. We developed a five-module series inside the organization to build skills around implicit bias in the hiring process. We take a multi-pronged approach to address the diversity of the talent we’re recruiting and the selection process used by our managers.
XD: We have developed external partnerships to attract talent to certain roles. We developed a workforce plan that targets certain areas of the business as a funnel to those roles, and we have inserted bias checks throughout the hiring process. When a manager goes into Workday and creates a requisition for a role, part of the approval step is for them to complete a short, eight-minute reminder about how bias shows up in the hiring process.
SA: We have found that the pipeline is challenging for specific clinical spaces. We've done much work with our graduate medical education program to examine how we create programming for underrepresented groups in medical residents and fellows. Over the last year, we’ve been looking to partner with organizations, universities, and schools to discuss ensuring a diverse workforce. In addition to that programming, we've also set up and established some scholarships. We recently did a second class of the prominent hospital scholarship awards, where we gave out roughly $1M in scholarships. This program offers two different tracks: the Health Professional students track, which includes everything from medical, dental, physician, assistant, and nurse practitioner programs. And then in addition to that, we did Non-clinical and Allied Health Student Grants, which included everything from surgical and radiology technology to respiratory therapy and paramedic programs. We found that even when being purposeful about it, the diverse candidates just weren't there. So how do we ensure that health care is a place diverse candidates want to be? And what does it take to keep those candidates? The workplace is different in a post-COVID world, and being a competitive employer looks different. Workplace wellness looks different. How do we make sure we are being comprehensive? Metrics and data are important, but you have to be able to pivot.
XD: I would add that a lesson we have learned is that building a pipeline starts well before a college graduate/new entrant applies for a job. Building that relationship years before they apply for a role is necessary.
JW: We have had leaders across our organization say they want to start working with high schoolers to help them understand the pathway to careers in radiology or ophthalmology. We had nurses create their own DEI committee and one of their key pillars was to become more present in the community. Those community relationships are agents of change. Relationships are the way we can change the trajectory of the pipeline.
LH: How do DEI and procurement go together? How are your organizations ensuring that their procurement processes actively promote DEI and what are the potential benefits of doing so?
SA: We are part of Cook County's larger MWBE (minority or women-owned business enterprise) efforts, also known as supplier diversity. We are leaning heavily into the county's MWBE program, which essentially requires by law that a percentage of the dollars spent on behalf of Cook County are spent within MWBE minority women business enterprise companies. Our aspirational goal is to spend 35 percent of the dollars that we spend in the health care space with those communities of people in Cook County. Doing this helps ensure that the community we're servicing also benefits from the dollars we spend.
XD: One of the things that we've incorporated into our procurement processes and supplier diversity program as a whole is investing in those small businesses we've contracted with to ensure their success. Just as we're having conversations with students and frontline workers about how to engage in their benefits, we are also sharing our expertise with those small businesses. Diverse suppliers being more successful helps us in the broader sort of ecosystem conversation. Looking into how we can help those diverse suppliers be more successful has been a critical part of our program.
JW: As a private, not-for-profit organization, the University of Chicago Medicine is committed to equity in terms of inclusive business practices for the same reasons that Shannon and Xan talked about regarding the impact. The impact is that individuals gainfully employed can access resources to manage their health better. This is an integral part of our community engagement and outreach pillar of our equity strategy. From a supply perspective, we're looking at 7.5 percent minority and women-owned business enterprise utilization. From a construction perspective, because there's a lot more capacity in that space, about 41 percent of our construction dollars go to minority and women-owned firms. We also think about workforce residency, where the workers live, our goal being 40 percent, emphasizing the eight zip codes that are proximal to our Hyde Park campus. And so, we've really been moving in that particular space.
UChicago also had a hand in establishing the Jewel store in the Woodlawn neighborhood. Those are some of the things we are doing to ensure that our procurement processes actively have an impact and contribute to greater outcomes for our patients and the community.
LH: I want to tie together a few things you said about the procurement piece. I suggest that it's tied to your community engagement. We know that hospitals and large companies are community anchors, so for both hiring and procurement, I'd even argue that that could start to translate into the pipeline.
LH: How is your organization ensuring equal access to opportunities, benefits, and resources for all employees? What specific policies or practices can facilitate this goal in the workplace?
XD: In order to charge forward, sometimes you have to take a step back in this space to ensure that you have equitable opportunities, equitable processes, and equitable outcomes. You really need to understand what equity means for your employees. What I might consider an equitable outcome may not be what that particular employee considers an equitable outcome. We've done a couple of different things. One is we've shifted in many ways the way we think about equitable outcomes and the way we think about equity in terms of the processes. Really, we have leaned into Maslow's hierarchy of needs and know that at the bottom of everything is needing to have basic needs met, such as food and safety. It’s important to rethink how we approach those policies and practices, especially from a benefits perspective, to understand that we need to start with the assumption that not everyone has those basic needs met before we start introducing more conversations around belonging and growth.
We conducted a human capital practice audit to see how our vision of equitable outcomes compared to what was actually important to workers. We found that things we thought were important, such as retirement benefits, are not as important to many of our colleagues. Some didn't even think of themselves as retiring. We were pouring resources into helping people get to a place where they could comfortably retire when they were more concerned about paying their student loans, having an emergency fund, and other things we weren't even considering. It was one of the most helpful things we've done in the last three years – taking a step back to better understand what equity means to workers.
LH: Where do you hope that things are in five years as we talk about this DEA and workforce conversation?
SA: I am very hopeful that we will all have been able to leverage the post-pandemic environment. Typically, people only thought about health care as it related to their own individual needs. During the pandemic, there was an interest and appreciation for health care. I'm hopeful that we can still stand on some of the results of that interest level and money being invested because I believe strongly that it will stay.
JW: In five years, I hope to be a part of creating a more equitable future for all and diligently working to address structural inequities across economics, education, environment, and policy. Because those are some of the root causes of poor health.
XD: For us to advance health equity, it will take a village. We all have to come together and understand the whole system of it all. There is not one single thing that Alight as an organization can do alone; we all must come together as stakeholders in all of this. Whether it's evaluating more closely how social determinants of health play a part in all of it and introducing social risk more intentionally or if it's starting to lean into how all the resources can be connected, I hope that we start to operate as a system and collaborate. That’s the only way we will achieve any meaningful impact.
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