Embracing cultural competency
Last month, healthcare leaders gathered in Nashville for the Council on Workforce Innovation’s symposium on trends and resources impacting healthcare workforce diversity and cultural competency in the delivery of quality healthcare.
Opening the half-day summit, Cathy Childs, event co-chair and director of Human Resources for Cumberland Consulting, noted, “One thing I’ve learned in my 15 years of healthcare HR is employee engagement and cultural competency go hand-in-hand.”
Organizer Jacky Akbari, board chair of the National Organization for Workforce (NOW) Diversity, welcomed Waller Chairman John Tishler, JD, to introduce the first speaker, Nashville Mayor Karl Dean.
“Karl has done many wonderful things for our city,” Tishler said, “but among the best involves protecting and promoting the rich diversity of our community.” He added the mayor was instrumental in helping defeat an English-only proposal in 2009.
Taking the stage, Dean thanked NOW Diversity for keeping the dialogue going. He noted the time is right to have these conversations as Nashville becomes more diverse. “In fact,” he said, “by the year 2020, the majority of Nashville’s population … 50.1 percent … will be people of color. By 2030, that number will be 59 percent, and by 2040, it will be 68 percent.” He added nearly 12 percent of the city’s population was born outside of the U.S. “As these numbers illustrate, the face of our city is changing rapidly.”
Dean remarked that when urban researcher Richard Florida, PhD, spoke to the Nashville Chamber of Commerce last fall, he cited ‘three Ts’ that are essential to a city’s success … technology, talent and tolerance. Dean pointed to recent media coverage touting Nashville as one of the country’s hottest cities. However, he said, “If we’re going to continue to build on the success our city is experiencing right now, we must continue to be a welcoming city that opens its doors to anyone and everyone who wants to be here and to be part of our growing community.”
He added, it isn’t enough to simply respect tolerance but said tolerance must be actively promoted. Dean said, “We all know businesses that embrace diversity do better in the marketplace than those that don’t.” He noted the strength of the healthcare industry is inextricably linked to the success of Nashville as the city’s largest and fastest-growing employer.
“Nashville strengthens the healthcare industry. The healthcare industry strengthens Nashville. And diversity strengthens us all,” he summed up.
Taking the podium, keynote speaker Memphis Mayor A C Wharton, Jr. talked about the impact healthcare workforce diversity has on Memphis.
“I can think of no better topic to bring us together than celebrating diversity,” he opened. “What profession is better positioned to talk about diversity than the healthcare profession? When it comes to healthcare, it is a universal need.”
Likewise, he said those who deliver healthcare are in the best position to see the world from a universal viewpoint. Walking through an Emergency Department in Memphis recently, Wharton noted one man had on a three-piece suit, another appeared to be homeless, but both were cared for based on triage protocols. “Wouldn’t it be great if our whole world could just operate that way every day?” he asked. Continuing the analogy, he said it would be nice if society could hone in on an individual’s needs at a particular point in time without regard to religion, race, gender, wealth, or any of the other characteristics used to make quick assumptions.
“I applaud you for saying, ‘We’re going to step out and lead where others dare not tread,”” he said of the day’s event. “This is something that’s going to transcend the boundaries of your profession,” he predicted.
Wharton said that like Nashville, healthcare is a huge force in the economy of Memphis, employing approximately 85,000. St. Jude, he said, is an excellent example of “an institution that transcends all lines.” He also applauded the major hospitals in Memphis that have chosen to stay in the core city when so many other businesses and industries moved out, and he noted the acute care facilities have been models when it comes to inclusionary business practices.
“There is so much that our hospitals and healthcare facilities do beyond the technical provision of healthcare. They are our anchor institutions in so many ways,” Wharton said.
From a clinical standpoint, he noted the industry has moved to the broader definition of health as being more than just an absence of illness but instead an overall state of well-being. “Because of the representation of diverse members in our healthcare operations, we’re now much more sensitive to the fact that it takes more than a doctor and some pills and some medicine and an X-ray machine to bring about health,” Wharton noted.
He added in many cases the greatest threat to health is environment rather than a heart attack. Wharton said it didn’t matter how many times healthcare providers patched someone up or got them stabilized, if those individuals were returned to unhealthy, unsafe neighborhoods — plagued by violence, pollution, absence of fresh food, or other barriers to healthy living — then all the hard work of the healthcare industry really goes for naught.
“Diversity is the best way to make sure that our hospitals … that all of our facilities … are attuned to the needs outside of the hospital,” he said. Wharton added that in Memphis … and probably most communities, a significant number of hospital employees come from neighborhoods facing these issues and have valuable input to share. “They are in the best position to tell the folks inside the hospital exactly what the real world is like,” he said.
Wharton also stressed the critical importance of being able to communicate across ethnic and religious lines. He was quick to add, this doesn’t mean a black patient must have a black provider or a Muslim patient a Muslim physician, but it does mean providers need to be sensitive to cultural and ethnic norms and not view everyone filtered solely through the lens of their own personal background or experiences.
‘Diversity,” Wharton said, “is a mind thing.” He added it’s a mistake to count the number of individuals in any particular group and think of that as diversity. “It is not a quantitative … it is a qualitative … matter. I always say, when we view it through the prism of numbers, all you have to do is look at the first four letters in the word ‘numbers,’ and what does it spell?”
His final point spoke to the array of research happening in Memphis through St. Jude, the University of Tennessee Health Science Center and the city’s large medical manufacturers and the recognition that research must include different populations.
“Diversity does matter,” Wharton said. “Diversity does pay … not merely to the fiscal bottom line but to the overall welfare of your community. It is an investment well worth taking.”
Also during the morning, the 2014 Healthcare Innovation Awards were handed out. Tatum Hauck Allsep, founder and executive director of the Music City Health Alliance Foundation, was presented with the Healthcare Employer award. Kennard Brown, JD, MPA, PhD, FACHE, executive vice chancellor and chief operations officer for the University of Tennessee Health Science Center, was named Healthcare Educator.
Following the breakfast, a panel discussion was held delving deeper into healthcare workforce diversity and challenges to delivering culturally competent care. Moderated by Nashville NewsChannel 5 Anchor Vicki Yates, the panel included Vaughn Frigon, MD, chief medical officer for TennCare; Leslie Wisner-Lynch, DDS, DMSc, executive director of BioTN Foundation; and Terrell Smith, MSN, RN, director of Patient and Family Engagement at Vanderbilt University Medical Center.
The summit wrapped up with a luncheon highlighted by comments and insights from Andre Churchwell, MD, associate dean for Diversity Affairs at Vanderbilt, and luncheon keynote speaker Robert Frist, CEO of HealthStream. Shannon Goff Kukulka, an attorney with Waller, also presented a summation of her white paper, “Workforce Diversity: Driver for Equality of Access to Healthcare.”