Rupert M. Evans, Sr., DHA, FACHE
After completing this chapter, the reader should be able to
• understand how proactive use of diversity principles can transform the organization’s culture;
• understand the business case for diversity and inclusion in healthcare organizations;
• work toward creating an inclusive organizational culture; • define the roles that healthcare providers, management, and governance
play in building a business imperative for diversity within the organization; and
• discuss how healthcare leaders can develop a diversity program in their organizations.
When you hear the term “diversity,” what comes to mind? To some, the word means the differences between human beings related to race or ethnicity. To others, it means the uniqueness of each individual. A few people still may jump up to argue that diversity is just a code word for affirmative action.
Healthcare organizations across the United States are beginning to move toward embracing and fostering workforce diversity. This cultural change means adopting new values that are inclusive and appropriately man- aging a diverse workforce. In the future, diversity will drive the business prac- tices of hospitals and other healthcare organizations, and this dynamic will re- quire strong leadership. This change will take time, but in the words of Reverend Jesse Jackson, “Time is neutral and does not change things. With courage and initiative, leaders change things.”
In this chapter, we provide a definition of diversity and a framework for understanding the different ways people view the term. In addition, we high- light several studies and legal issues pertaining to this topic and enumerate methods for building a case for and establishing a diversity program.
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A Definition of Diversity
People define diversity in many ways, depending on the way they live in and view society. In his book, The 10 Lenses: Your Guide to Living and Working in a Multicultural World, author Mark Williams (2001) discusses the framework that explains the way people see the world:
1. The assimilationist wants to conform and fit in with the group to which he or she belongs.
2. The colorblind ignores race, color, ethnicity, and other cultural factors. 3. The cultural centrist seeks to improve the welfare of his or her cultural
group by accentuating its history and identity. 4. The elitist believes in the superiority of the upper class and embraces
the importance of family roots, wealth, and social status. 5. The integrationist supports breaking down all barriers between racial
groups by merging people of different cultures together in communities and in the workplace.
6. The meritocratist lives by the adage, “cream rises to the top”—the belief that hard work, personal merit, and winning a competition determine one’s success.
7. The multiculturist celebrates the diversity of cultures, seeking to retain the native customs, languages, and ideas of people from other countries.
8. The seclusionist protects himself or herself from racial, cultural, and/or ethnic groups in fear that they may diminish the character and quality of his or her group’s experiences within society.
9. The transcendent focuses on the human spirit and people’s universal connection and shared humanity.
10. The victim/caretaker views liberation from societal barriers as a crucial goal and sees oppression as not only historical but also contemporary.
With this framework in mind, it is easier to understand why so many interpretations of the same idea exist. For our purposes, we describe diversity in the context of three key dimensions: (1) human diversity, (2) cultural diversity, and (3) systems diversity. Each dimension needs to be understood and managed in the healthcare workplace.
Human diversity includes the attributes that make a human being who he or she is, such as race, ethnicity, age, gender, family status (single, married, divorced, widowed, with or without children), sexual orientation, physical abilities, and so on. These traits are what frequently come to mind first when individuals consider the differences in people. Human diversity is a core di- mension because it defines who we are as individuals. This dimension is with us throughout every stage of our lives, guiding how we define ourselves and
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how we are perceived by others. A workplace definition of diversity includes human diversity as a minimum.
Cultural diversity encompasses a person’s beliefs, values, family struc- ture practice (nuclear or extended family, independent living), and mind-set as a result of his or her cultural, community, and environmental experiences. This dimension includes language, social class, learning style, ethics or moral compass, religion, lifestyle, work style, global perspectives, and military views. Cultural diversity is a secondary dimension, but it can have a powerful impact on how a person behaves in the workplace. The cultural norms vary from one culture to another and influence how individuals interact with their work en- vironments. For example, some religious groups are forbidden from working on the Sabbath, and this exemption has an impact on work scheduling and even hiring decisions.