By JULIE MINDA
About a year and a half ago, a chicken processing plant in Western Kentucky hired more than 150 Somali immigrants, with many of them settling in Mayfield, Ky. When a group of the new residents sought to open a mosque last fall in Mayfield, many townspeople objected.
With Mayfield just 25 miles from Lourdes Hospital in Paducah, Ky., the hospital's hallways were abuzz with talk of the mosque debate. At the same time, Lourdes happened to be actively engaged in talks with the chicken plant, encouraging the owners to turn to Lourdes for their employees' health care needs.
A diversity council at Lourdes sensed it was the right time to hold a "Lunch and Learn" session on the Muslim faith, and so they invited a Muslim presenter to speak with employees and community members."We wanted staff to understand the Muslim faith," and to promote respect for Muslim colleagues, patients and community members, said Martha Argotte, a human resources representative at Lourdes, part of Cincinnati's Catholic Health Partners.
Argotte is chair of Lourdes' 20-member diversity council. CHP has established these councils at the system level and in most of its eight regions to seek out ways to help staff members better understand and relate to people who are different from them. The councils define diversity broadly — it can relate to gender, race, ethnicity, culture or job status.
Staffed with white and minority volunteers, the councils base their work on a five-year diversity plan that CHP launched in 2009. That plan charges the councils with assessing and improving staff diversity and employee response to the needs and preferences of minority patients. They measure the effectiveness of hospital outreach to minority communities and leadership support for the building of inclusive cultures. The teams have much leeway to design programs, initiatives and policies that align with their regions' characteristics.
An inclusive culture
While the majority of Paducah's population is Caucasian, the number of African-American and Hispanic residents is increasing. Argotte, who is Hispanic, said that the vast majority of her colleagues are open-minded and accepting of people from other cultures and races. While she is unaware of any serious complaints of discrimination by staff, sometimes discrimination can be subtle, and, perhaps, unintentional.
A staff member once called upon Argotte to translate for a Hispanic patient, a common request for Argotte. The staff member referred to the patient as an "illegal alien." Argotte said that this was an inappropriate assumption, since the staff member could not have known the immigration status of the patient. Argotte spoke with the employee's manager, who talked with the employee.
Council members hold forums — sometimes with patients and sometimes with employees — to educate, skill-build and debunk cultural stereotypes.
"Acceptance (of others) is not an unconscious process, but rather a skill that is acquired as a result of personal reflection and respect for others," said Argotte. "We need to be aware, have knowledge and develop skills in order to avoid conflict in the workplace or with those we serve."
Skill development begins before employees are hired, with CHP regions making job candidates aware of the organization's commitment to diversity. During orientation at CHP's Mercy Health Partners of Knoxville, Tenn., for example, new employees learn about Mercy's inclusive values and fill out a self-assessment survey that challenges them to examine their own attitudes. They sign a statement acknowledging the expectation that they treat others with respect.
"We're trying to get them to stop and think about their values," said Cheryl Dalton-Norman, divisional vice president for organization development at Mercy. "We're not telling them what to believe — we're telling them what we believe."
Ongoing education
The councils host diversity fairs on hospital campuses to expose employees to various cultures, they exhibit artifacts from around the world and showcase how the hospitals recognize the idiosyncrasies of minority cultures when providing care.
The councils host meals featuring food and entertainment from minority ethnic groups. They provide online resources for staff, including a calendar of on- and off-campus cultural events, information about the diversity councils' work and fact sheets about cultural sensitivities and culturally relevant disease risks. For instance, the fact sheets distributed at the fairs and posted online describe commonly held religious beliefs, social mores and cultural practices of various groups, that might affect how care is provided to them.
"We want the activities to be educational. We have lectures and question-and-answer sessions and really get at the essence of what we're focusing on," Argotte said.
For instance, during a recent Cinco de Mayo event, Mexican speakers explained that May 5 is not actually Mexico's independence day. It is the anniversary of the 1862 Battle of Puebla between Mexico and France.
Argotte said that knowledge of other cultures can lead to better understanding and acceptance.
Patient connection
Having a workforce that is diverse, or that is at least open-minded about diversity, is good for patients, said Sascha Chatman, diversity officer for Mercy in Lorain, Ohio, and a member of its 13-member diversity council. "Understanding cultural differences in the community can lead to more patient-centered care. This understanding is helpful in creating care models that address the needs of specific populations, including different ethnic and age groups."
For instance, at Lourdes in Paducah, the diversity council has learned from focus groups that many African Americans don't like to go to the hospital, in part because few people on staff are black. The hospital is trying to address this by hiring more blacks and by connecting with African-American churches to build trust with congregants.
CHP's diversity councils slice patient satisfaction surveys by gender, ethnicity, age and other categories to determine whether any particular group is dissatisfied with their care. For instance, when Lourdes learned that Hispanic patients wanted more resources in Spanish, they updated their materials. The diversity councils provide staff with the training they need to close satisfaction gaps.
And, to ensure staff members are not victims of discrimination, they arm staff with information on dealing with patients who do not show them mutual respect. They encourage staff to recognize that patients are in a vulnerable state. They urge staff to handle insensitive comments from patients calmly. If an incident escalates, a team leader can intervene. When a conflict cannot be resolved, department managers may assign another caregiver to work with the patient.
All such training aims to increase the level of understanding between caregivers and patients and to help minority patient populations achieve full access to care. "We are committed to anticipating and being able to serve all populations equally and to be in readiness mode before they come through our doors," said Mercy Knoxville's Mary Rimer, regional resource development consultant.
This approach is important, Rimer said. "The most obvious reason is potential safety issues related to misunderstanding or miscommunication. Also, there is evidence that there is disparity in health care delivery across a variety of demographics throughout the country.
"Because of our core values, it is important that any gaps in service are addressed so that all patients receive optimal care," she said.
CHP councils build a pipeline for minority recruiting
Catholic Health Partners' diversity councils are finding ways to work with their hospital leadership to ensure that there are different races, ethnicities and cultures represented at all levels of seniority in CHP hospitals. This can be challenging in some communities with small or underprivileged minority populations.
Martha Argotte is a human resources representative at Paducah's Lourdes Hospital. Lourdes works with colleges to help minority students to assess which careers would best suit their interests and aptitudes and then assists those suited for health care to build a path to those careers.
Also to build the pipeline of health care workers, Mercy Health Partners of Knoxville, Mercy of Lorain, and Lourdes offer career days, summer job experiences, job shadowing, paid internships and college scholarships to minority students. Lourdes' Argotte said there has been some push back from staff concerned that Caucasian students are being short-changed. Lourdes leaders have explained that there are other internships available that are open to everyone, but minority preference internships are needed since there is such low minority representation in the health care field.
Mercy has difficulties recruiting minority candidates to Knoxville, as do many companies in smaller cities around the country. "Small- to medium-sized cities have trouble competing for top talent against the cultural attractions, professional organizations and even professional sports teams found in the larger cities," said Mercy's Cheryl Dalton-Norman, divisional vice president for organization development. "This certainly is a factor in recruiting minority candidates for executive positions, and we have to work harder to find the right candidate for the right position (who) enjoys the lifestyle of living in our community."
Lourdes requires its recruitment firms to include minority candidates in the pool for top posts, and Mercy Knoxville ensures a minority candidate is always in the final running for each senior leadership job.
Once CHP facilities successfully recruit employees who are minorities, their next focus is to retain these employees and help them to develop the skills they need to advance. Lourdes' buddy program for new minority hires, pairs each with a diversity council member. The diversity councils review employee survey data to watch for dips in satisfaction scores among these employees, and they are attentive to verbal feedback from minority associates as well. Their findings can help them to determine new ways to make the work environment more welcoming.
The efforts are paying off. The number of minority staff members is up in many regions and retention rates are improving. This is significant progress, said Sascha Chatman, Mercy Lorain's diversity officer and a member of its 13-member diversity council. "It is important for hospital staffing to reflect the community it serves and (for the staff to) truly understand the patient population it serves."
CHP's diversity efforts extend into community
The efforts of the diversity councils do not end at the hospital walls.
"We work hard to be out in the community, to have a presence," said Cheryl Dalton-Norman, divisional vice president for organization development for CHP's Mercy Health Partners of Knoxville, Tenn. She said the goal is to build relationships and trust with diverse populations in the region.
Mercy Knoxville staff are active at the local Martin Luther King parade and the Race Against Racism.
Mercy Knoxville; Mercy Health Partners of Lorain, Ohio; and Lourdes Hospital in Paducah, Ky., all host health events in minority neighborhoods and communities. Mercy Knoxville holds health fairs at churches, Lourdes hosts a Hispanic health fair and offers kidney disease screenings for African Americans and Mercy Lorain partners with another community organization to offer health screening and life coaching to minority groups.
Members of the Lourdes diversity council join community groups supporting diversity, including the local chapter of the National Association for the Advancement of Colored People, a women's group and a human rights commission. They link to diverse communities through a parish nurse board that Lourdes supports.
CHP's regions also attempt to contract with minority-owned suppliers when doing business. For instance, Mercy Lorain contracts with a minority-owned hemodialysis company for some outpatient services.
Staying connected with members of minority groups "sends the message that we care for everyone in our community," said Dalton-Norman.
CHP councils build a pipeline for minority recruiting
Catholic Health Partners' diversity councils are finding ways to work with their hospital leadership to ensure that there are different races, ethnicities and cultures represented at all levels of seniority in CHP hospitals. This can be challenging in some communities with small or underprivileged minority populations.
Martha Argotte is a human resources representative at Paducah's Lourdes Hospital. Lourdes works with colleges to help minority students to assess which careers would best suit their interests and aptitudes and then assists those suited for health care to build a path to those careers.
Also to build the pipeline of health care workers, Mercy Health Partners of Knoxville, Mercy of Lorain, and Lourdes offer career days, summer job experiences, job shadowing, paid internships and college scholarships to minority students. Lourdes' Argotte said there has been some push back from staff concerned that Caucasian students are being short-changed. Lourdes leaders have explained that there are other internships available that are open to everyone, but minority preference internships are needed since there is such low minority representation in the health care field.
Mercy has difficulties recruiting minority candidates to Knoxville, as do many companies in smaller cities around the country. "Small- to medium-sized cities have trouble competing for top talent against the cultural attractions, professional organizations and even professional sports teams found in the larger cities," said Mercy's Cheryl Dalton-Norman, divisional vice president for organization development. "This certainly is a factor in recruiting minority candidates for executive positions, and we have to work harder to find the right candidate for the right position (who) enjoys the lifestyle of living in our community."
Lourdes requires its recruitment firms to include minority candidates in the pool for top posts, and Mercy Knoxville ensures a minority candidate is always in the final running for each senior leadership job.
Once CHP facilities successfully recruit employees who are minorities, their next focus is to retain these employees and help them to develop the skills they need to advance. Lourdes' buddy program for new minority hires, pairs each with a diversity council member. The diversity councils review employee survey data to watch for dips in satisfaction scores among these employees, and they are attentive to verbal feedback from minority associates as well. Their findings can help them to determine new ways to make the work environment more welcoming.
The efforts are paying off. The number of minority staff members is up in many regions and retention rates are improving. This is significant progress, said Sascha Chatman, Mercy Lorain's diversity officer and a member of its 13-member diversity council. "It is important for hospital staffing to reflect the community it serves and (for the staff to) truly understand the patient population it serves."
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