BY: EVERARD O. RUTLEDGE, PhD, FACHE
Diversity has become a vital concern of the Catholic health ministry. In
view of that fact, Health Progress will publish a series of interviews
with people who have undertaken significant leadership roles in fostering diversity
in their organizations and communities.
The interviews were conducted by Everard O. Rutledge, PhD, FACHE, vice president,
community health, Bon Secours Health System, Marriottsville, MD. His first conversation
was with Sr. Karin Dufault, SP, RN, PhD, vice president, mission leadership,
Providence Health System, Seattle.
Rutledge: Why is diversity an important issue for Catholic health
Sr. Karin: I think there are many reasons why it's important. The
first, I would say, is that to call ourselves Catholic health care providers
we must be grounded in the healing ministry of Jesus, and basic to Jesus'
message was "love and service to all people." It was a very inclusive
example that he gave, and we do believe that God created everyone in God's
image and that each person has inherent dignity and worth. Jesus' example
encourages us to be an inclusive community helping to ensure that everyone has
his or her basic needs met and can contribute his or her gifts to the common
So the principles of Christian love and justice call us to be concerned about
issues of diversity. Our theological foundations, as well as our mission and
values, require attention to diversity and the creation of systems and structures
that support an environment of genuine respect for individual differences.
There's another reason why, in my opinion, diversity is an important issue.
The demographics of our communities tell us how important it is. The cities
and rural areas where Catholic health care services are present have growing
populations of first- and second-generation immigrant (sometimes refugee) men,
women, and children from many countries. What were formerly minority groups
are becoming the majority in some communities, counties, and states. To provide
adequate health care, we must be able to communicate with the people we serve
and understand the impact of their cultures on health. And in addition to racial
and ethnic diversity, there are, we now see, many other types of diversity that
influence the values, beliefs, preferences, and choices of the people we serve
and affect their health.
Then, too, as the demographics change in our communities, we need to have workforces,
medical staffs, and boards that match those changes. We need to be representative
of our communities for several reasons:
- To better serve the diverse population by having people who speak the language
and understand the culture of the people we serve
- To provide work opportunities to a diverse group of people, thus providing
them with an opportunity for meaningful contribution to the community
- To enrich the workplace with an array of skills and a variety of ways of
looking at issues, which will both make us more creative and help us celebrate
the contribution of each person to our mission
- To put our values into action by modeling a diverse workforce that can create
a welcoming and supportive community for all
- To provide opportunities across the spectrum for enhancing diversity, including
diversity in clinical professional positions as well as in middle and senior
leadership positions, all of which will open to us perspectives that might
otherwise not be considered
- To increase our awareness of ethnic and racial disparities in health care
services and help us address them
- To help us grow in cultural competence, in relation to both our patients
and to our workforces
- I'm sure there are many more reasons as well, but these are the reasons
that seem really important to me.
Rutledge: What mission considerations are central to our role as
Sr. Karin: In addition to what I've said already, I believe that
our primary Catholic health care mission requires us to have particular concern
for the poor and the vulnerable and to be advocates for those in our society
whose needs are not adequately addressed. As providers of care, we often have
an opportunity to identify individuals and groups that are most vulnerable by
virtue of their medical conditions or their social and/or economic situations.
Among them, people of color, people whose first language is not English, and
people who are undocumented are often disproportionately represented. We have
a responsibility, a Gospel imperative, to look beyond the immediate problem
presented to us, to respond to the whole person and use our knowledge, often
in connection with other resources in the community, including other church
ministries, to enhance that person's well-being.
In addition, our mission encourages us, as we look at enhancing the diversity
of our workforces, to support needy students who are preparing for health care
careers. As a matter of justice, we also have a responsibility to identify any
manifestations of racism—even any suspicions of racism— in our organizations
and to work to eradicate them. We also need to try to have a positive impact
on social policies that enhance quality of life for the vulnerable.
Rutledge: Are there market considerations that the Catholic health
ministry should consider when undertaking diversity initiatives? What are the
challenges that we have in health care generally in making sure that we are
able to maintain our mission during these troubled times?
Sr. Karin: I believe that we must understand the environment in the
development of all of our initiatives, including diversity initiatives. That
means that we do have to be aware of the market considerations. Among those
market considerations, I think, are an understanding of the demographics of
our communities, the met and unmet needs of the various segments of the population,
and the other demographic elements of the people we are currently serving. We
need to understand and develop the business case for diversity initiatives.
We must understand that whatever we do will affect the return on our investments—not
only financially, which is important—but also in terms of patient, physician,
and employee satisfaction; the strengthening of our mission; the building of
trust through community relationships; and contributing to a stronger and healthier
Rutledge: The Catholic Health Association has a Diversity Committee,
of which you are the chairperson. What is the charge given to the committee
and how will it influence our ministry and our respective strategies?
Sr. Karin: CHA's special Diversity Committee was established more
than five years ago to propose concrete messages that would help increase the
racial and ethnic diversity of both the association's committees and its
board of trustees. Currently, as the result of conscious efforts on the part
of member systems to nominate diverse candidates, the association's committees
and board are enriched by a diversity of people, perspectives, experiences,
Throughout the ministry, a heightened awareness of the importance of diversity
and implementation of many initiatives has resulted in traditionally underrepresented
groups having greater opportunities to contribute in leadership positions. The
Diversity Committee is currently identifying some of the ministry's leading
practices in this area and developing ways of sharing these practices across
systems. The committee is interested in learning about health care systems and
institutions that are strengthening the diversity of their boards and implementing
successful recruitment and retention practices for diversity among middle and
senior leadership positions.
We are interested in learning how our organizations consciously create cultures
of inclusiveness as part of the fabric of Catholic health care. We are also
learning from CHA membership in the Institute for Diversity and Health Management
and have also met with Catholic Charities USA's Diversity Committee, with
which we shared our experience in this area. We are identifying other resources
that may be helpful to our members; some of these resources will be highlighted
in this series of Health Progress articles. In addition, we would like to identify
a diverse pool of people—board members, former board members, and potential
board members—whom systems might consult.
Another area of great interest to us is learning more about studies showing
ethnic and racial disparities in health care delivery; we want to address concerns
raised in these studies. We are participating in the American Hospital Association's
Leadership Circles, which focus on eliminating ethnic and racial disparity in
health care. Recognizing that the ministry needs to make progress in this area,
we hope that our continued work will aid that progress.
Rutledge: Are there issues in our ministry that might compromise
or challenge successful implementation of diversity initiatives?
Sr. Karin: There are a lot of potential challenges, and we need to develop
ways of minimizing them. One such challenge would be the lack of a shared vision
concerning diversity. Another could be a lack of leadership—the absence
of a diversity champion, for example, or a general lack of leadership commitment.
To make implementation of diversity successful, we really need commitment at
the senior levels of our organizations.
In some systems or facilities, competition from other priorities for human
and financial resources may slow or block diversity efforts. In other organizations,
a diversity initiative may have been started but eventually failed because of
a lack of sustained effort. Diversity isn't a one-time deal or a program;
it's a philosophy, a way of being, part of the culture.
Some organizations may have defined diversity too narrowly. Others may have
been too quick to judge diversity efforts as unsuccessful. In still other organizations,
people have seen such efforts as threats to their positions, their competence,
or their power.
Those are things that, because they could compromise a diversity initiative,
should be addressed at the beginning of the initiative.
Rutledge: What advice would you give your colleagues regarding diversity
and cultural competency?
Sr. Karin: My advice would be to have senior leaders take time to scrutinize
the reality currently existing in our organizations, as it relates to inclusiveness.
We need to ensure that our employee satisfaction surveys are constructed in
a way to keep us aware of perceptions in the organization concerning a diverse
workforce and cultural competence. We also need to invest the resources that
enable us to consult experts: people who have successfully enhanced the diversity
of their own workforces and boards of directors; once we have seen how others
have succeeded, we can apply those methods to our own settings.
We must also raise consciousness by including diversity in our strategic plans
and strategic agendas, linking it very closely to our mission and our core values
as Catholic health care organizations. Being able to understand just how diverse
our communities are is very important. In addition, diversity initiatives give
us a great opportunity to help people belonging to ethnic, racial, and other
minorities to advance in their careers. We can, for example, create scholarships
for members of minorities in our schools of nursing. We certainly should be
seeking diverse people to train as managers. Management is definitely one area
where we need to improve.
The main thing for us to remember is that a wide variety of human beings have
wonderful gifts to offer the Catholic health ministry. We must prepare ourselves
to receive those gifts.
Future articles in this series will touch on:
- Diversity in governance
- Diversity and health care management
- Diversity basics: How to implement a diversity program at an institution
- Promoting diversity in multi-institutional settings
Websites Related to Diversity
Other information concerning diversity in health care can be obtained from the
Copyright © 2004 by the Catholic Health Association of the United States
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