Beyond the Glass Ceiling
Why diversity at the top is making a difference at the health system
Wednesday, March 22, 2006
Durham, N.C. -- For any organization, Gwynn Swinson would be quite a catch.
Well-educated, well-respected, and driven to make a difference, she
has capably served in a series of demanding roles, including
associate dean at the Duke School of Law, assistant attorney
general of the N.C. Department of Justice, and, most recently,
cabinet secretary of Gov. Mike Easley and chief administrative
officer for the State of North Carolina.
She also happens to be female and African-American. Just a few decades ago, it would have been hard to find someone of either description in such senior-level positions. But when Swinson took the job of vice president for government and community affairs and external relations for Duke University Health System (DUHS) in January, she joined an executive team already notable for its diversity — in fact, she was the fifth woman and third person of color appointed by Chancellor for Health Affairs Victor J. Dzau since 2004.
“I knew of Duke’s commitment to diversity going back to my days at the Law School,” says Swinson. “And it was clear in talking with Dr. Dzau and meeting the other members of his cabinet and the health system leadership teams that that commitment had been sustained and was growing. Frankly, I wouldn’t have been in the interview process if I hadn’t known that.”
Attracting the very best candidates for leadership positions at Duke is a perfect example of what Benjamin Reese terms “the business case for diversity.”
“Over the years Duke, along with many leading organizations, has realized that embracing diversity isn’t just an important ethical and moral value, it’s also critical to success,” says Reese, Duke’s vice president for institutional equity. A growing body of research is quantifying those benefits, he adds. For example, a recent study by the Catalyst organization found that Fortune 500 companies with a higher percentage of women in senior management dramatically outperformed those with a lower percentage, yielding a 34 percent greater financial return for shareholders.While Duke may not have stockholders, diversity does benefit its stakeholders — patients and the community, Reese says. “Making sure that different viewpoints are represented and welcomed at all levels of the institution helps us think more broadly and better understand the needs of the people we serve, which ultimately leads to better decisions and better patient care.”
Adding to longstanding efforts such as Duke’s Office of Institutional Equity and Women’s Initiative, Duke University Hospital (DUH) in 2004 launched a Diversity Initiative to actually build diversity-enhancing measures into its existing business structures. For example, the initiative holds the vendors DUH deals with to well-defined diversity standards, implementing an effective strategy for recruiting and retaining underrepresented groups in senior-level positions, providing diversity training, and routinely assessing and evaluating cultural competency for all staff.
In 2005 the initiative was extended to the entire health system, with Diversity Leadership Groups (DLGs) formed at Durham Regional Hospital, Duke Health Raleigh Hospital, and in Ambulatory Services in addition to DUH. The initiative is already recognized as such an innovative model that Reese and colleagues were invited to discuss the program at the annual conference of the American College of Healthcare Executives March 28-29.
“What is significantly different about this initiative, and what is embodied in our talk, is the personal involvement and support of our leadership,” says Kerry Watson, head of the DLG at Duke Hospital, who will be presenting along with Reese. “Each of our DLGs has senior-level executives on the team who are working directly to create an inclusive environment — which is critical. Cultural transformation must occur from the top down if it’s to be successful over the long term.”
At the Table
DUHS Diversity Initiative: What’s Happening• Diversity Leadership Groups responsible for implementing plans to meet diversity goals are established at Duke Hospital, Duke Health Raleigh Hospital, Durham Regional Hospital, and in Ambulatory Services, with an overarching team meeting bimonthly • More than 300 managers at Duke Hospital have completed an 8-hour diversity training course; 4-hour staff training begins this month • Duke University School of Medicine Department chairs will complete cultural competency training in May 2006, followed by medical staff • 12 DUHS employees have been trained as diversity facilitators and will begin training managers and staff system-wide later this year. |
Dzau shares that conviction: “As we work to create a more patient-centric organization, we must make sure that we reflect the perspectives of the diverse community we serve,” he says. “Diversity brings a critical balance to everything we do.”
But having a diverse team at the decision-making table can’t be left to chance — it takes commitment. Dzau, for one, has been known to prod search committees to seek diverse candidates, says Reese with a smile. “If the candidate pool isn’t reflective of the community we serve, he’ll challenge the committee to convince him that they’ve looked as broadly as possible to find the best talent America has to offer.”
Similarly, Reese, Fulkerson and other leaders have been working to establish formal recruitment and retention processes to increase diversity -- throughout the institution and especially at senior levels, where women and minorities have historically been particularly underrepresented. For example, DUH now requires senior leaders to certify that qualified minority candidates have been sought for open management positions, according to Fulkerson. The hospital is also measuring the success of these efforts: “We’re holding ourselves accountable for this,” he says.
What difference do these diverse leadership teams make? Just ask and the examples abound. At the Private Diagnostic Clinic (PDC), Martha Adams, M.D., recently became the first female member of the administrative board that oversees the 1,000-member faculty practice. The board now reflects greater racial and gender diversity than ever before.
“There is a much greater awareness of the broader social environment we work in,” says Paul Newman, who serves on the Ambulatory Services DLG in addition to being executive director of the PDC and vice president for ambulatory care services for DUHS. “I can see that reflected in so many ways, from little things like changing our bylaws to read ‘chairperson’ instead of ‘chairman’ to placing more focus on the needs of the diverse communities we serve as we’re developing patient care programs.”
And the benefits of are just beginning. “Ensuring diversity is an ongoing process, and we certainly have more work to do,” adds Reese. “Still, I don’t know of any health system that is as strategic and well-coordinated in diversity matters as Duke is.
“What you see in any organization’s environment is in large part because of the messages people get from senior leaders,” he says. “And in Duke’s case we are fortunate that diversity is not just a mantra that’s repeated — this is a place that walks the talk. When folks come to me and ask, ‘How do you convince your CEOs and chancellor and senior managers of the importance of diversity?’ I say ‘I don’t have to. They are the leaders and the champions. They are the ones coming to me with ideas.’”
Marsha Green assisted in the writing of this story.
