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BUSI 646: Managing Human Capital in Healthcare
BUSI 646 Managing Human Capital in Healthcare
The Purpose and Impact of DEI Training within Business and Healthcare
Joshua-Paul Johnian Sr.
Respectfully Submitted to: Colleen McLaughlin
March 4th, 2023
Author Note
Joshua-Paul Johnian Sr.
I have no known conflict of interest to disclose.
Correspondence concerning this article should be addressed to Joshua-Paul Johnian Sr.
Email: [email protected]
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BUSI 646: Managing Human Capital in Healthcare
Abstract
Few can debate the reality of a rapidly changing world in every sector of life. Technological
advancements have created global access to diverse thoughts, actions, opinions, and practices
and while some industries are suited for rapid transformations, other markets, such as healthcare,
are perceived as traditionally reactive and resistant to the adoption of progressive approaches to
business. Despite deep-rooted practices, the incorporation and evolution of diversity, equity, and
inclusion (DEI) training have resulted in new opportunities for industry and healthcare to pioneer
developing approaches to care that reflect new goals and benchmarks consistent with the present
reforms within the Affordable Care Act (ACA). The research will explore the purpose and intent
of DEI training and its impact on various aspects of industry and healthcare, with additional
research that will highlight DEI practices and how they positively affect consumers and business
practices. Furthermore, I will provide several Biblical concepts related to the intent of DEI
training and how such principles can be incorporated into the larger goals of DEI education. In
conclusion, I will highlight the current success and limitations of DEI training and present
possible solutions for consideration.
Keywords: DEI, Diversity, Equity, Inclusion, Healthcare, Process, Learning
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BUSI 646: Managing Human Capital in Healthcare
Introduction
Today, diversity, equity, and inclusion training can be found in most industry sectors,
from sports to entertainment, merchandise, and healthcare. A quick search on Amazon, under the
topic of diversity, equity, and inclusion, reveals over two-thousand titles dedicated to this topic,
followed by another search highlighting diversity, equity, and inclusion results in over two-
hundred titles presenting different approaches to DEI and their impact on society and business.
As the importance of this field grows, many corporations have initiated processes of DEI training
toward the goal of improving their impact on employees and the changing needs and wants of
consumers. Furthermore, while most corporations have incorporated DEI training as part of the
corporate culture, the vast spectrum of the topic requires frequent human resource management
(HRM) reviews of what has been successful or ineffective.
Why are Diversity, Equity, and Inclusion Important
When considering how diversity, equity, and inclusion (DEI) are engaged in our society
and vocations, typically, many focus on the narrow view of nationality, race, gender, age, skin
color, or religion. However, beneath the visible aspects of DEI lies additional areas of focus such
as value systems, heritage, thinking style, learning style, work style, perspectives, and sexual
orientation (Enders et al., 2021) that identify only a few of many complexities related to this field
of study and training. Corporate policies and training in diversity, equity, and inclusion have
expanded significantly in every industry sector, including healthcare, and as national socio-
economic demographics are changing, incorporating DEI programs is essential to supporting
business growth while meeting the needs of consumers, employees, and corporate goals. Palmore
(2023) highlights, and supports, the expanding role of DEI in the workplace and the need for
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every industry to re-calibrate their training and education to reflect the importance of intersecting
identities, honoring differences, and challenging inequities in company cultures (Palmore, 2023).
What is DEI Training?
Historically, every segment of society, industry, and business has been challenged with
toxic environments that reinforce attitudes and practices of exclusion and bias; however, with a
renewed focus on these challenges, organizations are now developing new strategies to support
effective DEI climates that primarily focus of diversity and inclusion (DI) training that provides
a series of comprehensive instructional and educational programs that encourage re-imagined
employee cooperation while addressing prejudice and or discrimination (Aggarwal, 2022). In
part, but not in whole, the systematic design of DEI training is primarily successful since it
incorporates employees' skills and knowledge and creates an open environment where employees
can learn from one another, resulting in training that provides understanding in evolving
conversations, such as awareness and behavior, by assisting employees in understanding bias
(Argueza et al., 2021).
What are the Goals of DEI Training
To narrow the scope of the purpose and goal of DEI training, I will focus on the aim of
DEI training that encourages collaborative environments in healthcare where the assets of
diversity, equity, and inclusion contribute to the industry's overall strength. Presently, research
has evidenced the positive impacts pieces of DEI training have impacted, revealing a 40%
increase in employees' ability to identify positive perceptions with diverse co-workers, further
resulting in growth opportunities that develop employee skills, improved staff knowledge, and
organizational culture (Thomas et al., 2023). While DEI training is essential, research has shown
its present goals are limited, and to overcome these barriers, one possible solution incorporates
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robust DEI programs, the Christian ERGs, that affirm foundational Christian principles that
reinforce God created one race—humanity and combined with this mindset, a reimagined
approach to DEI training can positively impact healthcare services (Eph. 2:15, NKJV).
Diversity and Inclusion Training and Labor
The global community of ideas, education, life experiences, and training is reshaping
every facet of our world and providing new opportunities for once marginalized socio-economic
demographics to contribute to the labor market across all levels of leadership and services. While
specific labor markets are naturally inclined to embrace diversity, equity, and inclusion,
healthcare represents one market that has been slow to embrace changes in the labor market
despite experiencing significant shortages in clinical staffing (Khuntia et al., 2022). Despite prior
attitudes and approaches to healthcare labor practices, renewed attention toward employee
retention, recruitment, and career advancement allows DEI training to provide a natural bridge
that healthcare HRM can utilize to recruit, collaborate, and improve the quality of the labor while
also better serving patient needs and the goals of the evolving U.S. healthcare system (Khuntia et
al., 2022). Furthermore, by incorporating DEI training with HRM goals and outcomes, HRM
specialists are equipped to work with DEI advocates to “find and identify prospective employees,
screen them, and arrange them to be interviewed by supervisors and managers throughout the
larger organization” (McConnell, p.61, 2021) that will aide employee retention while
encouraging a corporate culture that promotes changing attitudes and approaches to life and
work.
How DEI Training Support Employee Retention
Employee retention is one of the organization's most significant challenges, specifically
healthcare. Within my current healthcare employer, we have an 80% employee benchmark which
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accepts the premise that we anticipate losing 20% of our staff monthly due to competition,
retirement, dismissal, or departure from the labor market. The cost associated with training,
staffing, and bonusing existing staff to cover the absence of past staff provides an opportunity for
DEI training to re-imagine approaches to staff development that can contribute to staff retention
while providing a positive financial return on investment (ROI). Research provided by Morely
(2018) demonstrates that for every $1.00 invested in DEI training, there is a $4.45 ROI resulting
in a 445% profit based on healthcare providers' investment in the culture and needs of their
current diverse labor force (Morley, 2018). The primary reason DEI training has been successful
in retention is attributed to listening forums, activities, events, and career development
opportunities, which enables healthcare executives to understand better the needs of the
employees, which results in positive retention and productivity outcomes that directly impact
financial outcomes and control of the market.
How DEI Training Impacts Professional Growth and Upward Mobility
Further contributing to the goal of employee retention is DEI’s ability to allow employees
to grow professionally. For an effective DEI program to have a lasting impact, diversification
must be evidenced in all levels of employment and leadership. Historically, the higher the
leadership level, the less diverse the corporate climate becomes and in an attempt to address this
trend DEI training provides a renewed focus on professional growth and creating new pathways
for improving minority representation within multiple levels of leadership (Riner et al., 2022).
An example of a positive outcome in this practice is evidenced in surgical academia through
scholarship opportunities and intentional succession planning that have led to new opportunities
in business growth. McConnel (2021) writes, “succession planning is critical to the success of
any organization” (McConnel, p. 71, 2021) and combined with the efforts of DEI programs,
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professional growth models, path progression, and career ladders all contribute to the health and
diversification of a healthcare system.
The Impact of DEI Training
From Blue Cross and Blue Shield to Google, Walmart, Cocoa Cola, Cisco, and Dell,
major corporations have developed entire DEI departments and DI leaders who are responsible
for training, education, activities, and employee resource groups (ESG) that regularly meet and
discuss business, technology, well-being, personal development, responsibilities, roles, and
religion. The impacts of these systems and networks provide opportunities for professional
development while promoting awareness. An example of this dynamic within healthcare is
practiced at Aetna, which claims approximately 10,000 employees belong to an ESG that
represents a network of employees that can assist career skills while reinforcing a culture where
the collaboration of these groups' ideas meets the needs of a diverse marketplace. Furthermore, in
an article shared by Janet King, research indicates that “companies are most likely to provide
diversity training at all levels of the organization, implement recruiting policies to ensure an
equitable number of applicants from minority groups, create ERGs and provide career and
leadership development and mentorship programs targeted towards employees from
underrepresented groups” (PR Newswire, para. 1, 2022) further demonstrating the positive role
and impact DEI systems have on the corporate environment that reflects market dynamics and
customers.
DEI Training that Reflects the Market and Customer
Battle (2022) writes, “Integrating DEI across a healthcare workforce means more than
just hiring and promoting. It also involves building and supporting an inclusive culture” (Battle,
p. 232, 2022), highlighting the need for HRM to extend the vision of DEI training beyond static
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practices but to integrate entire systems that reinforce diversity, equity, and inclusion, in
healthcare community outreach, and labor. Diversity, equity, and inclusion are essential in
healthcare to lay the foundation for excellence, innovation, and trust, and studies show that
diverse groups with relevant training outperform homogenous teams resulting in an increased
likelihood of financial outperformance. Additionally, a recent survey from Deloitte revealed that
59% of those surveyed were uncomfortable sharing their race or ethnicity with their healthcare
provider based on how they felt they would be assessed (Hammersla, 2022). Such research
highlights a potential disconnect between healthcare consumers and providers and a possible
opportunity for DEI training to help change consumer perceptions of healthcare; therefore, if
DEI programs can assist healthcare practices to look and feel more representative of the
changing diversities of the environment, then perhaps positive collaborations between the patient
and provider would better impact the overall quality of healthcare services and delivery.
The Need for DEI Training
The vast scope of diversity, equity, and inclusion almost makes the task of training
unsurmountable. Earlier in this research assignment, I distinguished between seen and unseen
DEI, and throughout this paper, I have explored goals, needs, and reasons for DEI. However,
while DEI training can take many forms and address many issues, most DEI training focuses on
bias, awareness, and individual compliance as the foundational issues within diversity, equity,
and inclusion. While most professional environments believe they can identify diversity, equity,
or inclusion, the application of unconscious bias training has become an effective strategy to
increase knowledge, perceptions, awareness, and bias. This evolving aspect of DEI training has
also impacted multiple areas of learning, and while concepts and awareness of diversity and
inclusion, as well as DEI training, are being adopted, there still needs to be greater understanding
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within the global community. To address these challenges, DEI training is being encouraged in
early development environments with the goal that such interactions can have a generational
impact. In a recent study, “23.1% of medical students understood the meaning of “diversity,”
whereas 17.9% disclosed that they had not heard of the word. Only 3.8% of the students
understood the meaning of “diversity and inclusion,” whereas 73.0% disclosed that they had not
heard of the phrase” (Takasu et al., p. 965, 2022) highlighting the current gaps in understanding
as it applies to the global community. While the U.S., Canada, and Europe may be pioneering
DEI training, much of the worldwide community in Africa, the Middle East, and Asia still lingers
far behind Western understandings and applications of this initiative.
The ability to address the need for diversity, equity, and inclusion cannot succeed solely
with a top/down approach, and while organizational change is necessary, individual
accountability is the key to lasting change, beginning in the classroom as an ideal learning
environment where DEI can support cultural competency (Fuentes et al., 2021). By incorporating
DEI learning into the earliest stages of teaching, advocates for DEI believe teaching relevant
frameworks combined with best practices will result in learners who are better informed,
empowered, and equipped to understand and apply DEI best practices in future professional
contexts.
Has DEI Training Met Expectations?
While healthcare, education, and businesses are adopting aspects of DEI, training
questions remain if DEI methods have been effective. A standard critique of DEI practices
highlights how an organization can have diversity but still lack inclusivity since an effective DEI
program should reinforce a corporate commitment to continual staff development and social
investment. However, while DEI programs may be present and active, less than robust support
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from executive leadership often results in DEI training that is only applied annually or
voluntarily. Furthermore, since there is no perfect DEI method, DEI programs have been
criticized for their inflexibility in understanding a specific institution’s vision, goals, and needs
resulting in a DEI program that fails to connect with its employees or the purposes of the
organization. To address this concern, especially in healthcare environments, HRM can play an
essential role in the education process within executive leadership by assisting leadership in
understanding DEI as a preventative measure and tailoring DEI training to value the
organization's history. By shifting the focus of DEI learning from the narrow emphasis on race or
ethnicity, HRM can broaden the learning opportunities to include age, abilities, disabilities,
genders, religions, cultures, and sexual orientations, and by applying
expanded understandings DEI training, HRM specialists can customize
resources to focus on prevention, resulting in positive working environments
(Cuellar, 2022).
Furthermore, to narrow the gap between learning and change, DEI programs have
introduced employee resource groups (ESGs) that expand collaboration, bringing employees and
executive leadership closer to understanding and partnership. Currently, ERGs have shown the
highest levels of success by cultivating diverse workplaces, especially in environments where
senior leadership has less than 30% minority representation (Anderson, p. 1, 2021); however,
diversity still does not guarantee inclusion. Additionally, while DEI training positively impacts
specific labor environments, research has shown that diversity training programs still have
significant ground to gain in improving employee attitudes and behaviors. In an article by
Jonathan Butcher (2023), he writes, “Research has already shown that (1) diversity training
programs have failed to improve attitudes and behaviors for years, and (2) attempts to reduce
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bias through measuring just how much each of us has stored away in the recesses of our mind
have been a spectacular bust. Anthropology Now reports that “hundreds of studies dating back to
the 1930s suggest that anti-bias training doesn’t reduce bias” (Butcher, para. 5, 2023). Therefore,
to address this dilemma within healthcare, DEI advocates and HRM facilitators are beginning the
process of DEI teaching at the beginning stages of medical school. Using the Kern model,
precision learning methods are incorporated with hands-on practices that can motivate, empower,
and inspire future healthcare professionals and raise their awareness of DEI topics affecting peers
and patients (Castillo, 2022). However, HRM and DEI trainers also recognize slogans are
insufficient in the overall goals of DEI training, and the emerging labor market demands action,
as evidenced by a staggering 83% of present employees who consider DEI of equal importance
along with pay and work/life balance (Colvin, 2022).
DEI Training: A Future Path Forward
While critics of DEI training will cite its limitations or failures, the primary goal of DEI
learning is to encourage reimagined processes of teamwork, trust, and vulnerability. When these
elements are present, cross-disciplinary environments and equipped to support a broader
understanding of diversity, equity, and inclusion, resulting in departmental growth and a more
significant impact in their respective fields of industry. Research provided by Morales et al.
(2022) provided seven various methods that utilize the goals of DEI training and placed them in
a practical application that can be modified for any professional setting. While some of their
plans were theoretical, their research concluded that the success of any DEI program was based
on the participant's understanding of core competencies that was encouraged through group
climates, executive influence, and personal motivation, and when these factors were present,
motivated participants, more successfully applied DEI training (Morales et al., 2022).
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Further research offered by Cox (2022) does not excuse the limitations of DEI training
due to significant theoretical aspects; however, her research does not rely on good intentions but
substantive evidence-based practices supported by the scientific methods that “should look to the
science of cognitive and behavioral change, and insist on evidence-based, experimentally tested
approaches to DEI training” (Cox, p.16, 2022). Morales et al. (2022) and Cox (2022) represent
the professional belief that the future path forward for DEI training can only exist when human
behavior is combined with science and evidence-based approaches to change and by moving the
bar from expectation to theory and from theory to practice then, change will be the result of
efforts built upon the hope that diversity, equity, and inclusion will have a more significant
impact on life, industry, and healthcare.
In Conclusion and Biblical Consideration
Often more comprehensive discussions on diversity, equity, and inclusion are followed by
advocacy initiatives that elevate specific causes or demographics over others. While the adage of
he who screams loudest is heard first may appear to hold some merit, the reality is that Christians
are using the present DEI format to advocate for faith-based initiatives in growing numbers and
effectiveness. While some companies have been reluctant to embrace religious activities, the
importance of diversity and inclusion efforts within organizations has opened the door to
expanded dialogues about faith, collaboration, and corporate culture. Furthermore, since an
employee represents a whole entity of body, spirit, and mind, faith becomes an undeniable
identity for many employees that increase their effectiveness to belong in their workplace and be
accepted.
To effectively engage in a dialogue with DEI programs and HRM, Christian ERGs have
mainly been successful in advocating for faith-based groups that affirm prayer, policy, purpose,
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peace, and programming. By elaborating on these topics, a Christian understanding of love can
refer to and include one's neighbor, peer, and customer resulting in a natural cooperation between
DEI and faith. Furthermore, since part of the goal of DEI environments is to foster ethical
behavior and integrity, Christian ERGs are naturally enabled to find common ground with their
company and other DEI collaborations. At the heart of a thriving corporate environment is the
spirit and practice of excellence, which centrally rests at the heart of the Great Commission and
the desire to fulfill God’s purposes with adequate performance, further providing opportunities
for faith and DEI to co-exist. Additionally, the core concept of inclusion affirms every
corporation's goals since their customers represent a vast diversity of individuals that cross every
socio-economic background, race, ethnicity, and creed. In healthcare, the Hippocratic Oath binds
every person engaged in healthcare to care for people in the same manner Christ asks us to
follow by acknowledging that every human being is made in God’s image. In Genesis 1:27, the
creation account reminds us, “So God created man in His own image; in the image of God He
created him; male and female He created them.” (NKJV) From God’s creative call to today’s
DEI initiatives, Christians are ideally positioned to thrive and lead such an environment.
Throughout the research of this paper, I highlighted the essential component of education
that underpins any successful DEI program. By applying the Christian theology of work, faith,
and integration, Christian ERGs reinforce positive approaches to peer-to-peer support and the
deeper reinforcement of developing leadership skills that prepare future leaders. McConnell
(2021) writes, “human resources staff members often spend a considerable amount of time
interacting with representatives from different government agencies” (McConnell, p. 136, 2021),
and the same could be said for the role HRM plays with employees within their own companies.
Suppose the goal and outcome of vibrant DEI training in thriving corporate environments is
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action. In that case, the natural merger of Christian ERGs and community outreach will reinforce
employees' character and elevate the corporate presence within the community. Within a
healthcare context, society represents the core of a provider's consumers and supporters, and
healthcare providers rely on a reputable reputation that is above reproach with the exact
expectations of most Christians. The Apostle Paul writes, “And we know that all things work
together for good to those who love God, to those who are the called according to His purpose.”
(NKJV) And the Psalmist reminds us, “Unless the Lord builds the house, They labor in vain who
build it; Unless the Lord guards the city, The watchman stays awake in vain.” (NKJV) Both
passages subtly refocus the reader’s attention and heart toward issues of great importance and
opportunities of lasting impact. Within DEI initiatives, combined with the mission and goals of a
corporate environment, including healthcare, remarkable opportunities exist to develop and
foster opportunities for significant change. Today, as more executives engage with these aims by
recognizing changing generational attitudes, the need for quality employees and healthy
environments supporting retention is more critical than ever. With the combined efforts of
practical and progressive HRM, even the most challenging barriers can and are being overcome.
Diversity, equity, and inclusion are not diminishing, and as they gain importance within the
culture and business organizations, healthcare professionals at the forefront of this movement
will benefit from the success of those who have embraced the fullness of diversity, equity, and
inclusion and developed a greater consensus of collaboration and cooperation.
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