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E Q U I T Y O F C A R E

Increasing Diversity in Governance and Management

Thomas C. Dolan, PhD, FACHE, CAE, president and CEO, American College of Healthcare Executives, Chicago, Illinois

D isparities in care continue to be a major problem in tiie healthcare system. Thisissue will no doubt continue to grow in importance, considering the fact that racial and ethnic minorities currentiy represent one third of the U.S. population and are projected to become a majority of the population in 2042.

This is why five major healthcare organizations—the American Hospital Asso- ciation (AHA), American College of Healthcare Executives (ACHE), Association of American Medical Colleges, Catholic Health Association of the United States, and National Association of Public Hospitals and Health Systems—have come together to form the Equity of Care initiative to address disparities in care.

These associations decided to focus their efforts to eliminate healthcare dispari- ties on three core elements:

• Increasing the collection of race, ethnicity, and language data • Increasing cultural competency training • Increasing diversity in leadership

In a series of five columns in this journal, of which this is the first, representatives from the Equity of Care associations will address all of these topics. ACHE's focus, and the focus of this column, is increasing diversity in healthcare leadership.

I N C R E A S I N G D I V E R S I T Y ON T H E B O A R D Although minorities represent approximately 29 percent of patients nationally, according to the AHA and the Institute for Diversity in Health Management, they comprise only 14 percent of hospital board members and an average of 14 percent of leadership positions. The AHA, along with the Institute and the Center for Health- care Covemance, is tackling the issue of increasing diversity in healthcare governance through its Hospital Trustee Professionalism Program and Minority Trustee Candi- date Registry.

The Hospital Trustee Professionalism Program is a series of AHA-sponsored edu- cational programs designed to prepare participants for service on a hospital or health system board. The program, which is available for free to interested candidates who register online to attend, gives potential board members an idea of what it is like to serve on a board, including roles and responsibilities and unique challenges faced by healthcare governing boards. The Institute and the Center work with state hospital

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associations to identify minority professionals whom those associations can encour- age to apply.

Sessions are held quarterly on a rotating schedule with stops in several major U.S. cities. Since the program started in 2009, it has been conducted in 15 cities; 500 individuals have been trained, and 35 of those participants have been placed on boards.

"The program is a success in that we have begun a conversation with boards and CEOs about this issue, and we now have a tool to help them identify profession- als from minority groups to serve on their boards," says Frederick D. Hobby, CDM, president and CEO of the Institute for Diversity in Health Management, based in Chicago, Illinois.

Through the Hospital Trustee Professionalism Program, the AHA hopes to see an increase in the number of board placements in 2013, when it adds an early iden- tification component that will help gain CEOs' and other senior leaders' buy-in of potential board members on the front end of the board member selection process. "We'll be asking CEOs and board members to identify minorities within their mar- kets whom they are already considering for board positions and encouraging them to take our one-day symposium," says Hobby.

The program also maintains the Minority Trustee Candidate Registry, an online database containing profiles and resumes of each individual who has participated in the training. Hospitals and medical centers can log in to the registry and search for available candidates in their community to fill a board vacancy.

ACHE S D I V E R S I T Y E F F O R T S ACHE firmly believes it has a responsibility to further diversity and inclusion within the organization and in the healthcare management field. Diversity is one of our four core values (along with integrity, lifelong learning, and leadership), and inclusion is one of the 10 ACHE Standards of Excellence for Staff. To further diversity and inclu- sion in healthcare leadership, ACHE has undertaken a number of activities to help ensure that the association and its members' healthcare organizations reflect the communities they serve.

Within ACHE, recruitment efforts focus on attracting diverse job candidates. Fre- quent diversity training is provided to all staff—including at new-employee orienta- tion—to strengthen ACHE's ability to attract, retain, and develop a diverse, qualified workforce.

ACHE also has launched a number of diversity initiatives targeted to the health- care field as a whole. One major effort is its support of the Institute for Diversity in Health Management, which ACHE cofounded. We also collaborate vdth several other organizations to advance diversity initiatives.

To monitor the field's progress in the areas of diversity and inclusion, every six years ACHE conducts a study to examine the career attainments of Asian American, black. Latino, and white healthcare executives. The findings of the first Racial/Ethnic Comparison of Career Attainments in Healthcare Management study, conducted in

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1992, prompted the founding of the Institute for Diversity in Health Management. Results of the latest study, conducted in 2008, along with recommendations for steps healthcare leaders can take to eliminate inequities of care, are available in the Research area of ache.org.

In addition to our research, AGHE has developed policy statements that promote diversity and inclusion. Our policy statement "Increasing and Sustaining Racial/ Ethnic Diversity in Healthcare Management" formally acknowledges healthcare executives' role in furthering a diverse workforce and calls on healthcare leaders to promote diversity within their organizations.

AGHE also offers an internship program that introduces one diverse student each summer to a wide range of healthcare association management issues. In addition, we award scholarships to diverse students in healthcare administration graduate pro- grams. These initiatives help promote diversity in the field by attracting minorities to healthcare leadership positions early on in their careers.

AGHE's Statement on Diversity summarizes the efforts I mention here and other initiatives to promote diversity within our organization and throughout the healthcare management field. The statement, which is available under the Diversity Resources tab on ache.org, refleas AGHE's deep commitment to furthering diversity.

As another way to encourage growth of minority leadership in the field, in 2013 AGHE is initiating the Diversity in Executive Leadership Prograrii. The program will support a cohort of mid-level and senior careerists who aspire to higher leadership roles. Participants will benefit from

• scholarship support to attend AGHE's Senior Executive Program or Executive Program;

• specialized curriculum opportunities to address barriers in career attainment and developing executive presence; and

• enhanced career support, including mentoring opportunities.

As you can see, AGHE is firmly committed to increasing diversity and inclusion in healthcare leadership, and we will continue our efforts to do so. A multicultural society needs multicultural leaders.

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