Addressing Diversity

Lecture

Introduction

The idea of diversity contains a number of interrelated concepts, including mixture, variety, different classes, range, and assortment.

 

Types of Diversity

Although these examples are from Arizona communities, one of the challenges of the nationwide health care industry that administrators will face is that of addressing diversity in any given community. Diversity is not just color or race; it may also include religion, creed, age factors, place of birth, primary language, gender, and sexual orientation.

 

Race

In the late 1950s, it was common practice for a Woman's Hospital in Michigan to separate the Black maternity patients from the Caucasian maternity patients. On a regular basis, many women were put into ward rooms with two, four, or even more beds unless they could pay extra for private accommodations. However, Black women often suffered further indignities, being put into segregated maternity wards without screens for patient privacy except perhaps one kept in the hall doorway to enclose and shield Black women from the views of other patients and strangers during the doctor's examination.

 

One of the few Black doctors on staff at the time demanded that a screen, which was usually not in the room, be brought in for personal privacy when he examined his patients. At that hospital and at another large hospital, this doctor was known as an advocate for Black women's rights. Of course, since then, there have been great strides in respecting the ethical and moral rights of minorities and women in health care facilities. (B. Dickens, personal communication, June, 2010)

 

Religion

Religious factors can also present interesting challenges. The three main American religions, Catholic, Protestant, and Jewish, all have affiliated hospitals that provide services to everyone. Yet each religious hospital offers special accommodations to match the community it serves. For instance, Jewish hospitals maintain kosher dietary preferences and exclusions. There are religious adjustments as well. For example, Catholic hospitals offer Mass services and Jewish hospitals, Sabbath.

 

Age: Nationwide, children's hospitals commonly admit new patients up to the day they reach their age of eighteen. However, some limit patient population by age groups (e.g., from birth to 18), while others limit patients by diseases (e.g., cancer or orthopedics). In some facilities, a patient who has suffered from a childhood chronic disorder such as cystic fibrosis will be treated throughout adulthood. Some children's hospitals have associations with other facilities. For example, the Phoenix Children's Hospital (PCH) in Arizona has a special relationship with two major hospitals in the Phoenix area. Through this relationship, PCH may transfer their patients, some of whom are adults suffering from certain chronic childhood diseases, to St. Joseph's Hospital in midtown Phoenix. PCH also has a special Adult Congenital Heart Program with the Mayo Clinic in Scottsdale, Arizona for its congenital heart disease patients. The actual heart surgery will take place at Mayo, but be performed by a PCH surgeon. In some cases, the congenital heart problem was not discovered in childhood, but will still be treated by PCH.

 

Addressing the increased number of citizens over the age of 65 has become a current factor in providing health care. In this venue, the health care must be geared toward services and compatible with the community it serves. For example, Boswell Hospital in Sun City, Arizona requires and provides more wheelchairs, walkers, and volunteer staff to assist the handicapped than what is required in conventional hospitals. There are also social organizations that provide all sorts of wheelchairs, walkers, machinery, and other apparatus for free to the elderly with very few questions asked.

 

Obesity

Often left unaddressed is the issue of obesity, a serious health problem and a very high risk in certain service areas. A hospital should accommodate treatment for it to improve the health status of the community it serves. Insufficient amount of attention is given to obesity, which leads to a shortened life span due to diseases such as diabetes, hypertension, stroke, heart attacks, and cancer.

American government researchers said that obesity is quickly overtaking smoking as the country's number one killer. In fact, obesity is becoming such a problem that many experts now say it is compromising all the benefits of recent improvements in health care and medical breakthroughs. (Medical News Today, 2004)

 

This population group tends to be excluded from efforts to cultivate staff diversity. Leaders can influence the organization culture by recruiting people who have particular values, skills, traits, and orientation.

 

Organizational Diversity

Matching the diverse needs of a community is a critical component in rendering health care. Foreign-born people may present language barriers, significant because hospitals need interpreters or staff to speak a variety of languages. In California and perhaps other states, not providing a staff person to adequately communicate with patients in their own language may result in misdiagnosis or mistreatment, causing injury or death. In such a case, the health care provider, individuals and institutions, may be subject to medical malpractice liability.

 

Why is this relatively modern concept of organizational diversity of significance to the health care industry? Among many reasons, diversity in the workplace is being recognized as a benefit that will contribute to an organization's bottom line. Increased employee and customer satisfaction end up as increased productivity, all of which are measurable outcomes (Goff, 1998). One should consider the bottom-line effects of a health care facility in treating obesity in a community where obesity is a significant problem.

 

At University of California-Davis (UCD), the newly appointed Senior Manager of the Orthopedic Department entered the department and discovered a diverse team of employees, including physicians, nurses, technicians, admissions clerks, clinic receptionists, and billing clerks. Of the approximately 50-person staff, the Senior Manager was the only minority person in a leadership position. However, 25% of the entire staff were Hispanic, East Indian, Asian, Black, or Pilipino, with most Hispanic. 75% were White, including foreign White. 65% to 70% of the staff were female. The physicians' ratio was 80:20 White to non-White. There was one Black resident physician in training and one Black nurse.

 

During his tenure, the Senior Manager was committed to more diversity among the Orthopedic Department management staff. He appointed a Japanese woman as his Assistant Manager and a Black male as the Supervisor of the Orthopedic Clinical Laboratory.

Increasingly, leadership literature is focused on the critical requirement that organizational leaders bring people of diverse backgrounds and interests together in ways that provide fair and equitable opportunities to contribute their best, achieve personal goals, and realize their full potential. (Gandz, 2001)

 

This requires sensitivity to ethnic, cultural, gender, sexual orientation, religious, and other differences within the workforce and a commitment to developing organizational cultures, systems, processes, practices, procedures, and policies that reflect this sensitivity and remove the obstacles to achieving and leveraging diversity. The motivation to do this stems from a commitment of the leader to forge links between the organization and the community within which it operates, either because it is good business or because the leader has values which drive these behaviors. Ideally, it will be a combination of both.

 

The "leader of the future" is described as an inclusive leader, one who believes in people even when they don't fit into neat, conventional categories. Such leaders will not just be tolerant of others but will actively seek out leaders from non-traditional groups and challenge the stereotypes that tend to restrict leadership candidates to members of traditionally privileged groups (Gandz, 2001).

 

References

Medical News Today. (2004). Obesity overtaking smoking as America's number one killer. Retrieved August 26, 2010, from http://www.medicalnewstoday.com/articles/6438.php

Gandz, J. (2001). A business case for diversity. Retrieved August 26, 2010, from http://cc.bingj.com/cache.aspx?q=A+Business+Case+for+Diversity+by+Dr.+Jeffrey+Gandz-&d=4536911517319389&mkt=en-US&setlang=en-US&w=4365a3ff,83089ed

Goff, L. (1998). Making the case for diversity training: Confronted by growing criticism, consultants focus on bottom line.New York: Crains New York Business.