1. Diversity, Inclusion, Cultural Competence A Journey... Not a Destination Presented to the Comprehensive Countywide Diversity Partners Initiative Fond du Lac, Wisconsin February 27, 2008 Presenter - Rhonda Taylor Parris Director, Workforce Planning Aurora Health Care

2. Who Is Aurora Health Care? Established in 1984, community-owned, not-for-profit health care system serving eastern Wisconsin 13 Hospitals 100 plus clinics Visiting Nurse Association 130 Retail Pharmacies Laboratory services – ACL Aurora Family Services 25,000 plus employees 1 million plus people and 75 communities served

3. Definitions/Terminology Diversity is the full array or individual differences among people –Most often reflected in terms of representation of the external dimensions of diversity (race, gender, age) –The existence of diversity may affect certain organizational processes such as communications, creativity and problem solving, which are closely related to performance –Having representational diversity does not result in leveraging diversity

4. One of your goals should be to successfully manage diversity in such a way as to get from a heterogeneous work force, the same productivity, commitment, quality and profit that we get from a homogeneous workforce

5. Inclusion Inclusion means that employees are fully and respectfully involved in the work activities and life of the organization –A culture of inclusion leverages diversity in all of its many dimensions –Leveraging diversity taps into the unique power and potential of each employee, thus unleashing the talent that exists –When an organization leverages diversity in all of its dimensions, it sees things that cannot be seen by working from the basis of sameness

6. Culturally Competent/Culturally Proficient Culturally Competent/Culturally Proficient can be defined as a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals that enables effective work in cross-cultural situations –Culture refers to the integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values and institutions of racial, ethnic, religious, or social groups –Competence implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors and needs presented by consumers and their communities

7. Every employee and every consumer should feel culturally secure when they interact with us Culturally Competent/Culturally Proficient

8. The Journey–Continuous Improvement Cultural competency is a journey by which an organization must commit itself to a process of continuous improvement Three guiding principles of cultural competency are: –Commitment Recognition that cultural differences exist-between and within groups A commitment that change is necessary and acknowledge that barriers exist in the service delivery systems, in our policies and in our practices –Accessibility There is a purposeful elimination of barriers to service Assurance that at least the same range of choices and level of services are available among all communities of color

9. Three Guiding Principles - continued Three guiding principles of cultural competency are: –Relevance There is an aggressive plan for recruiting, training and retaining staff and volunteers of color throughout the organization Services are delivered by staff who are culturally competent Services are delivered in a manner relevant to the customer in a way that is meaningful and congruent with the customer’s class, language, culture belief, environment, concept of time and spiritual and religious beliefs The Journey–Continuous Improvement

10. Why Does This Competence Matter to Aurora? Because we recognize the personal nature of health care services, we are committed to creating environments that meet the diverse physical, emotional, spiritual, social and economic needs of our patients and clients, as well as the people who serve them

11. Why Do We Do It? Our vision is to continually find better ways to deliver health care services, and to measurably improve the health of the communities we serve Our mission is to promote health, prevent illness, and provide state-of-the art diagnosis and treatment, whenever and wherever we can best meet people’s individual and family needs

12. Why Do We Do It? We are committed to having a diverse workforce that reflects the people and communities we serve

13. Our Journey 2000 – System Assessment, consultant engaged 2001 – Senior Management Committee assumed responsibility for developing draft goals/objectives/strategic plan, all level management feedback 2001 – Senior leadership consultation, training, introduction of the plan

14. Our Journey 2002 – Introduction of the plan to mangers,training, consultation, strategy integration into business planning 2002 – Managers introducing diversity plan to direct reports, explanation of employees role 2003 – Manager development, systems audit

15. Our Journey 2004 – Employee education implemented (conducted by department leaders), diversity standards and performance expectations added to employees performance review 2004 – Introduction of Cultural Competency Training to physicians and nurses

16. Our Journey 2004 – Focused on Supplier Diversity in conjunction with Premier, our national purchasing group 2004 – Same gender domestic partner benefits introduced, Work- Life Balance Task Force started 2005 – Continuation of leader, employee and physician education, Adoption Assistance benefit added

17. Our Journey 2006 – Focused on moving from Inclusion to Cultural Competency by providing more in- depth education and training to caregiver staff 2007 – In depth analysis of employee satisfaction survey responses, conducted focus groups 2008 – Commitment to acceleration of activities and outcomes; system-wide plan and teams to address recruitment and retention, cultural competence education at all levels, health care disparities/clinical outcomes, supplier diversity

18. Diversity, Inclusion, Cultural Competence Goals Goal 1: Accountable for Diversity Results –Ensure organizational accountability for achieving our diversity commitment Actions – Systems Review, recommendations, action plans

19. Diversity, Inclusion, Cultural Competence Goals Goal 2: Become More Diverse –Ensure a diverse and highly competent workforce at all levels Actions – Determination of metrics, assessment of recruitment needs, development of recruitment plans, establishment of the Aurora Leadership Academy

20. Diversity, Inclusion, Cultural Competence Goals Goal 3: Leverage Diversity to Accomplish our Mission and Vision –Ensure wellness and healing environments that meet the diverse needs of the people and communities we serve Actions – Integration of diversity, cultural competence into our patient-centered, Planetree approach to care

21. Accountable for Diversity Results Diversity expectations and performance standards are on every employee’s performance review Results, as measured by the scores on the Inclusion Index of the annual employee satisfaction survey, factor into the leader’s merit and incentive pay

22. Accountable for Diversity Results Departments scoring in the bottom quartile of the Inclusion Index have the opportunity for additional skill building and management assistance Patient satisfaction and loyalty scores factor into leader’s merit and incentive pay All leaders are responsible for providing a minimum of two diversity modules per year to their direct reports

23. Our Structure – How We Do It The Diversity Function is housed in the Organizational Development Area Utilize the resources of 14 OD Consultants, 50 Clinical Nurse Specialists, Medical Education Faculty, and Human Resource Staff Leaders have direct responsibility for staff development and education – resources provided by the OD department

24. Inclusion Index Results 2001-2002 – No movement. We were in the communicating phase. 2002-2003 – The system-wide index moved 9%, (gap closure) from 3.49 to 3.63 2003-2004 – The system-wide index moved 1% 2004-2005 – The system-wide index moved 7%, from 3.65 to 3.75

25. Inclusion Index Results Of the four items composing the Index, the results are as follows: Commitment of leaders to having a diverse workforce – 6% gap closure – 3.83 to 3.90 Equal opportunity for all employees – 7% gap closure – 3.77 to 8.5 Evaluation process free from prejudice/favoritism – 4% gap closure – 3.5% to 3.56

26. Inclusion Index Results Feeling included regardless of individual differences they bring to the workplace – 13% improvement – 3.50 – 3.69 Overall from 2002 – 2005 the percentage of employees feeling favorable about efforts to ensure an inclusive environment for all employees has improved 13% points, from 57% to 70% of all employees

27. Inclusion Index Results The gap closure percent improvement in the Inclusion index between 2002 and 2005 is 17%, from a mean of 3.49 to 3.75

28. The Journey Continues – Next Steps Evaluate and continue what’s working Continue the integration to all levels, all plans Determine critical areas and initiate specific actions Continue the overlay of care management, patient-centered care, workforce development Implement senior leadership accountability for results

29. Questions? Contact: Rhonda Taylor Parris Director, Workforce Planning Aurora Health Care 2920 West Dakota Street P.O. Box 343910 Milwaukee, WI 53234-3910 414-647-3346 rhonda.taylor.parris@aurora.org