Academic journal article Journal of Healthcare Management

Setting the Stage for a Business Case for Leadership Diversity in Healthcare: History, Research, and Leverage/PRACTITIONER APPLICATION

Academic journal article Journal of Healthcare Management

Setting the Stage for a Business Case for Leadership Diversity in Healthcare: History, Research, and Leverage/PRACTITIONER APPLICATION

Article excerpt

EXECUTIVE SUMMARY

Leveraging diversity to successfully influence business operations is a business imperative for many healthcare organizations as they look to leadership to help manage a new era of culturally competent, patient-centered care that reduces health and healthcare disparities. This article presents the foundation for a business case in leadership diversity within healthcare organizations and describes the need for research on managerial solutions to health and healthcare disparities. It provides a discussion of clinical, policy, and management implications that will help support a business case for improving the diversity of leadership in healthcare organizations as a way to reduce health and healthcare disparities. Historical contexts introduce aspects of the business case for leveraging leadership diversity based on a desire for a culturally competent care organization.

Little research exists on the impact that the role of leadership plays in addressing health disparities from a healthcare management perspective. This article provides practitioners and researchers with a rationale to invest in leadership diversity. It discusses three strategies that will help set the stage for a business case. First, provide empirical evidence of the link between diversity and performance. Second, link investments in diversity to financial outcomes and organizational metrics of success. Third, make organizational leadership responsible for cultural competence as a performance measure. In order to address health and healthcare disparities, collaborations between researchers and practitioners are necessary to effectively implement these strategies.

INTRODUCING THE PROBLEM

The healthcare field has been calling for studies to support diversity management as an intervention for racial and ethnic disparities in access, treatment, and outcomes (Dreachslin, Weech-Maldonado, and Dansky 2004; Weech-Maldonado et al. 2002; Brach and Fraser 2000). Previous literature suggests that racially and ethnically diverse business organizations outperform their more homogenous counterparts in both quality and financial outcomes (Richard 2000; Dreachslin and Hunt 1996; Cox 1993). Some authors have noted that the business case would be easier to assess if interventions were implemented with strong evaluation designs that could isolate intervention effects associated with the business case for diversity (Lurie et al. 2008b). This article provides contextual support for a business case in leadership diversity as a strategy for reducing racial and ethnic health and healthcare disparities.

Public health researchers solve problems using a public health approach, which involves defining and measuring the problem, determining the cause or risk factors for the problem, determining how to prevent or ameliorate the problem, implementing effective strategies on a larger scale; and evaluating the impact of those strategies (Satcher and Higginbotham 2008). Racial and ethnic health disparity is a pervasive problem that has been defined and measured both in the research literature and in national reports (AHRQ 2008; IOM 2002, 2001; HHS 2000). It has been suggested that the pervasiveness of the problem is related to the operational drivers of the health system. Two of these drivers are leadership and the presence of culturally competent care. Research has yet to fully address these issues. Important topics related to these drivers, but missing from the literature, are an organizing framework for integrating the factors that promote workplace diversity practices and an understanding of leaders' perspectives on managing diversity (Ng 2008).

So is the absence of cultural competence a system failure? While organizational cultural competence is the preferred outcome, some scholars and practitioners involved in this debate believe that diversity management is the process leading to culturally competent organizations (Betancourt 2006). Others have stated that the commitment of top leaders to change is a fundamental element in the implementation of diversity management initiatives (GAO 2005). …

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