Diverse Healthcare Leaders’ COVID-19 Virtual Roundtable

Question 3

In early April 2020, ACHE invited a group of racially/ethnically and LGBTQ diverse healthcare executives to a virtual career roundtable for them to share in a safe space on how they are managing professional and personal realities amid the COVID-19 pandemic.  We extend sincere gratitude to the 23 leaders who made time in their extremely busy schedules to participate.

Participants selected one of three ways to share their perspectives:

• participate in small-group virtual 30-minute conversation,
• complete a 5-question online survey, or
• hold a 1:1 phone conversation with ACHE’s Diversity & Inclusion Director.

Below are highlights from their responses to the third question:

Agree/Disagree/It Depends: Those from marginalized groups are likely to encounter heightened implicit or explicit biases in the current, constant crisis-management healthcare workplace.

Initial response:

• Yes/Agree: 7 participants
• It depends/Neutral: 7 participants
• No/Disagree: 1 participant

General topics mentioned most often

• It depends on the pre-COVID D&I/E culture in the organization (4 participants)
• In crisis, people revert to their core nature (4 participants; includes 1 from question 2)
• Mentioned COVID-related discrimination against Asian-American (3 participants; includes 2 from question 2)

Key Quotes

“Crisis creates an environment where things will pop up if you don’t have a strong D&I presence in your organization.”

“The national data around COVID shows the inequity of what already existed. Representation and culturally competent care matters.”

Selected Response Excerpts and Summaries

Small Focus Group Responses

• I agree. We need to look at it and do something about it.
• I agree. There’s still an importance of representation for the communities we serve. We need to be at the table bringing these issues to the table.
• The national data around COVID shows the inequity of what already existed. Representation and culturally competent care matters.
• I think we have seen it in the Chicago area already. What I’ve heard in the news reports about people from Asian backgrounds experiencing a lot of horrible stuff from people on the street. People coughing on them and telling them to go back home; things like that may not be happening in the hospital but certainly in our city.
• I also didn’t think that healthcare workers would be discriminated against. I was so worried about managing the healthcare crisis at work that I wasn’t realizing how life was changing outside of work. I think there is discrimination towards those walking around wearing scrubs. My neighbor kicked my son out the yard saying your mom works at a hospital. I think we are going to have a whole new group of folks discriminated in a way that they have never been before.
  Some of the folks most vulnerable in hospitals are in EVS and come from lower socio-economic backgrounds and represent marginalized groups. They will feel a certain type of way, and there will be a lot of call offs in that group, and they don’t feel safe. They feel like they are putting themselves more at risk. It all comes down to leadership and messaging. We need those from those marginalized groups to understand that we aren’t purposely putting people at risk. We need to make sure we take some time to think about how we message and make sure that their needs are met.
• It depends on how strongly D&I is at the hospital center. I know at some hospitals everyone receives implicit bias training. It really depends on how the organization has trained the team to understand implicit bias.
• It depends. When you are in a crisis, you tend to go back to your base nature and when you go to your base nature, things will pop up. I haven’t seen anything in my organization. Crisis creates an environment where things will pop up if you don’t have a strong D&I presence in your organization.

Survey Responses

Survey Question: Consider the healthcare management field overall, not just your organization. Understanding that these are general statements that will not apply to ALL organizations, consider your response for what may be true in many situations. Indicate your degree of agreement with the statement: The healthcare management workforce from marginalized groups are likely to encounter heightened implicit or explicit biases in the current, constant crisis-management workplace environment.

• Strongly/somewhat DISAGREE 16%
• NEUTRAL 50%
• Strongly/somewhat AGREE 34%

1:1 Responses

• Explicit bias: no. Implicit bias: probably. In crises mode, we revert to our sentiments before we had implicit bias training, etc.  Implicit is always there, and when we are not consciously thinking about countering our own biases, they will probably show up.
• I originally thought I agreed, but now I think “it depends.” In times of crises, people operate from what’s ingrained, their comfort level. In organizations where diversity and inclusion were ingrained and real, then they will continue in crises.  But if they were just superficial, then I agree. …  Coming out of the crisis, we’ll see which organizations had real commitment.
• I do think so. I have no proof; more theoretical. Crisis is often a command and control leadership situation. It calls for leadership, but different forms of leadership should be appreciated. Woman of color do not have traditional command and control demeanor, or they have not been empowered to show that style of leadership.