Employ and Support a Diverse Health Workforce
Raising the Bar’s five principles provide the foundation for transformational action by healthcare payers, providers, and other organizations. This section focuses on healthcare’s role as an EMPLOYER, including the essential role payers and other organizations play in facilitating the provision of healthcare, and outlines concrete actions, each with a commitment that healthcare can make to advance equity and excellence, and a set of tactical strategies.
Concrete Actions for the Employer
The delivery of care and health outcomes are improved when the workforce and leadership reflect the diversity of the communities served. As employers, healthcare organizations should model practices that allow their workers to thrive.
Action 1: Invest in and grow leaders who advance and embed equity, quality, and value across the organization
- Establish a culture and practice whereby organizational leaders participate in ongoing training to strengthen their understanding of the ways in which health is impacted by and healthcare perpetuates inequities.
- Enhance the ability of organizational leaders to identify and seize opportunities for transformation. This includes but is not limited to implicit bias training, quality improvement training, and how payment strategies can be used to advance equity.
- Challenge leaders to commit to being agents of change and to develop strategic plans to create equity within the organization, improve equity and excellence of healthcare covered or provided, and improve health equity for individuals, their families, and communities.
- Identify opportunities for employees at all levels of the organization to embody their leadership potential. Create inclusive and equitable pathways for growth and development that can help to bring people who are deeply committed to equity into the highest levels of leadership.
- Equip all healthcare workers with a range of tools, resources, and opportunities to continually develop their skills and expertise in addressing equity and quality, particularly as it impacts the delivery of care and patients’ experience with healthcare.
Action 2: Employ and cultivate a representative workforce at all levels
- Develop and deploy comprehensive strategies to improve recruitment, hiring, growth, retention, and promotion of workers traditionally underrepresented in the workforce (including people of color, women, and workers with disabilities).
- Ensure that increasing and sustaining a diverse workforce is a key organizational priority and that processes, including inclusive mentorship programs, foster equity and reduce potential bias.
- Invest in local education systems, including middle and high schools, thereby directly investing in pathways for the future workforce and providing mentorship and other resources to develop a talent pool for healthcare.
- Partner with Historically Black Colleges and Universities (HBCUs), the Hispanic Association of Colleges & Universities (HACU), the Asian Pacific Islander American Association of Colleges and Universities (APIACU), the American Indian Higher Education Consortium (AIHEC), and community colleges and community-based organizations to advance recruitment, retention, and promotion of a diverse workforce.
- Appropriately train the workforce so that they can provide culturally and linguistically appropriate, respectful, and equitable care. This includes but is not limited to racial equity training, or training on providing trauma-informed or culturally congruent care.
- Evaluate and update medical and health profession curricula to focus on the role of health professionals in advancing the Raising the Bar Principles and Actions.
Action 3: Create and sustain workplaces and jobs where employees can be healthy, thrive, and help guide effective and equitable care while feeling safe
- Provide fair pay to all employees at all levels of the organization by ending wage discrimination by race, gender, or other factors.
- Offer a living wage with a comprehensive benefits package, which at a minimum should include paid sick and comprehensive family leave, support for childcare and elder care, accommodations for pregnancy and breastfeeding, and mental health and wellness services.
- Protect healthcare employees from infection and emergencies through security, training, access to vaccines and personal protective equipment, and communications in languages appropriate to the employees. Create a safe working environment that is free of violence and harassment.
- Create professional advancement opportunities and resources to help staff (particularly those traditionally underrepresented) expand their expertise and credentials or evolve their roles and networks within the organization.
- Engage employees at all levels of the organization to ensure that these insights are central to decision-making. This can positively impact care delivery as the healthcare workforce has firsthand knowledge and brings valuable insights and perspectives on the policies and practices that affect individuals, families, and communities.
Action 4: Leverage procurement to ensure the diversity and well-being of contract workers
- Encourage transparency in the bidding process by requiring contractors and vendors to disclose compensation and demographic data of their workforce by role in proposals.
- Include provisions requiring nondiscrimination and fair treatment of employees in contracting requirements to ensure that contracted workers are treated fairly and justly.
- Ask contractors to provide information about workforce diversity, and about pay and benefits offered to employees by role, and ensure these align with the organization’s own policies and offerings.
Raising the Bar for Maternal Health: The Employer Role
To achieve maternal health equity, healthcare institutions must employ and support a diverse maternal health workforce.
What does this look like? Hospitals, health systems, independent women’s health and multi-specialty provider groups, and FQHCs:
- Invest in and support leaders who advance and embed equity, quality, and value across the organization to improve maternal health.
- Employ and cultivate a workforce that is representative of the surrounding community and is trained, equipped, and supported to advance maternal and infant health equity.
- Create and sustain workplaces and jobs where employees can be healthy, thrive, and help guide effective and equitable maternal care.
- Leverage procurement to ensure the diversity and well-being of contract workers who provide care and otherwise support the health of birthing people and are birthing people themselves.
Get started with the newly released Raising the Bar for Maternal Health Equity and Excellence guidance.
Watch: Informing Workplace Practices and Policies
Featuring leaders from the Robert Wood Johnson Foundation, Washington University in St. Louis, MetroHealth, and the National Association of Community Health Workers.
The Employer Role in Practice
The following set of vignettes highlight examples of organizations already advancing efforts in line with those actions outlined in the EMPLOYER role.