Top Management Story

Writen by Tim Dawes

You're on your organization's diversity committee. You have the best of intentions.

And that's the problem.

It leads you to appeal for funding for all the wrong reasons.

Take healthcare for example.

The US foreign-born population comprises a larger segment than at any time in the past five decades. And this trend is expected to continue(1). People of diverse racial, ethnic, and cultural heritage suffer disproportionately from cardiovascular disease, diabetes, HIV/AIDS and every form of cancer. In addition, their infant mortality rates are generally higher(2). Minorities receive measurably poorer care and they suffer for it.

Great reasons for diversity training. Disastrous reasons to ask for executive funding for your diversity program.

If you doubt me, just look at your budget. Chances are you're getting sincere encouragement from the boardroom but not budget codes that represent significant financial resources.

Here's the nut of the problem.

If you're at or near the front lines--the medical floor if you're in healthcare, or sales or service if you're in a corporation--the discussions you're having about diversity training are not the discussions your executives are having.

In healthcare, for example, when physicians, nurses, and their department heads discuss diversity training, they talk about the increased needs they experience in serving minority populations.

That conversation centers on health disparities among ethnic and cultural minorities, how they might be overcome, the new treatments that are called for, and new techniques and perspectives staff need to be educated in.

That discussion is all good. All well-intentioned. And every part it increases the expense side of the income statement.

Your executives are having a discussion of their own.

What they want to know is how diversity training impacts the business of whatever business you're in. In healthcare, that means increasing your appeal to minority patients, competing for private purchaser business, responding to public purchaser demands, and improving cost effectiveness.

In other words, while frontline staff are talking about diversity training in a way that increases costs, executives are looking for strategies to decrease costs and increase income. As long as the frontline and boardroom talk past each other, programs like diversity training will fail to receive the recognition and funding they deserve.

But you don't need to wait for a more enlightened day. In fact, you can turn a few switches on yourself.

If you're a real advocate of diversity training, I recommend you start assembling a "business impact model", the sharp dark line that connects performance on the front line with your organization's ultimate business goals. There are some very good books where you can learn about this quickly. "The Success Case Method" by Robert Brinkerhoff and "Performance Consulting" by Robinson and Robinson are good places to start.

Here's the short course.

Instead of asking for money for diversity training, start from the top down. Look at your unit's business needs. In healthcare, this shows up as patient satisfaction scores, days in treatment, staffing levels, number of adverse events and law suits, and such.

Next, recognize that when your organization fails to work effectively with minority consumers, it's not only the consumers who suffer. You need to point out how your organization is missing its numbers, how improved performance on the frontline will help your unit meet it's goals, and how diversity training will create the improved performance you need.

Let me give you an example. Here's how diversity training translates to lower liability costs in hospitals.

Hospitals administrators have a significant incentive to reduce medical malpractice claims. If you do a little digging, you'll find out that four of five patients who sue haven't suffered medical negligence(3). Patients sue because they feel devalued, deserted, misunderstood, and misinformed(4).

Combine that with the knowledge that minority patients are less satisfied--in fact African Americans, Latinos, and Asian Americans are 10-15 times more likely than whites to believe they would receive better health care if they were a different race(5)--and you have a recipe for trouble.

It will cost your hospital $25,000 to mount a defense for each claim, even if you win. And your hospital has scores of claims, possibly hundreds.

Put an argument like this together and see the mileage you get.

The discussion starts like this: "We have a problem with medical malpractice that we all want to solve. Each claim costs us $25,000 to defend. And X number of them have come from our staff's difficulty in engaging minorities effectively. How many cases do you think we could head off if we trained this group of staff to perform more effectively in their interactions with minority patients?"

Now you're talking about saving money and meeting organization goals.

And that's a welcome reason to commit funding.

Whatever cultural issues your organization is facing, they have business impacts. You just need to point them out, and make your proposal part of the solution. ______________________________________________________

1. National Center for Cultural Competence, Why is There a Compelling Need for Cultural Competence?

2. Cohen E, Goode TD. Policy Brief 1: Rationale for Cultural Competence in Primary Health Care. Washington, DC: National Center for Cultural Competence; Winter 1999.

3. Focus June 4, 2004, How Doctors Might Curb Malpractice Claims, News from Harvard Medical, Dental, & Public Health Schools

4. Beckman HB, Markakis KM, Suchman AL, Frankel RM. The doctor-patient relationship and malpractice: lessons from plaintiff depositions. Arch Intern Med. 1994;154:1365-1370

5. Center on an Aging Society Georgetown University, Issue Brief Number 5, February 2004, Cultural Competence in Health Care: Is it important for people with chronic conditions?

Tim Dawes is the founder of Interplay, Inc., a firm that helps healthcare organizations to exceed their strategic goals by demonstrating unexpected empathy to patients. Learn about a step-by-step process that helps your staff make their natural compassion more deliberate and consistent for patients, and sign up for monthly "how to" articles at http://www.interplaygroup.com