Feb 7, 2019 in Medicine

Abstract

Workforce diversity in healthcare is a big concern in the United States. The society is becoming diverse because the number of minority groups is steadily increasing. As with every organization, healthcare organizations should promote workforce diversity to ensure the fair representation of all society members in their institutions. Such initiatives are essential in promoting satisfactory healthcare services to the diverse population. This discussion looks at various concepts related to the general idea of workforce diversity in the United States.

Keywords: workforce, diversity, healthcare, demography, ethnicity, race 

Workforce Diversity in the U.S. Health Care

Introduction

Thomas (2011) defines diversity as similarities, differences and other associated mismatch and complexities that are characteristic of a given population evident in the context of a workforce. He goes ahead to report that the similarities and differences that are characteristic of a diverse workforce can be based on workers’ demographics or the workers behavioral differences. Looking at variations based on demographics, diversity is understood on the basis of differences in gender, race, ethnic alignment, sexual orientation, and age differences. On the other hand, behavioral variations involve aspects like differences in individual’s thoughts, problem solving techniques and other behavioral characteristics that are associated with people’s personality. Thomas (2011) also defines diversity management as the ability to make viable decisions concerning similarities and differences and in situations where there are conflicts and complexities. In essence, a decision is said to be a quality one if it is in line with an organization’s mission, vision and strategy. 

As witnessed in every job environment, workforce diversity is evident and every organization has to initiate the ways of dealing with it. Some organizations fail to capitalize on the workforce diversity by failing to manage it effectively. However, when appropriately managed, workforce diversity can become an asset rather than a liability to an organization. In the United States, racial and ethnic disparities are widespread in health care. The research shows that despite the great changes in ethnic alignments, the United States health care provision institutions still suffer from the vices that come with racial and ethnic disparities. It means that a lot needs to be done to improve the situation and move towards ensuring better health care provision to the entire population. According to Thomas (2011), there is sufficient data to show that minority Americans suffer disproportionately, compared to their white counterparts, from preventable and curable health complications like asthma, cancer, cardiovascular diseases among other conditions.

While making reference to the Sullivan Commission on Diversity in the Healthcare Workforce, Thomas (2011) states that 30 percent of the country’s population is currently composed of people from minority backgrounds. Although there is a significant increase in diverse backgrounds of America’s workforce, there is no significant improvement that has been realized with regards to representativeness of the health care workforce. He states that the African-American, Hispanic, Native American and Asian nurses only total about 12 percent of the total nurse population. Despite the low representation of the minority nurses, Thomas (2011) acknowledges the fact that the skills and knowledge competition among the minority nurses has highly increased due to the increased need to have a diverse workforce. It is clear that having a diverse workforce in the health care sector is an impressive advantage as it is used as a strategy by health care organizations, as well as by larger business sector, to provide satisfactory services to clients. As such, it is conventionally accepted that workforce diversity in health care provision is an effective way of providing satisfactory services to the ever growing population of diverse customers in the United States.

The Evolution of Workforce Diversity

Betancourt, Beiter and Landry (2013), state that workforce diversity management has gone through a steady evolution in the last six decades. They identify the fact that workforce diversity management has evolved to the stage of considering three management strategies, namely workforce representation management, workforce relationships management and diverse talent management. Health care organizations can initiate various workforce diversity managing strategies in line with the main strategies. It is vital to understand what each of the strategies involves.

Managing Workforce Representation

Betancourt, Beiter and Landry (2013), state that this workforce diversity management strategy is anchored in the efforts of the civil rights laws and the civil rights movement. The main objective of the laws and the movement, and by extension, workforce representation management is to achieve a numerical workforce profile that can be said to represent social demographic composition and that of the general population. The strategy is commonly known as the number one approach to workforce management initiatives as it mainly focuses on ensuring numerical representation of the diverse population in terms of demographics. Health care organizations should adopt a variety of tools that are used by other organizations in their pursuit of proper workforce representation. Some of the tools to achieve this objective, available for use by the USA’ based organizations, include the affirmative action that ensures equal employment opportunities relating to diverse groups, the civil right laws, CEO sponsorship, assimilation and  formation of alliances with community organizations. Effective use of the tools can help health care organizations to promote workforce diversity with respect to the representation of both minority and majority groups found in the society (Kochan et al., 2003). 

 
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Managing Workforce Relationships

Every working environment requires effective team work and consultations to achieve the adjectives set. Team work and free consultations can hardly occur when workforce relationships have not been boosted. Based on this understanding, the US health care organizations should initiate strategies to ensure that their workforce can work without any form of friction. The increase in workforce diversity in the USA has presented an unavoidable issue of boosting relationships among workers of diverse ethnic and racial backgrounds. It is vital for all workers to feel that they are valued in the same way so that they consider their contribution to an organization to be appreciated. The effective management of workforce relationships is a sure way of achieving the necessary harmony that facilitates the attainment of fruitful work relationships in pursuit of pluralism. At the initial stages when interest in the promotion good work relationship among workers emerged, the efforts were aimed at ensuring corporate social responsibility, facilitating the prevalence of social justice and demonstrating adherence to civil rights (Betancourt, Beiter, & Landry, 2013).

Managing Diverse Talents

A diverse workforce should be perceived by every organization as an asset rather than a liability. It is essential to have a workforce that is endowed with different talents since such situations help in solving problems of different kinds. Health care organizations should develop strategies that can help to nurture various talents found within their workforce to better their service delivery. The approaches that are aimed at managing workforce diversity should be found to include everyone in the employee mixture and these approaches should focus on the creation of the conducive environment to enable all associates to exploit their full potential in contributing to the health care provision in the country. The need to have workers exploiting their full potential at work is essential for the existence of a diverse workforce in relation to demographic differences and behavioral variations. By giving workers time to exploit their talents, an organization manages to establish integrated and cohesive relationships among the diverse workforce (Betancourt, Beiter, & Landry, 2013).

Employing People with Disabilities

The slogan “Disability is not inability” has gained popularity in the United States. Health care organizations must join and become a part of the move to eliminate discrimination against those living with different forms of inability. The U.S has also emphasized that people with disability (PWD) should also be given an opportunity to be part of an organizations’ workforce. Organizations need to consider that there are particular jobs, requiring given sense of ability, that cannot be given to PWD who cannot get it even with the help of technology or any other means. This condition does not mean that all the PWD in the USA should be left out of the workforce completely. Other posts, apart from the extreme ones, can be given to PWD provided that they possess the necessary qualifications like professional knowledge and skills required for the jobs (Collins, Sord, Griffin & Borges, 2008).

The Root Causes for Racial/Ethnic Disparities in Healthcare in the USA

Provider/Patient Communication

According to Betancourt, Beiter, and Landry (2013), there is a lot of literature in support of the idea that socio-cultural factors, ethnicity, race and language barrier have critical impacts on health and clinical care. Patients come from diverse backgrounds. They can only be well served when the healthcare workforce in the country is made up of employees that have a similarly diverse background. The essence of communication in the healthcare set up is evident. Patients need to communicate their conditions to their health care providers. It needs to be taken regularly so that they get appropriate medical attention. This requirement can only be achieved in an organization that is keen to ensure diversity of its workforce. Patients also present different perspectives, values, beliefs, and behaviors based on their health and well-being. Patients are also different with respect to their symptom recognition, confidence in seeking care, ability to recall the management strategies and the level of adherence to diagnostic and therapeutic procedures (Guajardo, 2014). 

Patients can best identify with health care providers that belong to their group in terms of social, ethnic or racial group. As such, they can open up and share their experiences with one in whom they have confidence and trust. It becomes difficult for patients to give details of their health conditions to strangers that can hardly understand and identify with them. As such, health care organizations should not ignore the need to have a diverse workforce as socio-cultural differences between patients and healthcare providers largely influence communication and the overall outcome of the treatment process. Betancourt, Beiter, and Landry (2013) suggest that there is a great extent of evidence to support the idea that provider/patient communication impacts on the level of patient satisfaction.

Communication can become a very complex process when there are cultural differences and overall variations with respect to health literacy (Turk, 2014). The provider/ patient communication in the United State can encounter a great challenge with the existence of a minimal language barrier, if no efforts are taken to provide an interpreter for the communication process. The patients that have limited English proficiency often report their dissatisfaction with the care provided to them as they are unable to establish an effective relationship with their health care providers. As a result, the patients are most likely to omit the medications that are given to them, fail the office appointments and visit health care organizations’ emergency room to get medical help. This explains the reason why racial/ ethnic minorities and other people whose English is not good enough are likely to suffer adverse health complications compared to their English speaking counterparts. Betancourt, Beiter, and Landry (2013) also state that the patients that experience communication problems also record longer hospital stay when suffering from common medical conditions compared to their white counterparts. Based on this understanding, it is vital for healthcare organizations to promote co-existence of a diverse workforce that can help to establish effective communication between health care providers and patients.

Clinical Decision-Making and Stereotyping

Some nonmedical factors like patient’s physical appearance and the setting in which medical care is delivered can impact on the clinical decisions made by health care providers and the signs and symptoms of disease that a patient is to demonstrate. Stereotyping often comes naturally and subconsciously despite the need to provide equitable treatment to all patients. Stereotyping has been identified to have bad clinical implications in the USA, especially on patients that are perceived to belong to given categories that are considered to be less worthy of diagnostic or therapeutic procedures or resources. Stereotyping and the discrimination that come with it are more prevalent in healthcare organizations that do not ensure diversity (Betancourt, Beiter, & Landry, 2013).

Mistrust

The therapeutic relationships between a patient and a healthcare provider require trust. This is because trust facilitates the open communication that is directly associated with patients’ ability and willingness to adhere to the recommendations given by a physician and, thus, with the general level of patient’s satisfaction. Whenever the patient develops mistrust towards his/her healthcare provider, he/she can be hardly satisfied with the healthcare given to him or her. To boost the level of trust between patients and their healthcare providers, it is necessary for the USA healthcare organizations to ensure diversity in their workforce so that the patient can be served by a healthcare provider chosen by him. As such, healthcare organizations cannot only succeed in attracting more clients but also ensure effective healthcare provision, hence patients’ satisfaction. 

Cultural Change

Culture is known to be highly dynamic as it changes in accordance to the changes in the society. Organizations have their own culture that show their specific way of doing things. However, it is important for the USA health care organizations to adopt cultures that promote group diversities. An organization’s culture can help to limit the effects of different workers’ cultures as they are forced to conform to a unitary culture; the organizations’ culture (Scott, 2008). Usually, an organization’s culture is supreme and manages to suppress other ethnic and racial cultures that can compromise workers relationships and the production. In some circumstances, organizations may need to modify the existing culture in accordance to the prevailing workforce diversity. It enables healthcare organizations to effectively accommodate workers of diverse backgrounds and to ensure that the management can access and exploit the talent of all workers. To achieve it, the management needs to adopt an empowerment management strategy, where the leadership strives to facilitate employees’ work, rather than a doer management strategy. The latter means that the management considers itself as the doer of the action and the associates are perceived as assistants (Bengisu & Balta, 2011).

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Generational Diversity of Healthcare Workforce

It is necessary to design the working environment that attracts the younger generation while supporting the older one. Generational diversity is a vital issue in this process. A workforce that is made up of people of different generations is very effective in service delivery. This is because the mixture of talent, skills, experience, innovation and energy can help the workforce to achieve greater heights of excellence. The healthcare sector requires workforce diversity in terms of age; it can be achieved by attracting the younger generation to their innovative advantage and energy while performing tasks. At the same time, organizations are keen to retain the older generation for the sake of their skills and experience at work. The two generations are assigned tasks based on their competence and the gap that a healthcare organization seeks to fill. Currently, the USA healthcare organizations acknowledge the fact that workforce diversity is more heterogeneous compared to the past. Despite the importance of having a workforce that is made up of the members of different generations, the situation presents a great challenge to nurse managers that work with such workers as they need to establish a good relationship between the groups and get the best from their skills and experience (Jackson & O’Callaghan, 2009).  

Hendricks and Cope (2013) suggest that every generation that exists in the western society should have its set of cultural experience that influences the manner in which cohorts conduct themselves at work. A mixture of cultures results in the mixture of attitudes, values, norms and artifacts that can work to the advantage or disadvantage of an organization depending on the way they are managed. 

Various Cohorts within the USA Workforce

Veterans

The veterans’ cohort is made up of workers that have adequate experiences of economic hardship and going through under complex situations. The experience that veterans have is often translated to their level of loyalty, need for teamwork respect for those in authority and reward for hard work. Members of this cohort are also entitled to seniority-driven assignments due to their skills and work experience. They should be given time to play more of the advisory role in organizations and withdrawn from intense and highly involving tasks. The healthcare providers that fall into this category are mostly those that should have retired but that are encouraged to continue working through provision of governmental incentives so as to prevent brain drain. The other health care providers must know how to co-exist with this group.

Baby Boomers

The members of this cohort are those that grew up in a comparable stable state of free expression, educational growth and economic prosperity. They have much interest in various entitlements at the work place. The management needs to recognize them providing incentives for their work as they always show interest in recognition. They can be motivated providing monetary gains, promotions and other benefits. 

Other cohorts that should be expected at the work place include the members of generation X and the members of the millennial generation. Thus, the USA should have its organizations acknowledge the existence of all these generations so as to initiate programs to ensure that they are all taken care of in the most appropriate way. 

Conclusion

Based on the understanding of the importance of workforce diversity, health care organizations should make efforts to ensure that such diversities are maintained within organizations so as to boost the level of effectiveness of healthcare provision. It is important to ensure that the members of the society are effectively represented in the healthcare organizations, that diverse talents are exploited and effective communication is established between patients and their healthcare providers. The management of these organizations should also use different strategies to make every member of the diverse workforce feel valued and respected. Generally, organizations should increase awareness of racial/ethnic disparities among healthcare providers, facilitate interpretation services to solve the problem of language barrier and educate healthcare providers on health disparities.

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