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Six actions to strengthen leadership capacity through equitable hiring practices.

Address structural bias, shift your mindset, and elevate underrepresented employees to increase leadership capacity within your healthcare organization.

One of the thought-provoking talks I attended over the past week at the annual Congress for the American College of Healthcare Executives was given by Dr. Jaason Geerts. He shared an emerging model for a “leadership organization.”

The basic premise of this model is that we work to create cultural change in our healthcare organizations so that every person takes ownership of their role as a leader. no matter their 'role' within the system.

I’m intrigued by this idea, and I’ve spent the past few days reflecting on how this idea could play out in real life. My vision of this possible future isn’t clear. Still, to move forward in healthcare, we must shift the ‘leader’ stereotypes held by decision-makers and elevate a more diverse group of people to leadership roles.

Current executive leaders must take action to reduce the impacts of structural bias and stereotypes on leaders’ selection. And underrepresented individuals must shift their mindset to see themselves as leaders.

Dr. Chamarlyn Fairley and I had the opportunity to explore these ideas in our recent conversation about how to diversify the pipeline to executive leadership positions in healthcare.

Bio: Dr. Chamarlyn Fairley is a psychologist and consultant to healthcare executive leaders. She is the founder and principal consultant at the Fairley Consulting Group.

Listen to learn how to reduce bias:

Watch to learn how underrepresented employees can advocate for change:

There is a representation gap in healthcare leadership.

People with diverse identities and historically marginalized tend to be underrepresented in the pool of applicants presenting for executive positions in healthcare organizations. Having less diverse candidates will weaken the leadership capacity of your healthcare system.

Many things must change, including the structural elements reinforcing bias and underrepresentation.

So how should executive teams tackle this challenge?

There are six actions that leaders can take to reduce structural bias and elevate underrepresented leaders in healthcare.

1. Increase leadership capacity by developing diverse leaders within your organization.

Intentionally look within your organization to identify future leaders. This will require that you look beyond the experiences listed on each individual’s CV and thoughtfully evaluate employees’ strengths and capacity to demonstrate leadership.

Consider how individuals are selected for leadership or committee participation opportunities. Recognize when an individual’s network or “who they know” has undue influence on the leadership development opportunities they receive in your system.

Reduce bias within the system by inviting individuals with leadership capabilities to take on new challenging responsibilities and offer to mentor and support their success.

2. Reduce bias in your hiring and selection process.

It is time to recognize an inherent bias in healthcare hiring and selection processes. The first step to reduce bias is to separate the steps in the hiring process so that an individual’s CV, interview, and performance are evaluated independently.

When these elements are scored separately, less bias is carried over from one step to the next.

Another strategy to consider is to forget about hiring the individual with the highest score. Instead, consider all the applicants who score in a certain range and then decide who is the best fit. Of course, with the recognition that fit be thoughtfully considered for prioritizing diversity in advance.

3. Let go of stereotypes to identify future leaders.

It can be difficult to identify future leaders when they are hidden in plain sight. Sometimes the most capable individuals don’t look or sound like what we expect of our leaders.

Take some time to look for individuals who don’t match the leader stereotype in your healthcare system. Consider who is missing or underrepresented on your leadership team. Then dig deep and identify these future leaders' unique strengths, talents, and perspectives.

4. Start with an intentional conversation about why increasing diversity matters to your healthcare system.

If you’re not sure how to increase the diversity of your systems’ leaders in a values-consistent manner, consider asking questions such as:

- Why is increasing the diversity of our leadership team important?

- What type of future leaders are we looking for?

- What diversity factors would make our leaders more representative of our employee community? Of our patient community?

- How can we identify individuals who fit our needs and our community?

5. Ensure the diversity of your applicant pool is representative of the rich diversity of your community.

Diverse applicants are increasingly underrepresented at the highest levels of healthcare leadership.

Take the time and invest the energy to ensure that your leadership candidates represent the full range of diversity characterized by the individuals working at the lowest levels of your healthcare system and your patient community.

If your applicants do not reflect the diversity of your community, change your recruitment strategy. Advertise—partner with diverse organizations throughout your community. Ask your community for help.

Remember that increasing the representativeness of your leaders will elevate your entire healthcare community. Diverse teams are more stable, productive, creative, and energized. Your diversity will become your greatest asset.

6. Ensure each candidate is discussed for an equal amount of time.

Finally, structure equity into your selection process. A cursory discussion of the candidates makes it easy for a selection committee to make a snap judgment or fall into groupthink.

Committee members can reduce structural bias by ensuring that each candidate is discussed for an equal amount of time. Whether or not you like the individual or think they’re a good fit, challenge yourself to consider their strengths, weaknesses, and leadership capabilities.

Assign one committee member to play Devil’s advocate and invite this member to hold the group accountable to consider both strengths and weaknesses of each candidate.

These six actions will help you and your team reduce structural inequity as you build the diversity of your organization’s leadership capacity.

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