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The Power of the board in DEI endeavors: Children’s Minnesota

The Power of the board in DEI endeavors: Children's Minnesota

Diversity, equity, and inclusion are important strategic initiatives across many industries—but leaders at the recent NRC Health 2023 Pediatric Collaborative believe that they may be most important in healthcare. 

“I would argue that DEI is probably even more important or more impactful in the healthcare space, because we know it is directly related to patient experience and outcomes, and that’s a big deal,” says Laura Orr, Founder and President of Ford Governance Consulting. 

Take Children’s Minnesota, for example. The organization serves about 140,000 unique patients and families annually—almost half of them families of color. And about 15% of those visits involve interpreter services: the hospital interprets about 70 languages yearly.  

Minnesota consistently ranks among the top states in the country on a variety of outcomes for kids, health outcomes, educational outcomes, and economic outcomes, and has some of the largest disparities between white Minnesotans and Minnesotans of color. Dr. Marc Gorelick, President and CEO of Children’s Minnesota, says that they’ve had an imperative to address issues of diversity, equity, and inclusion in their organization to decrease those health disparities, and provide more equitable care for all those patients and families that come to them. 

A key element of the organization’s approach to promoting health equity is increasing the diversity and inclusiveness of our workplace, which occurs at all levels of the organization.  

“You can see that 30% of that team are people of color,” Gorelick says. “The next level down is similarly about one-third employees of color. Overall, across the board, we’ve increased from 19% employees of color in 2018 to just over 25% at the end of last year. Our new hires, year to date in 2023, are 41% people of color. Our goal is to get to 34% by the end of 2025, because the research shows that if our workforce more accurately reflects the population coming to us, we will get better outcomes for everybody. It’s not easy work, and we’ve only been able to make the strides we’ve been able to make because we’ve had buy-in and support from our board of directors.” 

The framework Children’s Minnesota follows consists of the following: 

Strategic oversight: Orr says that most people may know that a board has responsibility for the oversight of an organization’s general strategy. “Your DEI strategy is no different,” he says. “And some organizations are launching what I would call stand-alone DEI strategies; some are now incorporating a DEI lens into their already existing organizational strategy. There’s no right answer. The right answer is that they are focused on it and moving the needle forward. The board needs to be keenly aware of the current state of something like DEI. Where are we as an organization, and where do we want to be? What’s our desired state? They need to have a really good understanding of that difference. 

“We actually don’t have a DEI strategy,” Gorelick adds. “We have DEI as part of our strategic plan, woven throughout many elements of it. And as the board reviewed and approved the strategic plan we’re now in, which covers 2022 through 2024, we’re almost halfway through. They bought into that, and it is a standing agenda item at our board meetings. We give updates on DEI-related issues, including some of the cultural issues with the board that we’ll talk about.” 

Quality oversight: “We bring disparities in the organization—which we’re finding through good data and analytics—to our board and saying, ‘Here’s where we are. Here’s the current state of the disparities within our organization.’ And then we’re moving on to improvement initiatives,” Orr says. “The board needs to be aware of the disparities and what we are doing about them—how we’re investing, how we’re changing that and then monitoring that progress.”

“I would say that this is where there’s an incredible opportunity for those of us who care about both patient experience and diversity, equity, and inclusion, because those are two of the core domains of quality,” Gorelick says. “We do this in multiple ways, because I think most boards of healthcare organizations see their primary responsibility as ensuring the quality of care, whether through provider credentialing or their quality committee’s reporting. They see that as a core thing, so we’ve tried reinforcing it. One way we do it is through data, but we also do it through stories and anecdotes.” 

Board composition and culture: “The way you do this is through a very intentional—again, very strategic—multi-year cultivation plan,” Orr says. “What I mean by that is that there are senior leaders in your organization, and a few board members in your organization, who are tasked with being very strategic in who is put on our board for the next two, five, or ten years. And I would say that we are at a point in history where it is more important than ever to consider diversifying our board. Because what happens at the very top is starting to set culture, and that’s this inclusive piece.” 

Gorelick recalls that in the early days at Children’s Minnesota, they had a lot of really good people, most of whom were CEOs of small- to medium-size companies—and all of whom were male and white. “Great people,” he says, “but not a lot of diversity, of thought or otherwise. So we’ve moved to a system with a list of skills and competencies we’re looking for—legal, regulatory, healthcare, finance, health equity, and community relations. Then we also have a list of other characteristics. What part of the region do they live in? We’re seeking diversity of geography, gender, sexual orientation, and race/ethnicity. And we try to get balance as we’re recruiting new board members.” 

Championship and advocacy: “Board members have to provide internal support,” Orr says. “To be most successful, your board members have to be visible. They’re not as visible as your leadership team, but they can lend their voice to some newsletters; you may see some writings from them on your internal website; you may see them at events. I often see organizations doing patient rounds with their board members, and they are some of your best external ambassadors out in the community. Our board members, who are almost all volunteers in the nonprofit healthcare space, are significant business leaders in the community with a lot of connections. They’re out there talking about the great things that are going on within your healthcare system, and they also have an opportunity to get out there and talk about the great DEI work that’s being done that can draw attention and resources and collaboration, at times, to your organization in a very different way.” 

“With that support,” Gorelick adds, “the people I work with and I can be out there trying to drive change that will help make not only our institution, but also our community a more equitable and inclusive community on behalf of our kids.” 

Click here to learn more from the NRC Health 2023 Pediatric Conference.