e047. Health Equity with Dana Beckton

#IncludingYouPodcast Interview with Dana Beckton

Full Interview Transcript

[00:00:48] Amy: Welcome back to Including You. I’m your host, Amy C. Waninger, the Inclusion Catalyst. With me today is my friend, my client, my just, oh, one of my favorite people in the whole entire [00:01:00] world. I love this woman so much. Her name is Dana Beckton, and she is the VP and chief Diversity Officer at Sentara. They are a hospital conglomerate, and they employ 30,000 people across Virginia and North Carolina.
Dana, welcome to the show.
[00:01:16] Dana: Amy, thank you so much for inviting me. It’s a pleasure. It’s always a pleasure talking with you. This is going to be fun and I’m really looking forward to sharing with your audience.
[00:01:26] Amy: I wanna be very respectful of your time, ‘cause I know you’re in a media frenzy right now with everything you have going on.
But I wanna talk really specifically about the work that you’re doing at Sentara. Why is it so important for your company your hospital to be focused on inclusion?
[00:01:43] Dana: Great question. Great question. So, my role was actually, I’m actually the first Chief Diversity officer at Sentara. My role was created, and I was, I came in 2019.
And there was a recognition from the board as well as our executive leadership team that we [00:02:00] needed to have a specific and intentional focus on diversity and inclusion. Recognizing that, and this was pre-George Floyd, pre pandemic. But there was a recognition that both from a team member perspective as well as how we engage our patients our consumers, because not only are we a hospital, but we are also a health plant.
So, we’re an integrated delivery network. So thinking about all of the things that impact our health, recognizing that there are diversity components that are important for us to recognize, cultural competency, it’s important for us to recognize so that we can deliver the best care and services to our communities.
[00:02:44] Amy: In so many instances where I talk to people who are leading diversity and inclusion work, it’s not life and death. There are components of the work that are very important. There are components of the work that are trauma inducing for employees. They can be, they [00:03:00] can wreak havoc on people’s health. But in a hospital setting, we are talking about patient outcomes that are literally life and death based on the biases of the people and the processes associated with everything from intake to surgical care, to aftercare to nursing and staffing.
There is really- pharmaceuticals. All of it is a life or death decision.
[00:03:25] Dana: Absolutely. And it’s, it’s interesting, ‘cause you talked about there’s, there are structural things that are very important for us that can either create barriers to inclusion and they’re also behavioral.
So when we talk about mindsets, when we talk about relationships, one of the things that the pandemic showed us is that we don’t have the trust of the communities that we are looking to serve. That can create a barrier to us being able to provide the best care. We saw that with the vaccines. The, if [00:04:00] there’s, if the folks that we are trying to serve, recognizing historic-
So this wasn’t just things that popped into people’s head. There was historic, pre protocols, if you will, that created that level of mistrust. So we have to make sure that we are engaging our communities in a way so that we can deliver the best care. So it’s not, so it’s multifaceted how much this comes into play when you think about healthcare.
You hit on some of the really he highlights of some of the things that we know in healthcare. And then when we start to look at statistics… When we look at maternal health. So across the board, maternal health in the US is one of the lowest out of the 10 similarly situated countries.
But then when you look at the dynamics of not only is it, are we, do- having poor outcomes in general. When you start to disaggregate the data based off of race and [00:05:00] ethnicity, it gets even worse. It’s three times worse for African American women. It’s, I think it’s two times worse for Hispanic women, Asian women. So those are all things, when we talk about structurally what is in place that is impeding proper maternal health?
And coupled with that is it, are there things like bias? Are we listening to women when they tell us that something’s not right, that they need certain care? When we think about things like language. It’s just so complex and we’ve gotta mix all of that in together and be intentional around how we address all of that so that we can have better outcomes.
[00:05:39] Amy: Yeah. ‘Cause it’s not just the outcomes when people come in, it’s getting them to come in the first place. Exactly. If people are afraid that they won’t feel welcome, that they won’t be listened to, that they won’t be heard, they’re likely to stay home and get sicker or stay home and get worse or stay home and, that can be really tragic for them and their families and…
There are so many people who have been so [00:06:00] excluded for so long or so mistreated for so long by the healthcare system, and I think it’s amazing what you’ve been doing, not only to get out in front of that in the community, because I know that you’ve done a lot of work in your community, but also to make sure that your employees understand why that community engagement is so important.
[00:06:19] Dana: And it’s also important because our employees are our community. When we think about the community and going out into the community… I’m really blessed that, at Sentara when they created my role, they also created a senior director of health equity. So we have a health equity arm that is also looking at and is very involved out in the community.
If you think I’m involved, she is the one that is like hands on. Everyone knows her. She is on call. Folks call her morning, noon, and night. And she’s looking at things like social determinants of health. So when you talk about like it’s not just in the hospital, but it’s also what are those other factors that are playing out around [00:07:00] economics, housing, employment. All of those things also play a part in how well someone can access healthcare.
So we also, as Sentara, we have a responsibility to address not only the in-hospital aspects, but outside of our walls. What does that look like for us? And recognizing how different cultures, different backgrounds, different social economic status, folks in different social economic statuses, how that also can create a barrier to them accessing care.
[00:07:31] Amy: Oh my gosh, I, we could talk about this all day. I am, I love talking to you. So, what do you think is one critical initiative that you’ve been able to implement since 2019 that’s really moved the needle for inclusion at Sentara?
[00:07:47] Dana: Wow. Oh, I only have one, huh?
Amy: You can pick two.
Dana: But, I want, one of the things that I will say is because this was new work for Sentara…
Foundationally just [00:08:00] getting people comfortable talking about this because, for some folks talking about the very real realities of race, ethnicity, culture, language difference in general. If this is new for you, it can be uncomfortable. So we, you I’m really proud of the fact that at Sentara, We’ve had this initial journey.
I say we are now, we were at the infant stage. We’re now at that toddler stage where we can stand up now and we can walk, we can walk. We might have to hold on a little bit, but we can walk it. And a part of that has been from top down, getting leaders, getting our hospital presidents who have been phenomenal in engaging with this work and getting our team members even comfortable having the conversation.
That is a huge first step. Secondly, I would say it’s been this triad partnership between the diversity, inclusion, and cultural competency function that [00:09:00] I lead; the health equity team that I mentioned; and also our government affairs and community relations team. So they are our sponsorship grant arm.
So together, along with some other team members, we have really been able t o address those social determinants of health that I mentioned. I’m really proud of the fact in 20- I have to remember what year we are now, this is 2023. In 2022, we funded over a hundred different organizations who are at the grass roots of doing this work because they know their communities. They know what the communities need.
So we have funded, I think it’s like $11 million to these organizations to go out in the communities to help their, help their neighbors through things like, as I mentioned before, housing, skilled careers.
We’ve done things like getting better access. So we’ve stood up a number of community clinics. We have mobile vans where we go [00:10:00] out into the neighborhoods. So we’ve been able to do all of those things and we’re, right now, I’m leading an initiative called Project Choice, where we’re really looking at not just getting people into those front door jobs, those low skill, low wage jobs, but how do we encourage everyone from middle school students all the way up through college to go into those careers in healthcare that are mid to high skill, mid to high wage-earning jobs?
Because there’s an economic component that’s important with that as well. And when you talked about building trust, as we build more healthcare workers who are at that front line, who our patients can see when they come in the door that’s what helps them build that trust.
Because they see someone that looks like them, that can understand their lived experience and be able to advocate for them.
[00:10:58] Amy: That advocacy is so [00:11:00] important. Representation matters tremendously, but it’s what happens when the patient leaves the hospital, and the doctors are doing morning rounds or the doctors are doing their case collaborations, or the nurses are talking at the nurses’ station?
It’s the things that happen among the staff that carry through the long term. Beyond that one patient, beyond that one case or that one illness, or that one hospitalization. And like I said, representation is important, but that advocacy is key if you wanna create long-term sustainable change.
[00:11:36] Dana: Exactly. Being able to share stories, being able to have a colleague that you can go to and say, “You know what? I just had this encounter with this patient. Can you help me?” ‘Cause I- we talk about cultural competency and, within this field there’s a lot of debate whether or not the goal is cultural competency or if the right terminology is cultural humility or cultural awareness. [00:12:00]
For us, what we want is number one, to have cultural humility to recognize there’s more than one way to see a situation. There’s more than one way that people embrace and or encounter healthcare. So once you have that cultural humility, it then should spur you to have some cultural awareness to seek out, to learn about the different cultures, the different differences that make a difference in people’s access of healthcare.
And the way you can do that and build that awareness is if you have team members that might have that shared experience. And if you open the door, remember what I said about foundational, being able to even talk about it. If you open the door that people feel safe and feel okay with asking the questions.
And having someone there that could answer the questions. That builds up and starts to create that cultural competency. So now you can recognize and say, you know what? I know everybody is [00:13:00] not a monolith, but now I have language to ask the question where I might not have asked the question of a patient before.
Now I have some built in background that I can feel comfortable in asking a patient to say, “How do you want to be referred?” And I don’t default to my own cultural way of how I refer to people and think that’s how everyone wants to be referred to.
[00:13:24] Amy: It is just so important. And it establishes trust early. Yes.
And it, it really puts the patient in a place where they feel like they can share. They can talk about what’s going on. I’m curious, with all the work that you’ve done, what kind of results are you seeing at Sentara?
[00:13:38] Dana: So it’s amazing. When I first started back in 2019, I’ll use this one example: our employee engagement survey.
So we had, every year we do an employee engagement survey. When I came in, I asked, can we just aggregate the data? Because it’s one thing to say, on average, our engagement score is X. [00:14:00] It’s another thing to then drill down and look at different demographic breakdowns to understand is that experience consistent across differences.
So we initially, we disaggregated it based off of race, gender, tenure, and generations. And what we saw is, as I expected, there were variations in experience, that not everyone was experiencing Sentara the same. There were some demographic groups way above the average. There were other groups that were way below the average.
Then we also created something called what I call inclusion indicators. So there were questions that spoke to, regardless of difference, how included do you feel? Because that’s the other thing that’s really important. We talk about differences and sometimes people go to the usual suspects, and we don’t realize that sometimes inclusion can be a very personal thing regardless of [00:15:00] what that difference might look like.
So we looked at those inclusion indicators and then, based off of that, we started to build and look at programming. How do we get in front of this? How do we create more awareness and develop that language for people to be able to talk about difference, to be able to talk about what does inclusion and belonging look like for them.
Over time, what we’ve seen is that our diversity numbers. When I say our diversity numbers the vendor that we use has a diversity index that looks at how well we’re doing in that space. And we have gotten, even through the pandemic, we have gotten high marks for that. So more and more of our employees feel that sense of inclusion. They feel that sense of belonging and we are closing the gaps of that experience.
So that, for me is like, really a shining moment because number one, it took steps for us to be open and willing to look at that data. And then number two, it shows that through the engagement of our division presidents [00:16:00] and our senior leaders, that there was a commitment to doing the work to start looking at that and closing those gaps.
[00:16:09] Amy: What you said is so important because I think a lot of companies engage in these surveys so they can say, we are doing a great job. Look. Right? We’ve hit some watermark that says that we are a terrific place to work. And the devil is in the details in those survey results because if your population, if your employee population is overwhelmingly, let’s say male, and the numbers for women do not match the overall numbers you’ve got a big inclusion problem.
If your employee population is mostly white and you’ve got a subset of employees who are black and brown, who don’t feel the same way about the workplace, that you’re 80% of your workforce that’s white feels, you’ve got an inclusion problem. And [00:17:00] so those surveys, those little badges are great.
But I always wanna ask the next question about those. Okay, who’s it inclusive for? Who’s it a great place for? Who’s it a wonderful place to be for? And then the other question that comes up, I think it’s just so important to know specifically who feels included in your organization, who doesn’t, and why?
Because that’s where the real work is.
[00:17:23] Dana: Exactly. And it’s so to answer the why. That’s the other piece of it. So we, so folks can give us information, but we’ve gotta be willing to listen to them and then act on it. So I’m, I’m really happy that we are in a place now that we’ve got a new CEO who has placed a big importance on metrics.
So I’ve been in, I’ve been in spaces and places in the past where, we can talk about diversity and inclusion, but we never have those measurable goals. Now we’re at a space where it’s oh, we want som e metrics. To look at this, to be able to say, here’s how we’ve move the needle.
And it’s not just [00:18:00] anecdotal. So I’m thrilled about that. We’re in the process of looking at organizational strategy and one of the enablers that has been declared is our diversity, equity, and inclusion work. So that is an enabler for us to attain. The strategies that we’re looking for in the next 3, 4, 5 years.
That’s important work and it’s work that has to be owned across the enterprise. It’s not just Dana Beckham’s work. It’s not just my team’s work. It’s really up to everyone to embrace this and want to put in the work to do better.
[00:18:36] Amy: That is so true. It just like quality.
It’s everyone’s job. All the time, every interaction, every task, every process. Every single piece of it is part of everyone’s job every day. That’s what makes the culture, yes. Oh, Dana, absolutely. I have so enjoyed talking to you. We must do this more often. Thank you so much for being on the show.
[00:18:59] Dana: It [00:19:00] is my pleasure, Amy.
Thank you so much. And anytime. Ready, willing, and able. ‘Cause every time I talk to you, it’s, I’m at different place, a new plateau. And it’s, it’s just been phenomenal growing and growing in this work and being able to impact so many people because, diversity, equity, and inclusion: it touches everyone.
And sometimes folks don’t understand how it touches them and they think, “Oh, that’s for someone else.” Until you start to have a conversation and then they realize, oh, that’s me too. And that’s really what we want people to understand, that this work is about everyone.
[00:19:33] Amy: We’re gonna leave it right there.
Thank you so much.
[00:20:00]
[00:20:24] Amy: That’s it for this week’s episode of Including You. Join me next week when my guest will be Janessa Mondestin of InTulsa.