The Path to Inclusion in the OR: Tips for the C-Suite

Here at Whitman Partners, we are frequently asked to include diverse candidates in our Directors of Surgical Services pool. As a result, we’ve adopted the mindset that “every search is a diversity search.” It’s a good policy, but is it enough? Unfortunately, the data tells a different story. The Institute for Diversity in Health Management (IFDHE), an affiliate of the American Hospital Association, shows that the percentage of minorities in healthcare executive positions is low: 11%. In first and mid-level management positions, the numbers aren’t much better: 19%.

So last year, prompted by the Black Lives Matter protests, we launched our first annual BIPOC Perioperative Leaders to Know recognition award. In celebration of Black History Month, we went back to the BIPOC award winners from 2020 and asked them how CNOs and COOs could make operating rooms more diverse and inclusive? Their recommendations are below, the main takeaways bolded from each for you to digest easily. There are amazing ideas here, including the one that brings us back full circle: the need to look at the data.

Dr. Edna Gilliam, DNP, MSN, MBA, RN, CNOR
Senior Director Perioperative Services, Nemours Children’s Health System

Partner with historically Black colleges and universities. “There is a slew of talent graduating soon and I think COVID has given us the option and the ability to connect with educational institutions all over the world. You can set up virtual job fairs. There are also a lot of colleges looking to partner with facilities where their students can have an opportunity to complete their clinicals and research projects. This is a great way to be in a position to recruit BIPOC talent.

Hospitals also need strong policies in place to address discrimination and advertise their efforts. My organization, Nemours Children’s Health System, has done a phenomenal job in this area. Our CEO put together a committee that includes frontline team members, leaders, physicians, and nurses, called DRIVE (Diversity, Anti-Racism, Inclusion, Value, and Equity). We look at retention, recruitment, pipeline programs, research, and staff development and education.”

Dr. Katie Boston-Leary, MBA, MHA, RN, NEA-BC, CCTP
Perioperative Executive Consultant

Get the data. “Purpose and intent are great but being data-driven about this is even more important. There has to be a structured approach to increasing diversity in your organization. It starts with understanding your data and engaging your Human Resources Department.

Context is really important because overall the numbers may give you a sense that you’re a diverse organization. But where exactly are people working? You can see your total numbers and think they are good, but most of your BIPOCs are in entry-level positions because that’s where the opportunities are and there is less resistance to hire into those positions. We need to heavily focus on improving diversity in the roles that require additional levels of education, preparation, certification, and licensure.

Partner with your local community. Many healthcare institutions were established before the 1980s and have long histories of discrimination and racism, so it’s important to acknowledge that, be transparent and partner with those very community members on diversity efforts and opportunities.”

Brian Dawson, MSN, RN, CNOR, CSSM
System VP of Perioperative Services, CommonSpirit Health

Instruct the Recruiters. “When I served as a CEO, I worked hard to have a diverse leadership team. That means different genders, nationalities, sexual orientations, cultures, etc. The panel choosing candidates should also be individuals of diverse backgrounds that represent the OR, PACU, Pre-Op, and SPD.

Search firms need to diversify their recruitment staff by hiring Black, Latinx, and Filipino account executives to amplify their outreach. There is a large percentage of Filipinos in nursing and there is a significant number of Filipino nurses in CA that we have tapped into for leadership opportunities. Hiring nursing leadership recruiters that used to be OR Directors would be a huge benefit to any HR firm.

Everyone has to play their part to achieve diversity in healthcare leadership. We have to go beyond lip-service. The key to increasing leadership diversity and business growth is widening your recruitment net. To achieve that goal, adding diversity to your recruitment force is the first step. I don’t think people fully appreciate the work that needs to go into improving diversity among our health care leaders.”

Byron Robinson, MSN, CNOR, CSSM
Senior Director Perioperative Services, Methodist Le Bonheur Healthcare

Engage the C-Suite. “CNOs should be intimately involved in the interview process and be open to hiring qualified BIPOC candidates. Routine meetings or check-ins with BIPOC perioperative leaders to address potential needs and mentoring will help with retention.

The relationship between the perioperative leader and the CNO varies from organization to organization. Some report to the CEO or COO. But overall, I believe it’s important for C-Suite members to ensure that the perioperative leader, BIPOC or otherwise, is included in any new developments in nursing within the facility.”

Chris King, MHA, BSN, RN, CNOR
Director of Perioperative Services

Address the elephant in the room. “The C-Suite has to be comfortable with the uncomfortable. I’ll be blunt and say that too often, some are uncomfortable with the idea of a BIPOC individual potentially being the face of a critical service line, such as perioperative services. It may be tied to misconceptions or an unconscious perception that minorities aren’t capable of leading a hospital service line, that they don’t have the knowledge base, or have the connections and network to be successful in a perioperative leadership role. These roles, be it manager, director, or VP, are high profile.

So, self-awareness and honesty are important. I have had colleagues, especially during this past year with the pandemic, ask me how I felt about these things and our relationships have grown. They didn’t realize they were thinking or feeling a certain way. My other piece of advice is to not be afraid to help a minority network. Oftentimes, we may not know how important it is to network and that any connection we make today, may come full circle for us five years from now. I would challenge the C-Suite to involve minority leaders, perioperative or otherwise, in that networking process.”

Robin Menefee, MBA, MSN, RN
Regional Director of Operations, Palo Alto Medical Foundation Surgery Centers

Pull in the additional voices. “Please don’t avoid issues regarding diversity. As one of the few people of color within my division and the only female executive BIPOC leader, I was proud to see that my organization created a platform for all employees to join in and share their feelings about what was happening in the world during the Black Lives Matters events.

BIPOC leaders like any other leaders appreciate being asked for their opinions and enjoy being heard when they share their thoughts. Seek to actively engage them in meaningful conversations about race and diversity and how they feel about your organization’s representation of people of color.

When leaders of color espouse their frustrations lean in and really listen. That will communicate that you understand what they are saying is important. Echo back what you heard them say to confirm understanding. Then work together to figure out how to best address the concern(s). This is not special treatment, everyone should be treated this way and too often, that is not the case.

This is how you can create an environment of inclusivity, mutual respect, open communication, and appreciation for that person and what they contribute to the job. True growth would be arrival to a time when leaders of color are appreciated for their diverse views and multifaceted contributions to their roles. Being able to show up without filters and flourishing as their authentic selves within the workplace.”

Shelba Dujon, MSN, BSN, RN, CNM, CNOR
CNO, former Director of Surgical Services, Big Bend Regional Medical Center

Learn the cultural differences. “I think the C-Suite should understand that when working in a diverse environment, there will be cultural differences. There are aspects of each individual’s cultural beliefs that impact behavior in the workplace. These cultural differences can manifest in several ways depending on the unique background of each individual. For example, people from different backgrounds communicate and provide feedback differently depending on how they were raised. Some people tend to expect eye contact and speak and say exactly what they mean in a conversation, while others are not as confident and hold back. Therefore, acceptance, understanding of cultural competence and effective communication are necessary to work collaboratively with others of all cultures.”

Will Bryant, DNP, MBA, NE-BC, CNOR
Senior Director of Perioperative Services at Montefiore Medical Center

Hire from within first. “Before you decide to fill a position of power and influence, assess your talent pool within the organization. Is there a talented person who is ready to step into a leadership role? Sometimes there is a natural inclination to look beyond where you are and find someone through a recruitment firm or networking channels available to the organization. I really encourage leaders to look within your organization first, particularly at facilities in metropolitan areas, where there are a significant number of minorities that constitute the everyday environment of care that might make good candidates.

Oftentimes people don’t make it clear that they have an interest in being promoted or have a skillset or talent that stands out. They are waiting for someone to promote them, instead of positioning themselves to have the conversation in the event a position inside their wheelhouse becomes available. There is definitely an entrepreneurial aspect in leadership roles. The reality is that some people who are in leadership positions aren’t necessarily there because they are the most qualified or talented or capable. But they knew how to sell themselves, how to have conversations, and know how to work the system to their advantage. You have to strike the right balance between having an entrepreneurial flair to yourself and being humble in your approach.”

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Carisa Brewster

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The Path to Inclusion in the OR: Tips for the C-Suite