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Im­proved health­care re­quires re-ex­am­in­ing long-held no­tions

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Re-ex­am­in­ing long-held no­tions is one path to im­prove health­care

We make as­sump­tions. Most times these as­sump­tions are based on ex­pe­ri­ences in our lives from which we learn. Many times these as­sump­tions can be help­ful be­cause they struc­ture our world in mean­ing­ful ways. But what hap­pens when as­sump­tions hin­der our world? And when that oc­curs, how do we at­tack those harm­ful un­der­ly­ing as­sump­tions so we can shape our en­vi­ron­ment in a pos­i­tive way?

Last year, I had the great honor of ac­cept­ing the chair­man-elect po­si­tion at the Amer­i­can Col­lege of Health­care Ex­ec­u­tives, and as I was walk­ing through the lobby of the ho­tel with my hus­band, I ran into an ac­quain­tance. He be­gan to make in­tro­duc­tions to a col­league I hadn’t met, in­di­cat­ing that he’d like to in­tro­duce him to the new chair­man-elect. Be­fore he could fin­ish, how­ever, his col­league ex­tended his hand and con­grat­u­lated my hus­band, as­sum­ing he had been named to the post.

It was a small mat­ter and an hon­est mis­take. The col­league turned out to be a thought­ful per­son who in­stantly rec­og­nized that his as­sump­tion had struc­tured a re­al­ity that led him to a faulty con­clu­sion.

Yet, we all carry these as­sump­tions with us through­out our lives. They can be­come hard­wired and even the most in­sight­ful must strive to fight through them to en­counter truth. In essence, that is the core of cul­tural com­pe­tence.

This is why the ACHE’S com­mit­ment to di­ver­sity is so crit­i­cally im­por­tant. The ACHE be­lieves that it has a re­spon­si­bil­ity to fur­ther di­ver­sity within the or­ga­ni­za­tion and the health­care man­age­ment field. We em­brace di­ver­sity be­cause we be­lieve it is an eth­i­cal and busi­ness im­per­a­tive that can im­prove an or­ga­ni­za­tion’s qual­ity and its ser­vices. This com­mit­ment is re­flected in the ACHE’S val­ues, not­ing that we ad­vo­cate in­clu­sion and em­brace the dif­fer­ences of those with whom we work and the com­mu­ni­ties we serve.

The ACHE pro­motes di­ver­sity in its lead­ers, af­fil­i­ates and staff be­cause di­verse par­tic­i­pa­tion can serve as a cat­a­lyst for im­proved de­ci­sion­mak­ing and in­creased pro­duc­tiv­ity, as well as pro­vide a com­pet­i­tive ad­van­tage. In ad­di­tion to be­ing the right thing to do, di­ver­sity con­trib­utes to an or­ga­ni­za­tion’s suc­cess

We must con­tin­u­ally ask our­selves and our col­leagues if our as­sump­tions are shap­ing an ac­cu­rate view of our world.

and im­proves the over­all pa­tient ex­pe­ri­ence.

Be­cause we be­lieve that di­ver­sity is such an im­por­tant topic, the ACHE has de­vel­oped spe­cific pol­icy state­ments that can be found on its web­site at ache.org. The ACHE’S broader State­ment on Di­ver­sity out­lines ef­forts to pro­mote di­ver­sity within the ACHE and within the health­care man­age­ment field as a whole. Ad­di­tional re­sources, such as the Di­ver­sity and Cul­tural Pro­fi­ciency As­sess­ment Tool for Lead­ers, also are avail­able on­line.

Or­ga­ni­za­tions must work to foster an in­clu­sive en­vi­ron­ment that rec­og­nizes the con­tri­bu­tions of and sup­ports ad­vance­ment for all, re­gard­less of race, eth­nic­ity, gen­der, re­li­gion, age, sex­ual ori­en­ta­tion or dis­abil­ity, be­cause an in­clu­sive en­vi­ron­ment can en­hance the qual­ity of health­care, im­prove hospi­tal-com­mu­nity re­la­tions and pos­i­tively af­fect the health sta­tus of so­ci­ety.

The ACHE pro­motes the con­tin­u­ing de­vel­op­ment of di­verse lead­ers by en­cour­ag­ing on­go­ing learn­ing op­por­tu­ni­ties through pro­grams such as the Al­bert W. Dent Schol­ar­ship, given in honor of the first African-amer­i­can fel­low of the ACHE, post­grad­u­ate ad­min­is­tra­tive fel­low­ships, and Ex­ec­u­tive Pro­gram and Se­nior Ex­ec­u­tive Pro­gram schol­ar­ships.

The ACHE also is a found­ing mem­ber of the In­sti­tute for Di­ver­sity in Health Man­age­ment and sup­ports its work. Pro­fes­sional health­care or­ga­ni­za­tions rep­re­sent an­other mech­a­nism to foster lead­er­ship op­por­tu­ni­ties, and the ACHE has strong work­ing re­la­tion- ships with the Asian Health Care Lead­ers As­so­ci­a­tion, Na­tional As­so­ci­a­tion of Health Ser­vices Ex­ec­u­tives and Na­tional Forum for Latino Health­care Ex­ec­u­tives.

In col­lab­o­ra­tion with other na­tional or­ga­ni­za­tions, the ACHE sup­ports the Eq­uity of Care ini­tia­tive, a na­tion­wide call to ac­tion that seeks to elim­i­nate health­care dis­par­i­ties and im­prove qual­ity of care for all pa­tients.

We as lead­ers also need to di­rect more at­ten­tion to the needs of the les­bian, gay, bi­sex­ual and trans­gen­der com­mu­nity. If we are to truly em­brace the con­cept of cul­tural com­pe­tence, we must de­velop in­clu­sion­ary steps for this pop­u­la­tion as well. As a start­ing point, the Joint Com­mis­sion has al­ready is­sued im­por­tant pa­tient-cen­tered care guide­lines, cov­er­ing such crit­i­cal ar­eas as visi­ta­tion rights.

As our in­dus­try un­der­goes ex­tra­or­di­nary trans­for­ma­tion, it is im­per­a­tive that we use this as an op­por­tu­nity to fur­ther our goals around cul­tural com­pe­tency and di­ver­sity. This will be an im­por­tant foun­da­tion for the ACHE’S ef­forts in the fu­ture.

To ef­fec­tively man­age the care we pro­vide to the pa­tients we serve, we must un­der­stand that there is far more to ad­vanc­ing qual­ity than new tech­nol­ogy and in­no­va­tive in­ter­ven­tions. With­out a doubt, they are crit­i­cally im­por­tant. But no sur­gi­cal ro­bot, no break­through in ge­nomic se­quenc­ing will ever guar­an­tee the com­fort we ex­tend to the pa­tients we serve more thor­oughly than a ba­sic un­der­stand­ing of hu­man need.

We must con­tinue to chal­lenge our­selves and our col­leagues to re-ex­am­ine our long­stand­ing no­tions. We must con­tin­u­ally ask if they are help­ing to shape an ac­cu­rate view of our world—and if not, we must be pre­pared to re­con­sider them as we ad­vance health­care to the next level of com­pe­tence.

Gayle Capoz­zalo is chair­woman of the Amer­i­can Col­lege of Health­care Ex­ec­u­tives

and ex­ec­u­tive vice pres­i­dent of strat­egy and sys­tem de­vel­op­ment at

Yale New Haven (Conn.) Health Sys­tem.

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