Diversity, equity and inclusion initiatives: Practicing the Platinum Rule to meet people where they are

We’ve all heard of the Golden Rule: “Do unto others as you’d have done unto you” — that is, treat others as you would like to be treated. But the Golden Rule often falls short, because not everyone wants to be treated the same way.

A more inclusive approach is the Platinum Rule: “Do unto others as they would want done to them.”

According to Dave Kerpen, author of The Art of People, we all have different experiences, which helps ensure that everyone’s wants and needs aren’t necessarily the same as ours. “When you follow the Platinum Rule, however, you can be sure you’re actually doing what the other person wants done and assure yourself of a better outcome,”¹ he says.

This is particularly salient in healthcare, where patients are the focus. As such, Nathan Ziegler, PhD, system vice president, Diversity, Leadership & Performance Excellence, CommonSpirit Health, said during CHG Healthcare’s webinar, “Diversity, equity and inclusion — Moving from discussions to solutions,” that we can take the Golden Rule a step further by asking, “What is it that you need? How can I help you?” Making this small pivot beyond our own awareness to a more empathetic mindset can help us meet people where they are rather than where we are.

But it’s not always easy to see the world through others’ eyes, and making assumptions often leads to miscommunication or worse. “We’re all a little guilty of assuming that everyone has the same interests, desires, passions as we do. It’s pervasive throughout society,”² says CJ McClanahan, executive coach.

The power of empathy

Moving beyond our worldview is the first step to becoming more empathetic, which is at the core of the Platinum Rule. Empathy can be divided into three categories:

1. Cognitive empathy — Understanding and perceiving the emotions of another.
2. Emotional empathy — Sharing the feelings of another.
3. Compassionate empathy — Acting based on another’s feelings.

Empathy comes naturally for some, but according to Jessica Ellis-Wilson, CMPE, founder and principal, Practical Management and Leadership Consulting, it can also become learned behavior. She notes that organizations can practice compassionate empathy through regular exercises during team meetings or huddles. For example, your team could consider the irate patient who visited your practice last Monday and assess what happened:

• What was the patient going through?
• What was their mood like?
• What could have been going on in that person’s life that might have made them sad, anxious, scared or angry?
• How did you contribute to how that person felt?
• What could you have done or said to improve their situation?

The more you practice these types of exercises, the easier it will be for you to empathize with others. “We have to be able to … hold space for all sides to feel heard and validated regardless of the outcome,” she says.

For organizations, practicing the Platinum Rule and honing empathy skills is also a good starting point when prioritizing diversity, equity and inclusion (DEI) initiatives. These terms have been at the forefront of employers’ attention in recent years, but they have specific meanings in the context of DEI initiatives: 

• Diversity — Attracting, recruiting and hiring a diverse workforce. As Jan Stucki, MPH, diversity, equity and inclusion consultant, Intermountain Healthcare, Salt Lake City, notes, it’s unlawful to set goals around hiring for diversity, but organizations can set goals around diverse applicants. “That means sourcing, recruiting and removing barriers for diverse people, including applicants from the outside in and internal applicants for promotion,” she says.
• Equity — Upholding nondiscrimination and Equal Employment Opportunity (EEO) efforts. This goes beyond equality or giving everyone the same opportunities. As Stucki maintains, it’s “giving everybody the thing that they need to get to the same place, and some people might need more to get there.”
• Inclusion — Developing an inclusive, respectful and supportive environment where every employee, particularly marginalized and underrepresented groups, can thrive. “Inclusive organizations not only have diverse individuals involved, but more importantly, they are learning-centered organizations that value the perspectives and contributions of all people,” says Ellis-Wilson.

Although workplace diversity training programs have been around since the mid-1960s, the number of DEI programs has rapidly grown during the past few years. LinkedIn data show there was a 71% increase in DEI roles from 2015 to September 2020.³

In practicing the Platinum Rule, inclusion is a good place for organizations to start. According to McClanahan, however, it can be challenging to apply on the job. Therefore, he suggests the following steps:

1. Start with a blank slate. Many of us, especially in leadership positions, are tasked with coming up with the best solution to an issue. It’s important to keep in mind team members with different perspectives, which can prompt different solutions. Be open to considering how someone else might interpret something through their experience.
2. Listen. Give individuals an opportunity to speak without interrupting and connect with them through eye contact. After they are finished speaking, wait a second or two before responding and consider repeating what they said to ensure you are on the same page.
3. Follow through. Since we all have different life experiences and interests, take note of something from their experience that caught your attention and mention it the next time you speak to them. Similar to addressing someone by their first name, you will convey genuine interest in who they are as a person, not just another employee.⁴

What is a DEI initiative?

A DEI initiative is a voluntary organizational program that’s broader than compliance-related workplace nondiscrimination and EEO efforts.

For many organizations, the process of embracing diversity, equity and inclusion has happened over time, as their patients, staff and providers have become more diverse. “In the 27 years I have been with this practice, the makeup of our staff and providers has significantly diversified to more accurately reflect the community that we serve,” says Leah Markewicz, RN, BC, CMPE, chief operating officer, Pediatric Associates of Fairfield, Inc., Fairfield, Ohio. “In the past decade we have also seen an increase in mental health awareness and support of gender identity. This simply required that we be vocal about our support and advocacy for safe spaces inviting patients to speak openly with us without fear or judgment.”

Similarly, the impetus behind a DEI initiative may have been prompted by another initiative. “Our introspection actually began when we moved to a new office space in 2013 and realized the changes we needed to make in our physical structure to accommodate the physical needs of those with unique challenges and differing abilities impacting their mobility,” notes Markewicz.

As the practice began researching best practices for meeting the needs of this group, Markewicz pointed out that it “shined a light on so many other underrepresented groups … in our everyday attempt to provide the best pediatric care.”

As a baseline, DEI initiatives help ensure organizations are committed to making certain that employees from diverse cultural, ethnic, gender, racial and other backgrounds are supported in the workplace. But it can have the added effect of helping providers and staff better meet the needs of underrepresented patient groups. Before embarking on a DEI initiative, organizations should determine the following:

• What organizational concerns will define the scope of the initiative?
• What outcomes does your organization seek?
• How will your organization set benchmarks and define success?

 Once these questions have been answered, organizations should:

• Gather and assess baseline information, including organizational demographics, best practices, and employment policies and procedures.
• Decide which data to assess. For example, is the organization having a difficult time retaining a specific group of employees? If so, review promotions data, employee complaints, and information from employee engagement surveys and exit interviews.
• Collect and analyze data to determine whether you are reaching your benchmarks. Review applications, hiring history, promotions and terminations, but also such metrics as first-year turnover rate, employee engagement and job satisfaction, and employee resource group (ERG) participation.
• Create a plan to remedy issues such as discrimination, harassment and retaliatory conduct and/or deficiencies in development and training programs.

 After collecting and analyzing data, organizations should determine achievable outcomes along with accountability measures that align with their culture.

DEI initiatives often include quantitative and qualitative metrics to measure results and help organizations adjust going forward. For instance, Intermountain Healthcare not only measures the diversity of its employee population, but also asks questions in its annual survey about inclusivity. They then sort that data by demographic, job, leadership level, etc., so they can identify areas to be more inclusive.

Although DEI initiatives may include aspects of affirmative action programs (often used by organizations that work with the federal government), they are usually wider ranging and voluntary. Nonetheless, DEI initiatives must operate within the framework of nondiscrimination laws, so organizations need to ensure that their employees — especially those individuals who champion and implement DEI initiatives — receive training on relevant EEO and nondiscrimination legal principles and expectations. This can help reduce legal risk while boosting the DEI initiative’s chances of success.

What should a DEI initiative accomplish?

As many experts indicate, DEI initiatives need to be ongoing as results don’t happen overnight. “We realized that this is deep work; one training is not going to do the trick,” says Ziegler of his organization’s investment in its DEI initiative. “We need to have a place where people can continually learn and reflect and engage with the material and let themselves in the space.”

The journey starts with creating a foundation with leaders who are committed to getting buy-in from employees during the first couple years of the DEI initiative while also being realistic knowing that sustainable change takes time.

Analyzing diversity metrics provides insight into an organization’s demographics as well as challenges and opportunities it may need to address. Organizations can then formulate a plan of action to accomplish its goals.

For example, Ziegler’s organization sent out a 70-question survey to underrepresented groups asking them about their work experience and then compared it to responses from the organization’s white associates. “It was really meaningful data, because we were really able to pull apart things that were happening at the front lines and in leadership that could help us be more proactive and intentional,” says Ziegler. “It gave us really deep insights, more than just a typical culture survey.”

DEI metrics should be used as a component of a greater business strategy that evaluates organizational demographics and culture but also vendors and suppliers, if applicable. “We also look at our investment in our community,” says Ziegler of the relationship his organization has with other groups and individuals. “We do that by looking at our supply chain efforts, by ensuring we’re investing in the women- and minority-owned businesses within our local communities.”

In addition, if included in the business strategy, DEI metrics can be an effective tool throughout the employee lifecycle, from attraction and recruitment to onboarding, retention, development and advancement.

Once a DEI initiative is put into place, diversity metrics can be used to analyze the number of job applicants for a specific type of job based on demographic group and then formulate a plan to improve outreach and recruitment efforts for particular groups. “We have a lot of partnerships with colleges and high schools, and we’re especially interested in those that have diverse populations,” says Stucki. In addition, Intermountain Healthcare partners with community organizations such as the Department of Workforce Services and the Office of Refugee Resettlement, along with veterans’ organizations and organizations that work with people with disabilities.

• Learn more: For a comprehensive look at diversity, equity and inclusion at the organizational level, access the Society for Human Resource Management’s (SHRM) “Introduction to the Human Resources Discipline of Diversity, Equity and Inclusion.”

Intermountain Healthcare: A sense of belonging for all employees

Awarded several honors for its DEI initiative, including Forbes’ Best Employers for Diversity, Forbes’ Best Employers for Women and the Gartner Talent Diversity Champion of the Year, Intermountain Healthcare has made diversity, equity and inclusion an integral part of its culture, especially during the tenure of President and CEO Marc Harrison, MD. One of the organization’s key employee resources is its eight Caregiver Resource Groups (CRGs):

• Differently Abled
• Empowered Women
• Interfaith
• LGBTQ+
• Military
• Multicultural
• Women in Analytics
• Women in Medicine

These groups help individuals with common life experiences further their careers through networking and development. They also provide a platform for employees to share ideas and concerns and offer their perspective on organizational goals.

According to Stucki, one of the most active groups is Empowered Women, which “encourages women to elevate other women’s voices.”

“They have pretty intense discussions about the hard issues people are facing,” she says. Another highly engaged group is LGBTQ+, which provides a safe and supported space for marginalized and medically underserved communities. Stucki notes that the group is very active in the community, participating in National Coming Out Day, Transgender Day of Remembrance, and the Utah Pride Festival.

Intermountain Healthcare has also worked to have about 18 hospitals participate in the healthcare equality index (HEI), a national LGBTQ benchmarking tool that evaluates healthcare facilities’ policies and practices. “We’re still on the journey toward better serving the LGBTQ+ community. But earning this certification means you’re really working hard at it,” says Stucki.

• For more on Intermountain Healthcare’s DEI initiative, including education and training, visit bit.ly/3I1vRKR.

Strategies to promote a DEI Initiative

When implementing a DEI initiative, organizations need to determine why it’s important to their organization. Once the organization is committed to moving forward, it’s crucial to effectively share that vision throughout the organization. Although there are many points to consider in justifying a DEI initiative, two of the most important are human values and the business case.

Human values

Diversity, equity and inclusion epitomize basic human principles such as fairness, caring and respect, which every employee deserves. By educating and training staff, DEI initiatives can be used as a basis for employees to productively interact and support one another. A key point to always keep in mind is that every individual sees the world in their own way. “They may go to places with a different set of expectations than I might have,” noted Nicholas Vasquez, MD, MHSH, emergency medicine physician, during the CHG Healthcare webinar. “So I have to set aside my own experience for a second and turn my ears on and ask, ‘What do you know that I don’t?’”

The business case

When considering the business case, organizations should first determine how a DEI initiative promotes its mission, vision and values. For example, Intermountain Healthcare’s mission is “helping people live the healthiest lives possible.” Stucki notes that “everybody knows and uses that phrase very often. … It’s a unifying statement that helps us all see how our work is attached to the mission of the organization.”

Additionally, organizations can tie their DEI initiative to strategic priority areas. All healthcare organizations support equitable care, so that should carry over to hiring and training in practices. “What we’ve been very intentional in doing is that all of our talent acquisition staff has gone through bias training and we’ve implemented an equity lens in the talent process to ensure that we’re removing our bias at each stage of the recruitment cycle so that we’re not being biased about a person’s name … age, location, perceived gender or race,” says Ziegler.

“DEI initiatives create safe, equitable and inclusive spaces for our caregivers, which directly translates into creating safe, equitable and inclusive spaces for our patients,” says Stucki. “This means better health for all of us.”

When Ziegler was at Bon Secours Mercy Health, the human resources department had key performance indicators (KPIs) to measure DEI success. “We tied 24 of our HR metrics to diversity and inclusion outcomes,” says Ziegler, as the organization measured such data as pay equity, culture, manager behaviors, engagement with benefits and first-year turnover rate.

In addition, he asked the organization’s HR chiefs, who monitored and tracked performance and were responsible for diversity and inclusion outcomes, the following question: “What does the turnover rate look like for our associates of color, our clinicians of color and what is happening in their experience that is causing them to leave at a higher rate?”

Conversely, Intermountain Healthcare has developed a system-level equity steering committee that is coordinating equity-focused KPIs, measurements and culture change in every area of the organization.

During the past year, the organization added equity to its fundamentals of extraordinary care. “Making equity a fundamental of care is a force multiplier for us. All of our goals hinge on these fundamentals,” which Stucki says also include safety, quality, experience, access, stewardship and engaged caregivers. “Every department has to align its goals with these fundamentals, so recommendations on equity cascade from leaders and also travel from the front lines back up to senior leaders.”

Supporting data

Several studies, including those by McKinsey & Company and Boston Consulting Group, show that organizations that promote DEI initiatives are more collaborative, innovative and productive, ultimately leading to long-term financial success:

• Organizations in the top quartile for ethnic/cultural diversity on executive teams were 33% more likely to lead the industry in profitability.⁵
• Organizations in the bottom quartile for gender and ethnic/cultural diversity were 29% less likely to realize above-average profitability compared to all other organizations in McKinsey’s data set.⁶
• Organizations with above-average diversity on their management teams reported innovation revenue that was 19% higher than organizations with below-average leadership diversity — 45% of total revenue compared to 26%.⁷

 
According to McKinsey & Company, some of the factors that have likely improved performance include the ability to attract first-rate talent and enhance employee satisfaction, decision-making, and customer orientation.

That said, DEI initiatives look good on paper, but if organizations aren’t fully vested, they will fall flat. As noted in Harvard Business Review, “Increasing diversity does not, by itself, increase effectiveness; what matters is how an organization harnesses diversity, and whether it’s willing to reshape its power structure.”⁸

If an organization has the mentality that diversity, equity and inclusion are going to be an integral part of its culture, it has a better chance of accepting different viewpoints and ways of thinking. “For us, diversity and inclusion is a vitamin, not an antibiotic,” says Ziegler. “It’s something that we take daily, something that we exercise; that we see as an essential nutrient to a healthy body organization.”

At the end of the day, continuously monitoring data is much less important than creating and sustaining an inclusive culture. As Vasquez expresses, “It isn’t about setting a target or a goal and say, ‘there, done.’ It’s a process by which you incorporate outside opinion that is divergent from your own, and then make it part of your culture.”

Notes:

1. Economy P. “How the Platinum Rule Trumps the Golden Rule Every Time.” Inc. March 17, 2016. Available from: bit.ly/32OF5tV.
2. McClanahan CJ. “The Platinum Rule: Why It’s Time to Forget How You Want to Be Treated.” Forbes. March 23, 2000. Available from: bit.ly/3FZIlkq.
3. Anderson B. “Why the head of diversity is the job of the moment.” LinkedIn. September 2, 2020. Available from: bit.ly/3IiDE7o.
4. McClanahan.
5. Hunt V, Prince S, Dixon-Fyle S, Yee L. Delivering through Diversity. McKinsey & Company. January 2018. Available from: mck.co/3FYucE4.
6. Ibid.
7. Lorenzo R, Voigt N, Tsusaka M, Krentz M, Abouzahr K. “How Diverse Leadership Teams Boost Innovation.” Boston Consulting Group. January 23, 2018. Available from: on.bcg.com/3I5pPcj.
8. Ely RJ, Thomas DA. “Getting Serious About Diversity.” Harvard Business Review. November-December 2020. Available from: bit.ly/3o8I9Jt.