Health care organizations have long questioned what their role is in their communities and how to approach health equity.
Barry Ostrowsky, President and CEO of RWJBarnabas Health, spoke with Rachel Woods of Radio Advisory to talk about the role of social justice in a healthcare organization and the specific steps it has taken to integrate equity into every aspect of RWJBarnabas Health’s strategic plan.
For more on Ostrowsky, including why he “tore up the mission statement” to realize his approach to diversity and inclusion, listen to the full episode of Radio Advisory below.
The Health Sector CEO’s Guide to Advancing Health Equity
Rachel woods: You were talking about the exact same advice we give to every healthcare organization. It’s not about doing this or that, it’s really both, and you have to have investments dedicated to health equity, investments dedicated to social aspects. But you also have to think about the impact on the stocks in your existing portfolio, right?
We’re building this building, how can we make sure we reach out and use local black-owned businesses where possible? But that doesn’t mean that we don’t also create dedicated strategies to say, increasing diversity in the leadership ranks, it has to be both.
Barry ostrowsky: We have always been criticized – our organization in particular – for having 100 number one priorities, everything is a number one priority. So that’s right, you can’t do it that way, but you can also do one thing at a time. You’re going to have to do several things at once, and our system has about 40,000 employees and people. So it’s a big operation and she has the capacity to do a lot of things at the same time.
And as you point out, you have to have quiet investments in some areas and joint investments and others, you have to have partnerships with people in the community, you have to do all of that if you want to have an impact.
And one of the things we should be talking about is what you come across, which unfortunately is structural racism, which we have now taken over the past 14 months as a very serious tenet of our existence. Unless you address that, you’re going to constantly be reluctant, openly and subtly, to some of the things we want to do socially, unless you know you have to be an anti-racist organization. . It is an uncomfortable subject.
Woods: And where exactly does this fit into the process, the operations, the strategic plan that you set out to rebuild eight years ago? Where does acting as an anti-racist organization fit in or how does it work?
Ostrowsky: It requires a certain integration and a certain balance, but it requires real concentration. So, as I tend to describe, we have a clinical platform with all the medical schools and things of that nature, as well as clinical facilities. We have our platform of social programs, from food to housing. And then what we decided to do is create an Ending Racism Together pillar that permeates everything. So it’s more of a horizontal pillar if you will, but it has a low-key executive head, with a low-profile set of programs and training that we deliver across the organization.
The board of directors has set up a committee to oversee this pillar. And so the anti-racism pillar, as I say more like a horizontal log, must be part of everything we do, including medical education which, moreover, has been structurally racist for a few hundred years.
Infographic: 7 excuses not to make health equity a priority in word and deed
So the students that we teach in medical school — from the way we have developed and cared for, to what we do in social programs — all of this has to have a teaching, training, learning vein. anti-racist program and behavior. And that’s probably among the frankly clinical and end-of-life conversations, the Ending Racism Together conversations that we’ve had over the past 14 months, have been the most difficult conversations we’ve had.
Woods: I want to ask you a somewhat optimistic question, because in the last 14, 18 months we’ve seen a lot of organizations appoint someone to a new position. Maybe they had never had a DEI manager before, maybe they added an equity manager. And what I find is that one challenge when appointing just one person to one of these roles is often that they are only a leader in name. When I start digging into the layers of resources that this team has, does it really have the autonomy to make management decisions? Who else is on their team?
I hear a lot of organizations fail, and it’s almost like, “Well, we put this person on a pedestal, but we didn’t give them anything that they really needed to be successful. I haven’t heard that this is the case with you, but I would like to ask you what kinds of resource investments did you have to put into this team in order for them to really succeed in transcending the clinical and social pillars?
Ostrowsky: We have had a very active DE&I program for years. We had an executive leading it from the board level down to the grassroots. We’ve been able to diversify a lot, not enough in decision-making roles, I have to say, but we have a very diverse workforce. But not the people who make the decisions. We were vastly under-represented, but we had this structure, we had this infrastructure of leadership and resources to end racism now, and we have to somehow, as you pointed out, establish. a link with attention to social determinants and DE&I.
And now we have this executive running the Ending Racism Together program, which has a full staff of outside consultants. So she works with our DE&I manager and our Social Impact and Community Investment manager, three executives who, at the end of the day, are people of color.
But it just so happens that these three people collaborate on the program and, of course, how we deliver it. In my opinion, you can’t give all of this to one frame.
In addition, there is no chance that you will be successful in DE&I unless you destroy races. People hire people who are like them. So I said to our DE&I manager, I said, ‘Look, you are doing a great job. But the reason you’ll never get to where we all want to go is because we have racism in our system. to get rid of it, so that DE&I can actually achieve its aspirations. “
So what I’m really happy with, after a little bit of field in whose field, is that these three executives working together are applying for three separate executive vice presidents, all of which have budgets and staff, you can now start addressing these things to yourself more effectively.
The easy way out is to appoint someone to oversee that, and you send it to seminars across the country most of the year and report back. I don’t really like it. Frankly, I don’t do this myself. So we got serious about it.
The only thing is, Rae you know, this stuff costs money and nobody’s reimbursing you for this stuff. And so if you don’t have a commitment, or your board is reluctant about the financial aspects of it, or there’s a lot of criticism about it. “We have the money to do it, but I can’t buy a new ultrasound machine at this clinic.” It’s going to happen, it’s going to be part of the challenge of taking on some of these missions, even if no one is paying for it.