At Northwell Health, diversity efforts are tied to improving patient care

More than a decade ago, Jennifer Mieres became the first chief diversity and inclusion officer at Northwell Health.

“It’s been a long journey,” she said.

Dr. Jennifer Mieres

Nearly 12 years later, Mieres doesn’t proclaim the mission is accomplished. But she can look back and cite substantial progress at the New York-based system, which includes 22 hospitals and 77,000 employees. For two years in a row, Northwell Health has been named the nation’s best health system for diversity by DiversityInc.

In an interview with Chief Healthcare Executive, Mieres said a key factor in Northwell’s success has been linking improving diversity, equity and inclusion to the goal of improving patient care.

“This is about health outcomes and seeing our patients as partners,” Mieres said.

“That whole lens of seeing our patients as a partner means we have got to look beyond just the medical encounter and worry about how we can partner with our patients to understand where they’re coming from and customize care to meet their unique needs.”

Mieres said Northwell’s success stems from a strong commitment by leadership, engaging employees throughout the system and listening and responding to feedback from patients, staff and the community.

Engaging the workforce

When Mieres first took the role of chief diversity officer, she said there were some efforts to improve diversity at Northwell but it hadn’t become a formalized approach.

Mieres is a cardiologist and as a scientist, she said she needed to gather information, so Northwell began surveying its workforce to learn where the deficiencies were.

There were challenges throughout the process. One of the biggest early hurdles involved people simply understanding the meaning of diversity.

“People would have preconceived notions and the conversations couldn’t even start,” she said.

But she said the power of storytelling, and getting employees to talk about what diversity means to them, helped spur progress. “That was a huge catalyst,” she said.

With her experience in the system as a practicing doctor at Northwell, Mieres brought credibility as she engaged others in the system. She could talk about the importance of checking for high blood pressure or getting women to see the threat of heart disease.

“My lived experience as a practicing cardiologist definitely helped shape the vision and tell the story of how we should look at diversity, inclusion and health equity,” Mieres said.

Northwell formed teams of employees engaging on a host of issues, such as language access, a critical issue in treating patients in New York City.

“One of the key things in addition to getting buy-in is we engaged the workforce,” Mieres said.

When Northwell saw leadership was committed to improving diversity, that helped get staff to understand it was a priority. Mieres said the employee teams helped spread the message that improving diversity on staff would improve patient care.

“If you could point to one thing as a buy-in and linking diversity and equity with healthcare outcomes, it was the employee resource groups,” she said.

The murder of George Floyd changed conversations about diversity and equity, Mieres said. “It was truly an a-ha moment and a time to hit the pause button,” she said.

“There was sort of mediocre buy-in on unconcious bias before George Floyd’s murder,” Mieres said.

However, Floyd’s murder “started a conversation in naming racism as a true factor in determining health.”

‘Measure it’

Northwell is measuring its efforts to improve diversity, equity and inclusion in a host of ways.

“I always say unless it’s written, it doesn’t exist,” Mieres said. “You have to measure it.”

(In the video below, she talks more about the metrics for measuring progress in diversity. The story continues after the video.)

The system measures areas such as surveying employees about meeting the language needs of the community. More than 60% said the system is meeting those needs, up from the low 20s, but Mieres said, “We still have work to do. It’s a work in progress.”

Northwell also tracks the amount of supplies being purchased from women and minority-owned businesses as well and has seen progress. She said supply diversity is a key goal for the system.

Northwell is now looking to more accurately measure - and improve - its performance in health equity, Mieres said.

“A big area of focus now is really looking at healthcare delivery and looking at performance improvement in the clinical world,” she said.

Northwell is establishing diversity, equity and inclusion committees in each clinical department. They’ll be collecting more data on race, ethnicity and preferred language to see how well the system is managing hypertension or heart disease in patients who identify as Black and Hispanic or those who speak other languages. Those diversity committees have already been set up in the cardiology and psychology departments, and surgery is next, Mieres said.

“That’s going to be a big area of focus in the next few years,” Mieres said.

Works in progress

Northwell is aiming to bring more diversity to all levels of the organization. And that includes the C-suite.

The system is instructing search firms to present a diverse slate of candidates when recruiting for leadership positions, Mieres said.

Northwell is also aiming to incorporate more diversity into the board of directors. The system is expanding the criteria of board membership “beyond the financial contribution you’re able to bring to the table,” Mieres said.

Internally, Northwell is working on developing more future leaders in the workforce as well.

Northwell is looking to bring in more diverse doctors as well. The effort includes boosting the number of students from minority communities in the medical and nursing schools.

The system has developed a more formalized approach to improving community health equity, including the establishment of an office of community and population health. Mieres said that was necessary. Among Northwell’s key pillars in improving diversity, “the community partnership piece was our weakest link,” she said.

The community felt “we were not as strongly committed as we could have been.”

The COVID-19 pandemic was the catalyst for Northwell to strengthen its community engagement. A health equity task force was formed and went on a listening tour, and community members didn’t hold back. “They gave us honest feedback about how they felt,” Mieres said.

But it led to the establishment of the office of community health and a more focused approach to health equity. “We are ready to be a true partner with our communities,” Mieres said.

Some stubborn hurdles exist, including microaggressions experienced by minority members. Microaggressions could include disparaging remarks or simply ignoring someone.

“To me the most egregious is when someone speaks over you and you’re not acknowledged like you’re invisible,” Mieres said. “That’s the worst.’

But Mieres clearly takes pride in the gains Northwell has made in diversity and in improving the quality of patient care.

“I am an optimist. My mantra is shared mission, shared vision, shared leadership,” Mieres said.

“The team we have built represents the mosaic of people in all aspects. And I believe we all contribute, right? And everybody brings something to the table.”

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