 Good morning and thank you for joining us for a conversation about the impact of equity, inclusion, and diversity on our communities, lives, and organizations. We hope that you will take the conversation back to your organizations and advance this work no matter where you are on the continuum. It is through this conversation, learning and sharing that we evolved. So please know that you can feel safe where you're at and we hope that you will engage as we continue this journey together. I'm Jennifer Stacy and I am pleased to be the moderator for today's event. I'll start with some quick housekeeping. We will be recording the event and posting it later for you to view and for those that were unable to attend. Your cameras will be turned off and your microphones will be muted, but that doesn't mean that you can't join the conversation. We have received some questions ahead of time and we will work to incorporate those into the discussion, but you can also submit questions through the Q&A function on your screen. We'll do our best to work your questions in during our conversation today, but if we aren't able to get to them, we will follow up directly with you. And now it is my great pleasure to introduce our panelists. Dr. Ruth Chang is the Chief People Officer and Vice President for the advancement of people and people operations for Northwest Permanente. She is a family medicine physician and she is focused on equity, diversity and inclusion, recruitment and retention and wellness and resilience for our physician group. Gwen Turner is the head of equity, inclusion and diversity and talent engagement also for the physician group. With over 20 years experience driving diversity and social impact initiatives across global industries, she is now responsible for building a workforce that is culturally responsive and reflective of Kaiser Permanente's diverse membership. Deanna Dudley is the Vice President for Human Resources for the Kaiser Foundation Health Plan of the Northwest and the hospital group. She is responsible for a broad range of human resource activities, including learning and organizational effectiveness, equity, diversity and inclusion, employee and labor relations and workplace safety and workforce well-being. And finally, Michelle Teoples is the Senior Director for Mental Health for the Health Plan. She brings a long history of working to deliver the best experiences for our patients at crucial points in their lives. Most recently her work to lead the mental health department through COVID-19 has been of key importance as mental health needs escalate, particularly for those most vulnerable in our society. Now, to set the tone for our discussion, I'd like to offer you a quote from Dr. Amelda DeConis, the Chief Executive Officer and President for Northwest Permanente. Dr. DeConis serves on the Board of Directors for the Kaiser Permanente Bernard J. Tyson School of Medicine and Virginia Garcia, among others. She was named one of the top 25 minority leaders by modern healthcare for Northwest Permanente's clinical innovations, including the implementation of widespread screening for social needs and referrals to community-based resources. She's a passionate and powerful voice of change in our organization and in our community, and she embodies the philosophy, vision and desire to improve that I believe bring us all here today. Now, I'll turn it over to Dr. Cheng to kick off our program. Please give her a warm virtual welcome. Thank you so much Stacy for setting the stage for us. And I want to again thank all of our participants for logging in. I know that it takes time and commitment to carve out this space to join this webinar today. So we're really pleased that you can be part of this conversation. And we do very much want to hear from you. Our intent is to create this safe space so we can have this discussion. We welcome your input, your questions because we are ultimately on this learning journey together. So our hope is that you will take some new ideas back with you today to further not only your own growth, but to really bring about change in your parent organizations. So we hope that we have a rich conversation for today. So as you saw on the slide earlier that we have really looking at our philosophy and our intent today is to share with you what our strategy is at Kaiser Permanente Northwest with regards to equity inclusion diversity. So we'll be breaking down further around our workplace service delivery and community and what that means to us. So and, and lastly, again, we want to hear from you. So please use that chat function, and we will incorporate your questions and comments as we go. Thank you, Dr Chang. Equity inclusion and diversity can be buzzwords. And I've heard that equality approaches only work if everyone is starting from the same place. Can you talk about how we'll begin to account for historical and current systemic injustice in our workplaces and in our communities. When we know we do not all start from the same place. Yeah, that's a really key question. It's that we're not starting from the same place. And I would say even even before that maybe we take one step up and think about what do these words mean because they've been used so frequently now. And what's the difference between equality versus equity. What does inclusion really mean, and what ultimately is diversity. So if we can just take a step back. Now I think of equality or how we treat everybody equally would be giving everybody the same thing. Like on the surface that seems quite fair, you give everybody the same thing there's, and, and they can make the best of that. But equity is really giving people what they need in order to be successful and and to really support their total health. So for example, here's an easy illustration to think about. Let's say we did a community health initiative where we wanted everyone in the community to exercise more so we're going to give everybody the same bike on the surface that seems fair. But then you say wait a minute, well, what about you know the toddler that can really only balance on a tricycle, or the school age kid who needs a small bike in order to be able to get on it and ride it safely. And then what about the veteran amputee who really needs a racing wheelchair in order to get his or her exercise. So equity would be thinking through how do we give each person what they need so that ultimately they can be the best person, healthiest person they can be. So thinking through what that means, then let's move on to inclusion. So inclusion really is about the intentional creating that intentional engagement in space for every individual to belong to feel like they really are there. And I often have thought about this in the healthcare space and watched our evolution. So for example, in our waiting areas we have chairs of different sizes, you know, because if every single chair was the same size what is that telling people about what size they should be. Whereas if you have chairs of different sizes, then you'll find something that fits everybody for each person. Then there's also other simple things like what's the height of your buttons for people to access. So is it going to be wheelchair accessible, or do you have to be standing adult height in order to push a particular button for service. So there's just some basic things about even how our space communicates a lot about who belongs and who doesn't belong and as well as representation and artwork and written materials. So how do we be intentional in how we include people in the messages that we bring both spoken as well as unspoken messages. And then lastly the term of diversity. You know, oftentimes people may think about gender diversity or ethnic diversity, but diversity is really multi dimensional. So I'm certainly a woman, a woman of color, but I'm also an immigrant, and I have multiple dimensions to how I define who I am and what makes me unique, and each person has that as well. So when we roll up all those terms we really think about, you know, back to your question about how do we account for those historical differences. And I think it's one is being aware that there are a lot of historical differences that in this country that was built on the economic facts of slavery, that that multi generational trauma that our African American population experiences has really put them behind with accumulation of wealth, all the racist policies that have affected ability to have home ownership that really creates a very very uneven playing field for people of color, especially African Americans in our community. So I think we have to think through that you know even in medicine, historically medical research has included white male subjects as part of the research so a lot of the recommendations that we have proof that medications work is based on just white men, and and lo and behold, when we've done further research in more recent years, we found that not all medications work equally well for populations of color so for African Americans they might need something for Asian Americans they might have much higher risk of poor drug reactions to particular classes of medications. So those are all the things that we are continuing to work on now in medicine but certainly in larger society as a whole. Thank you Dr Chang that that really helps lay the base about how broad and complex these issues are, and really supports the need to, you know, break this down continue the conversation and start to prioritize for long term change. So, let's talk a little bit about with Diana. More and more companies can tie their equity inclusion and diversity strategies and their community involvement directly to return on investment. And with your experience not only in healthcare but within higher education and the legal legal community. Can you help start explaining this correlation. Yes. Thank you, Jennifer. Thank you everybody for joining us. Our relation is, I would say undisputable with regard to equity inclusion and diversity strategies and community involvement and the return on investment. We know, based on data and studies that, for example, take the Northwest, the Northwest population and demographics, they're changing. And by 2030, some of our minority groups may actually end up being a majority group. And so it's time for organizations to really see this opportunity to make the investment take the time to make sure that their organization is ready for this changing demographic. There are several benefits and these are the returns. First and foremost improve performance and that's what we all want for organization. We want to be able to perform at our best, whether it's providing a product or providing a service. By including equity inclusion and diverse strategies. That will help you with regard to improving your performance. We have some statistics that gender diverse organizations perform around 15% better than other organizations that are not gender diverse. With regard to ethnic diversity in organizations, they perform approximately 35% better to share a little bit of information about how we Kaiser permanent a as an enterprise performs. Our studies have shown that we see a 50% improvement with regard to team collaboration and employee commitment to the organization. And that also translates into a 12% increase just for our organization increase in productivity. So for us, it's undeniable that this is a very important strategy for organization. So an additional benefit is becoming an employer of choice and becoming an employer choice is really important these days we all understand that the generations that came after the baby boomers are smaller. They're not as big as a baby boomers. So the war for talent is real and will become more real as the years pass. And so focusing on employee retention is very important and employees stay because they believe in the mission they're comfortable with their coworkers their managers. And so, by making sure that you provide a workspace that's comfortable and welcoming for all of your employees will help with that retention. And of course, if we're increasing retention, that means we're decreasing turnover. You know, there's a statistic out there that says the cost of onboarding and hiring a new employee ranges around 30,000 give or take. That's a lot of money for companies to spend just to keep their business going. And so being able to cut down on that cost is a real benefit for an organization. Another area that shows a return on investment is really enhanced creativity. And we know from studies that people have a tendency and we all do it I do it you do it, you know, we like to be around like minded people we like to be around people who remind us of ourselves or it's easy for us to relate to them. But it's when you're having a diverse a conversation with diverse participants, when you have people who can share a different viewpoint. When you have the uncomfortable conversation when you're trying to solve a problem, because someone brings to the table and experience and a perspective that you yourself have never thought about because your life experience hasn't allowed you to get to that level of thinking. And that's when you really get the enhanced creativity and it makes your service, whether it's through the process of how you're delivering the service, or it makes your product. You know, how do you enhance or make that product better that creativity comes into play and that's really how companies are innovative and leaders in the marketplace. And finally, I talk about employee and client satisfaction. And that's another area where we can see a return on investment as it relates to equity inclusion and diversity strategies and reaching out in the community. Yes, we all like to survey clients members patients and get feedback of how we're doing as organizations, but more importantly what we also want to do is contain costs. By making sure we're providing workplaces where employees are respected for who they are, and their backgrounds, then we can do cost containment by avoiding litigation. And that is a real savings for employers and organizations. So these are just several of the ways that we see the return on investment as it relates to equity inclusion and diversity and community involvement for organizations. Thank you, Deanna. What I liked when you were talking about that while it was in the context of the business space and return on investment, it also really acknowledges that that individual has different things to contribute and then it's important to support the individual and where they're coming from then to be successful because only with a successful workplace can you serve your customers successfully. And that really segues well to a question that has come in from the audience, which talks about how we create long term change at the individual level as well because there's acknowledgement that we all are starting at different places. As we pivot to the next slide here, I think we'll be able to start that conversation, as well as touch on another area that has come in about advancing recruitment of a diverse provider network. Because we know that in the physician community, nationwide, there is an under representation of minorities. So Gwen, as we turn to you, we're looking here at examples of benchmarks that Kaiser Permanente uses for guidance and setting goals for the organization. Can you talk about the importance of these measurements and the approach to advancing this work? Thank you so much, Jennifer. This work for us has been a journey. Diversity and inclusion has been a real journey for our organization. And like many organizations, we're not there yet. We know that we have a long way to go in order to achieve equity and inclusion for all, which is the vision for our effort at Kaiser Permanente, Northwest Permanente. And so when we look at the work that we do, we look at diversity and inclusion from two lenses, two sides. One is on the workforce side, and that's that recruitment that you were just talking about. But the other one is they're also around patient care. And so let me just focus on the patient care aspects to give you some best practices and some of the great things that we're doing there. And I'll talk about recruitment of it. We have been recognized as a leader for providing centers of excellence for our patient population. But I'm particularly proud of because I came to Kaiser Permanente because of its focus on the minority community as it relates to health. And we have three centers of excellence that we have created or two centers of excellence that we've created locally. One is our Latino module that is focused on the Latino community and the health issues that arise in that particular community. We also have our gender pathways clinic and our gender pathways clinic is focused on the LGBTQ plus community and those health issues. And then we also are looking at creating a center of excellence for the African American population that is focused on things like hypertension and diabetes and some of the issues that exist within the African American community. And so we're really, really proud of the work that we've been able to do there with our physicians and the focus around that work with our centers of excellence. But then we switch over and we think about we talk about some of the work that we're doing with our workforce. And I'm really happy about the opportunity to build upon the work that we have there. And so we have a focus on a three year focus on really helping to build diversity within our physicians right within within our physicians. And what does that look like. So that looks like really creating partnerships and doing things differently than we've done them before. So one of the things that we're doing that we're really excited about is our partnership with two organizations, the National Minority Medical Association and the National Hispanic Medical Association. Both of these organizations will be great hubs for us as we start to recruit for various positions within our within our group. The other exciting opportunity is with historically African American colleges and universities that house med schools, and we'll be partnering with those schools in order to build relationships with them, and to look for the next generation of physicians for Northwest really building out our marketing for a diverse group of physicians and making the case loud and clear as to why people should come and work for Kaiser Permanente. So we're really happy about that work as well. And then lastly, one of the things that I'd like to call out is a huge accomplishment for us and an opportunity for the organization is with our newly established organization that is named after our late founder. And the school is mission based it is focused on cultivating culturally diverse physicians, and the school accepted its first cohort. In July, we have approximately 45 students within that first cohort. And we're really happy about the fact that that will then also lead us with an opportunity to be able to recruit from a brother RJ Tyson School of Medicine. So I think that as we take a look at the work we've done, we've also looked at other organizations to create benchmarks. But again, we've done some great work in this space and the best is yet to come for our organization as it relates to building a leadership position in diversity and inclusion. Thank you. I think that's very helpful. And, you know, you talked about the inner twining really of the workplace and how we can deliver care, which is the service delivery portion of our organization. And then what that means to the community. So, for the audience, what we're seeing here are really the pillars of our strategy. And I'd like to invite everybody to consider what the pillars would what pillars would be relevant for your organization when you're thinking this through. This is just a structure around how do you organize all the various aspects and start to prioritize that work. And when you're looking at workplace, we had another Q&A that came in, or I guess it's just a few will will provide the a now and then we'll have time at the end. But it talks about the employee retention strategy and how do you improve employee retention, particularly as it relates to EID. So we'll start to work that in as we go through these pillars. So, I'd like to pivot to Dr. Chang, please. Can you talk about the focus and the approach to EID in our workplace care delivery in our community and some of the concrete actions that are being taken to better serve some of the underserved communities, particularly the black community. Dr. Chang, I think we need your microphone. So, just as Gwen had mentioned, we are in the process of standing up African American centers of excellence. And this is really recognizing the fact that in primary care, we're really building the longitudinal relationship with our patients. We want physicians and staff who look like the community that they serve and also have additional interest and are well steeped in the culture and the history and have a clear understanding of some of the historical mistrust that our communities have with the healthcare system. Because honestly, in the past, we have not always served our patients well because of institutional racism, because of individual racism that was perpetrated. So we know that there's trust that needs to be rebuilt. So that's really the driving force behind us standing up these centers of excellence. You know, that was one of the key driving forces of us standing up a gender pathways clinic is that for transgender medicine, there's such specific knowledge that needs to go into taking good care of our transgender population. And not every physician knew all those details to be able to provide excellent care every single time. So we recognize that there was very much a need to create that space to have the physicians recruit the physicians who have that niche knowledge and who have a passion for serving the community and really deliver top notch world-class care for our patients. So really, you know, on the screen here, we're showing the model of what our strategy is with equity inclusion diversity. It's about workplace service delivery and community. And, you know, as mentioned earlier, not only are we here to take care of our patients, we also have a very large workforce that we want to attract, retain, develop and obviously ideally have them retire with us and have a long career with us. And what does that look like and how do we really create an inclusive work environment and acknowledge people's different beliefs and what they need to have a thriving workplace. And we mentioned the service delivery, you know, how do we serve patients across a very diverse background, especially patient populations with special needs. And then ultimately, community had to re-invest back into your community because that's where we all live and we work in the communities we serve. And knowing, acknowledging the fact that really about 80% of health and health outcomes really are determined by where you live, what family you're born into and what are your economic and social circumstances. So these social determinants of health plays a huge role in impacting the health of the population we serve. So it only makes sense that we really invest and think through how do we help our patients, not only when they're physically present in our clinic or hospitals, but how do we link them back into social services in the community to make sure that we're really wrapping the care around them. So we're really proud to be national leaders in this thought process around connecting patients to social services. And we have been promoting a tool called Thrive Local. And what that is is a social service resource locator that we've linked back into our electronic medical record. So our team of community navigators can meet with patients, understand what their unmet social needs are, and then link them into social services place that referral, but we also get feedback information to know that the referral is completed and the patient did get the services they need. So this is really a holistic approach to how we're taking care of patients. And our Kaiser Permanente Northwest is leading that work, piloting it. We're also building this tool for all of our local health care partners. So it's not just Kaiser Permanente, but now it's available with just you legacy Providence and at the other geographic areas of Kaiser Permanente throughout the country. We're also leading those conversations in those communities as well. So I think really in essence is that we see these three circles are really intricately linked together. You can't separate one from the other. But I would also say that one is you have to start at the workplace and really think about how do you create a really safe inclusive workplace to bring people in. Thank you, Dr. Chang. So that's a great segue, Michelle. We have a kind of some multifaceted questions, but I think you're all really in your bailiwick. You've got some great questions coming in about mental health diversity and when employees work with others managing a mental health workplace. As well as some that Dr Chang touched on looking at the broader person sort of financial mental environmental and Dr Chang just talked about drive local and I think key to that is the screening for those broader impacts or we call social health. Michelle, as we pivot to you and continue to address the fact that there is mistrust in communities that have been, you know, systematically disadvantaged over time. Can you speak to the role of well being and psychological safety in the workplace and how that plays into EID. And then maybe we can touch on the actions that are being taken to improve mental health support for the different groups. Yes, thank you so much, Jennifer. So hopefully my mic is on and sounds good. And so psychological safety is incredibly important in the workplace. So without psychological safety in the workplace, your equity inclusion and your diversity will suffer. It will struggle to retain persons of color or other vulnerable populations. And additionally, you're going to be left trying to support traumatized employees, patients, members, customers. And I would say part of the workplace psychological safety is creating that brave and safe space where it drives for the speak up culture, making people feel comfortable to be a part of the conversation. In terms of opinion and embrace that difference among us. I would say that KP does this exquisitely as we've woven it into one of our pillars of our principles of responsibility around a speak up culture. So we review this annually with our employees through a training but also we we pulse them through a survey called people pulse, in which we, we ask them specific questions about their comfort level and raising concerns or speaking up when something is good, bad or indifferent and being comfortable doing so. So really understanding on a heat map, if you will, where we have areas of opportunity around the speak up index that ties to psychological safety. So I would also add and I think it was touched on earlier by some of my colleagues around when you have this type of psychological safety in the workplace, you are able to realize better and different outcomes for your teams. You're no longer looking through a single lens of thought or opinion, and you have the capacity to design the programs that benefit all of your customers or your members, not just a single type. And I would say a part of creating that psychological safety is providing the opportunity to share the experience so thinking from our own internal KP systems. We do this in a unique environment where we have the labor management partnership so through that process that naturally invites our employees to the table to have a discussion about gaps in workflow and process. And we do this through natural work groups called unit based teams. So these folks evaluate the workflows look at the processes, and it really invites the conversation to be an inclusive speak up components, which in turn, improves our ability to deliver care to all of our members. And I would say in one key important factor here is that these natural work groups are made up from everyone from your housekeeper all the way to your position group. So involving everyone in the process to feel as though they have a voice in what's happening within the organization. So for our members, we do strive to provide a lot of different pathways for them to provide a set feedback loop, because for them to having psychological safety when they come in is a big key component too. So our patient advisory councils membership services are always to bring that feedback back to the team so that we can improve the care that we're delivering inside of KP. But I have to say, my all time favorite is rounding on patients in the lobby and so taking a moment to carve out that opportunity. I haven't been turned down yet. So I say talking to your customers to your members and to your employees and creating that feedback loop again is what ties to the speak up culture, which drives that psychological safety in the workplace. And so Jennifer you mentioned wanting to maybe concrete steps or talking about stigma around mental health. So I think are you okay with me just jumping right in and going right for it. Absolutely. Thank you. You're welcome. Okay, so some concrete steps being taken to improve our mental health for our organ and Southwest Washington members. These all that I'm going to talk about have a strong tie to equity, inclusion and diversity. And they're woven in. It's deeply woven in reducing the stigmatism of mental health and how we can meet our members where they are in their journey sooner. So one of the first things that we're doing in the Northwest is a behavioral health consultant model. So this is a licensed therapist in which we are embedding in our primary care facilities across the Northwest region. And these folks are there for your non traditional brief intervention. So when we think about therapy we think about it from that 60 minute couch time traditionally. We are really wanting to be available on the fly and pre scheduled if you will for a 20 minute 20 to 30 minute brief intervention with our members. And during that time those therapists are focused on helping that primary care provider and that team that care team find a way to tie the behaviors for the member and give them tools to manage that chronic condition or their anxiety or their depression. So they don't have to go to a higher level of care. And what I would say about this is these behavioral health consultants can see our commercial members are Medicaid members are Medicare members. So we're going sooner in the process and reducing all of the referral pieces to even get to them. So it's a wonderful addition to what we're doing in KP Northwest. And from a specific standpoint I would add that only about 15% of our members who spend time with a behavioral health consultant actually need to go to a higher level of care. So it's proven that in the unique membership that we're touching year over year since implementation we're seeing fewer folks needing to go to that longer 60 minute session higher level of care. So just kind of some neat thing that we're doing in the Northwest. Another thing I'd like to touch on and I know I don't have too much time but we have contracted with MHA AO and youth era to provide what we call peer support specialists for our members who are in our specialty mental health. So these contracts enable us to work with a group of folks who have lived experience with mental health or or substance use disorders and have had successful recovery. They will meet our members in the community. They can provide transportation. They reduce the isolation and that stigma system. They help be the bridge to be able to support the members. So I like to say that they bring to life the interconnected elements of the disease management through this peer value. So if you can imagine a pyramid and you put your peer at the center of it, you have each point like behavioral social and medical that here is at the center and they're the webbing that keeps it together. So we're meeting our members in our ed in our residential programs in in our outpatient therapy at the local coffee shop. So I think working with this group in the community will also allow us to expand the diversity of the folks in which we're contracting with. I have just a couple more points Jennifer if I'm okay on time. You are totally fine. Thank you. I mean I gave you like a 15 point question so you get some extra. Okay, wonderful. All right, so I did mention digital therapeutics earlier when we were talking about behavioral health consultants. So in KP Northwest, we are in the KP nation, the leader in implementation of digital therapeutics. So one of the things to talk about in this space is we have multiple apps, calm, my face or my face my string. Well bought and headspace. And those are just to name a few what we've seen in the implementation of these digital therapeutics and specifically during COVID we've seen a rise of people having an interest in having an app that produces music, meditation, stories, sounds that allow them to focus and become centered again. So of the folks that we're referring 60% of them are actually going on and using the application. And I don't have that statistic in front of me and there was so much to come through but we are showing that folks that are using the applications are showing a reduction in their depression screening. So when they're coming back in to see their PCP or their therapist or their psychiatrist and they're being screened, they are showing a reduction in how they're reporting out their feeling around depression. So that's a great move to the two final points that I'd like to make around this is COVID did move us into a more video first approach. So I would say KP Northwest, our mental health department was pretty concretely embedded in our clinic. In that face to face component, we have now moved to virtual which has given us this geo expansion and being able to get to populations that we that may suffer from transportation or financial barriers to be seen or get to the clinic, or childcare barriers, you know, I really need that intent about patient program, but I can't get there. So this video component really has allowed us to capture the teens and the young adults and the adults and the geriatrics across the region and kind of bring them in. And again, reducing the stigmatism reducing the barrier to participation. And then, lastly, I'd say, overall, and I am super excited I have been recently appointed to take over this department, I'm really excited to say that we are super focused on our diversity of our teams in our walls, as well as in our community, and that is always going to be a part of the KP Northwest mental health department and addiction medicine. So we have many specialists of in many different areas inside our own program, but we're not the keeper of all the great things in the Pacific Northwest so partnering with agencies, inpatient and residential facilities, as well as individual therapists, these partnerships expand the diversity of our providers exponentially and help our members remain confident in our ability to meet their needs. Can I get every question Jennifer. I think you did and you know one of the things I really like is while you're talking about this through the lens of our care delivery there are some real components that are cross the communities across organizations right and that includes, you know the partnerships that you might develop as you do to improve both the workforce and the community how that helps then recruit a more diverse and builds the community so there's there's a lot of pieces to that that although they're specific to what you do, they are into other organizations. And you know the one thing I realized I took the call map to and I didn't know that I needed Matthew McConaughey to read me that time stories but it turns out that I did. So, you know, that's are awesome. So, thank you. Let's get it to the deeper tenants of the service delivery and talk to Dr Chang. Dr Chang you touched before on some of the centers of excellence that we're working on both that are stood up and also the African Americans that are of excellence. Can you speak further about how personalized care and services result in more equitable outcomes for all population. Yes, absolutely. And that's really when I thought about this it's it's ultimately about how well do we really know the individual patients so that we can meet their needs and really around that reduction of disparities. We stood up these different centers of excellence because we really thought about how these were kind of traditionally marginalized communities that had specific needs that were not being addressed to the so they were gaps. And how did we build a system to make sure that we really brought them into the fold and met their needs. And so I think that really speaks to that bigger idea around when you build or solve fine solutions for issues for a particular marginal solution, ultimately everyone benefits. So, I think a good real life example was that the gradual sloped curbs on sidewalks at street crossings that was built after World War two when we had a lot of veterans return with amputations. And so having this sloped curb step off instead of a step off was then not only beneficial for all these veterans but it was also for every parent that had a stroller out every older adult who maybe were a little bit less stable on their feet. Every kid who's riding their bike. You know so so all of these things that you designed to serve the mark like the quote unquote marginal populations will ultimately benefit everybody and it makes us all stronger as a whole. And so that's why we've intentionally set out to create these centers of excellence is that not only to close the gap for those particular populations, but ultimately it will make us better. And then around really knowing our patients, you know, for that inclusive care. It's really asking a very simple question of what matters to you. And this really gets at the heart of understanding what's important to the patient we can't assume that we know we can't assume that their values or their prioritization of their values is the same as ourselves. And so really asking that very simple question you know so just getting to know where patients are or for you, getting to know your customers your clients who you're serving and what matters to them will be really key in bridging any gaps that may exist as well. And then the third point about really knowing the patient is also around communication, you know, do we know what their preferred languages do we know what their health literacy level is. You know, our research we see that our American has probably a health literacy level of about sixth grade reading level. So, as all of our reading material at the appropriate level. Are we communicating in the correct language with our patients. Are we providing written materials in a diverse array of languages. And do we have the systems that support this. So early on in my career when I was practicing straight out of presidency or super excited to to join Kaiser Permanente and we had a great system that we still do which is patients can email their physicians, and we can take care of a lot of straightforward questions that way. So I was taking care of this family and the daughter had written in on behalf of her mom. And so I provided some patient instructions that we have that's pre populated. And thinking I was being helpful I saw that the last name was Perez so I added the instructions in English, as well as instructions in Spanish. Well, then the daughter, thankfully, wrote me back and she said, Well, Dr. Ching just so you know, we're Filipino, and my mom's preferred language is to go like so if you can be send those instructions and to go like that be really helpful but don't send us any more instructions in Spanish. So I, of course I was mortified. But then I also realized like, Oh, we have a real opportunity here to make sure that we list preferred language. We're not, you know, not just our patients. But for every, every single member, and that information should be available for anyone who accesses the patients chart. And the types of systems issues that we've built over time so now not only do we have preferred language we also have preferred pronouns, we have preferred names as part of the health record and that's the first thing I see when I open up the chart as a doctor is really kind of just getting the basics you know, if we have to, if we can't get the basics right it's really hard to build trust with the patients. So those are the types of systems improvements that we've made. And I would really, you know, ask all of you in the audience to think about what are some of those basic systems improvements that you could bring back to your organization that would really help better serve your clients and your customers. Thank you. And, you know, while you were talking about that you really touched on that effective communication, and particularly when you're asking someone to get personal, you know, medicines very personal and if you if you don't know my name or you don't know my pronoun, you know how, how do I expect you to know, have a deeper level of understanding. So, thank you. Just a reminder to the audience you can continue to submit those questions and we'll work them into the conversation as we utilize the expertise and knowledge of our speakers and we'll have some time at the end. Particularly if you have questions about how to get started in your own organizations or continue the work, you know, we're happy to speak to that as we continue this conversation. So as we pivot to community, Deanna, we just really spoke about the tenants under our service pillar. And as we go to community I can imagine that this is an area where many organizations might include community in their framework. Can you talk about how ideas like reputation and attracting local diverse talent change our communities. So at Kaiser Permanente, we believe that the total health of a community stems primarily from economic and environmental conditions. And so our approach is really to impact those two so that we can help communities thrive. And so we take it as our corporate organizational responsibility to really connect with the communities where we are serving. We do that in a couple of ways. We do it through economic impact. So we're very mindful actually intentional about making sure we work with a diverse supplier group. And so by doing that we are supporting local minority owned businesses so that ties to the economic piece. We also work really hard with regard to attracting local talent, and of course being able to retain them and develop them as they go. You know it's interesting. This is a real passion of mine, based on my own personal experience. When I entered my professional life, I was practicing law at a large law firm in San Francisco is at the flagship headquarters. And I was the only African American lawyer in the firm at that time. And one learning how to practice law transitioning from studying law is an experience in and of itself. But to be in an environment where you don't feel supported. You don't feel as though you have anyone to talk to you don't have anyone that you can ask questions of. It's a very, very lonely place to be. And so we now know. And we're now talking about openly. How do we support our employees underrepresented minority employees. What can we do for them and Kaiser Permanente like other organizations we've developed business resource groups. And those groups actually allow employees to find the connection to find their safe space and by having these various business groups. We are able to get the word out about our organization because they go back and they have ties to their own local communities family friends and businesses, but also it provides a safe space for people to be able to be at work. Feel connected feel as though their presence perspective background is welcomed by the organization and and I just can't stress how important that is. This year alone, even though Kaiser has been focused on EID strategies for quite some time, we ourselves in the Northwest. We've seen a 50% increase with regard to membership in our BRGs this year since March. It's pretty amazing. And that tells us that given our strategies and what we've tried to do, people are really looking for connectivity they're looking for support. And we're pleased that we have the business resource groups that are allowing people to make those connections. And so I know that we may have some organizations who joined us today and they say, you know, we don't have enough employees in order to start a business resource group or, you know, have multiple business resource groups. And what I would say to that is work with what you have, meaning that if you have employees who are minorities or from underrepresented groups, reach out. Now is the time to actually have open dialogue in your organizations. At Kaiser, we've been having listening sessions so that we can have employees share their experience share their thoughts share their ideas. And that has been tremendous. We have really just brought in the dialogue and with everything that's going on in the world, especially here in Portland. Now is the time so don't let this critical period of openness, honest discussion, ability to listen and learn, pass you by, because that is how you can return retain the employees you have and make your work environment better for everyone all the way around. And I also want to touch upon, you know, when you are creating an organization and an environment that employees feel as though they can thrive in that really makes you a leader in the marketplace, it really builds up your reputation. We are all aware of social media and how employees talk how they exchange information. And we want to make sure that at least for Kaiser Permanente, we are having employees who are talking about as well who are feeling as though we are trying to make sure they're developing and they're welcome. And I'm sure those who joined us today feel the same way. And so, again, if you don't have a structured business resource group program, then you can still have listening sessions with your employees. And that gets your name out. It builds up your reputation. And when people are looking for jobs, your company's name may come up and then there you are attracting diverse talent. So, those are some of the things we're doing in our organization and focused and how we improving the communities that we serve. Thank you, and it brings to mind as we talk a little further with Gwen about business resource groups and how we make sure that we can both harness the enthusiasm and energy of people within our organizations and then help provide that support. And community for those that really there's, there's a place for all of us. I know that some of the things that I've most appreciated over the past months just as an employee of Kaiser Permanente is the training and work that I've been able to do to advance my own ability to be an ally. So, you know, when we're talking Gwen about how do we how do we make sure that we don't put on all the burden on the people of color, right, to fix what is not caused by the color right so can you talk a little bit about that and you know how how we make the successful and healthy organization in that regard. Well, at Kaiser Permanente we have several business resource groups and Diana said it beautifully. These business resource groups create a safe space for our colleagues. It provides an opportunity for them to have community. But in addition, in addition to that, it's also a great value to our business, because what we've been able to clean from these business resource groups is recommendations for our own organization and things that we can do differently within our business in order to be best in class. And so I'm really happy about the fact that we have these resource groups, they've been able to work together to do a great job. But what we found to with our resource groups is that it they are open, and they are welcoming to everyone. So many of them do events throughout the year to celebrate heritage months. They also create developmental opportunities where there are seminars and workshops about career development. And then many of them also get involved in community based initiatives. One of the things that we've been able to do with our physicians is create a group called women in medicine, and women in medicine is similar to the women empowered at KP, but is for physicians, it's a community for our physicians that's really focused on helping them have their and create a sense of belonging within our physician population. And so, last year, we kicked off our very first women in medicine symposium, where we had our physicians come together, and they were able to hear from various leaders within our organization. And we also had workshops that were created for them, specifically to meet their needs. And throughout the year this year, we've been able to have various virtual workshops for them from everything from career management, we have some planned around microaggressions, and then how to be an ally to these various communities within our organization. And so we're really happy about the fact that we've been able to do that. And one of the other things that I'll call out is that our business resource groups have been valuable in helping us with community based initiative that we have to really cultivate and grow the next generation of physicians, cultivating and growing the next generation of physicians starts really early. We have a partnership called the Hippocrates program. It is with two middle schools in Portland, and the initiative is really focused on helping to build the next generation of physicians. And so every year we have students that apply to the Hippocrates program. We have 35 students at both schools that participate. Our physicians go in on a monthly basis, so we workshops and seminars for them, and also talk to them about what it really means in order to be a physician, the commitment that you need to put in to be a physician, and the focus on STEM. So we also have them come to our facilities, we have them come to the hospitals to go to our simulation labs and many other things. So that has been a really successful program for us. And this year I was very happy to see that one of our programs at the school was 90% female and 60% young ladies color were in that program. So I'm happy to see that we are really evolving around that. And that's what I say what I mean that when I, when I, when I say that we're recruiting very early in the process, we want to ensure that we're opening ourselves up and being a catalyst for change so that we see this growth and change in the lives of future physicians. We also have another program at the Oregon Health Science University that is focused on our, our residency program that is really focused on helping our future physicians understand what it's like to be a doctor. And so they are paired with physicians throughout the year, and they're able to be mentored by these physicians. And we're in our second cohort of the program that will conclude in November. And this program has been really, really valuable in helping those students. So we're really happy about that program as well. Thank you. And so I'm going to add another question both for Gwen, you and Deanna, and this is about unconscious bias. And I'll take this opportunity to let the audience know that, you know, as we work on our journey together, we are offering to send you a copy of a book called blind spot hidden biases of good people. And this is a book that helps us explore our hidden biases that we all carry, you know, from a lifetime of exposure to race, ethnicity, gender, social class, sexuality, disability status, all of those cultural attitudes that we've grown up with and that we see every day. So when we send out the survey at the end of this, if you will include your name and where you'd like to send it, we're happy to provide you this book. So now that I've given you a little bit of time, can we talk a little bit about recruitment and if we're recruiting diverse talent, how do we address unconscious biases during the recruitment process? Because once you get people in, then you need to, you know, have them enter the workforce itself. So I take the first stab at that. With regard to how we approach it. The first thing we think is important is that you try and have a diverse interview panel. That is important so that when people are coming in and you're having your internal discussions about after you've interviewed the candidate, you actually do have diversity of view and exchange as you're assessing candidates that you've interviewed. And a step before the interview panel is really insisting upon a diverse candidate pool so that the people who are coming in to your organization to be interviewed that you are considering a diverse pool will help you bring in candidates of a wide spectrum. And so those two components I think are key with regard to if you're serious about enhancing diversity practices and strategies as it relates to recruitment. We and Gwen touched upon this. We also pre steps to these two is how we reach out and where we look for talent. So when talked about some of the partnerships we have with colleges, and by getting out to those colleges getting out to certification programs, making ourselves known, what we're trying to do is even get some interest, diverse in interest of people who are thinking about our organization, so that when they are on our site, or when we have jobs available, we are gathering diverse interest for our organization and the opportunities that we have available. And making sure that diversity is built into your interest base, your candidate pools, your interview process will help address and avoid the unconscious bias, which could be impacting some of your recruitment efforts. In addition to that we actually offer unconscious bias training for our leaders and managers as well, because people aren't aware of themselves sometimes sometimes we're our own worst enemies, in a sense, because we don't actually know our blind spots. And so taking the time to have an open conversation taking the time to challenge yourself and really think about how you're responding to certain things that are presented to you helps you get to that. So those are some of the strategies that we use here. You know, and again, Deanna said it beautifully, I think that over the last couple months since the murder of George Floyd and Breonna Taylor and I'm on Arbery, we have received overwhelming number of requests for unconscious bias training. So our unconscious bias training went from one every other month in person to two every single month, and we have a wait list for unconscious bias training people want to understand they're hidden. They're unconscious bias they want to know and understand some of the things that they can do to conquer that unconscious bias. And so we are really, really focused on helping our colleagues understand that. The other thing that I would just add to Deanna's comments is just around being intentional. So within your organization, these things just don't happen. We have to be really intentional about this work. We have to be intentional about goals and accountability for leaders, as well as the rest of the organization. And we have to model this behavior at the top of the organization. And one of the things I've noticed about our organization at Kaiser Permanente is that our leaders are reflecting this diversity. And they're also asking us to be accountable to it and to ensure that we have a diverse slate of candidates as we go out to source positions. So I think that leadership plays a big part in this and accountability. Thank you. And thanks for, thanks for filling the questions as they come in. I really appreciate it. Okay, I think we have really touched on the how the workplace is impacted by the talent management and recruitment and how we build the community. And let's move to the next part where we talk about next steps. So Deanna, when we're looking at the pillars and when people are thinking through what that means to their organization, what can people do with the information we've talked about today? And how do we work then to prioritize and move this work forward? So the first thing I'd like to say is that today is the start of the conversation. You know, today is the, the, we're having this conversation, we're sharing with you what we're doing in our organization and what our pillars are. What I would encourage you to do for your organization is to go back and think about what would be the pillars for your business. How would you start this conversation within your organization? And what might that look like? I think that for us, based on our business, health care, our pillars will look very different from yours because you're in a different industry. As of your organization may be different, but the topic and the concern of creating safe and psychologically safe, emotionally safe, diverse environments that are inclusive of different opinions and backgrounds. That's something that we all share. That's something that we should share and that's something that we should all be striving toward. So going back and having conversations with your employee base. I mentioned earlier that we are having listening sessions. We've been having listening sessions. Gwen just shared that we're doing unconscious bias training, implementing some of those no matter the size of your organization. Those are things that you can start doing now. Those are actionable items that you can take away from this conversation. And in addition to some of these suggestions, and Jennifer, I hate to put you on the spot, but I also think we are going to send kind of an action plan or guide out. For those of you who may be interested to kind of help you think about some of the steps that you might take as you start to look at making your own work environments and implementing strategies as it relates to equity, inclusion and diversity. Jennifer, do I have that right about the action guide? Yes, we will provide the action guide as well as the book. So everyone gets the action guide if you signed up and the book you have to ask. So those are some concrete steps that you can take. But really, the important thing is to maximize this opportunity that we have in our history to improve your organizations, improve the culture. Welcome people. Make sure that it represents the community and where we live. And as I mentioned earlier, we are changing, the demographics are changing. And the Northwest is looking different. California is looking different. A number of the states are looking different. And if you want to maintain leadership, if you want to maintain productivity, if you definitely want to see your return on investment, broadening up the workforce, making sure that you have different perspectives so that you are innovative, competitive and employer of choice, you can't go wrong with that. That is a model that is hard to beat. It puts you in the success circle. Thank you. So we're getting some great questions from audiences about some of the work that you're talking about, whether that's unconscious bias training or listening sessions and wanting a little more detail about what does that look like. Gwen, would you mind starting this off and talking about who do we utilize to provide that unconscious bias training or how do we determine what will train and what that looks like, sir tips or information. It's interesting because we created our own unconscious bias training. We provided it's in house, our continuing medical education group created that unconscious bias training. We served as a subject matter expert. We also had others within our organization who weighed in on the training and who participated in a pilot program that we had that where we gave the unconscious bias training, we see feedback from a number of our physicians on the training. The other aspect is that we use some best practices and we use some, we use some leading authors and experts on unconscious bias to understand unconscious bias from a medical perspective and really bring some of those examples into our training. And so that was really helpful. One of the things I really like about our training is that it's not us talking to people, it is as providing information, and then having a conversation about bias is uncovering the bias that you may have within you know that you've been exposed to, or that you have seen as a professional in some of the things that you would do. One of the other aspects of our unconscious bias is around the institutional bias and those systems that we've created within our organization, and some of the things that we've been able to point out and some of the things that we're going to do in order to change those. And so we've been able to get a lot of great recommendations from our physicians about how we can change bias, how we can change some of those systems within our organization to better impact them and to impact others that may be socially or even economically disadvantaged who may come to work for us. So that's the outline of it. I'd be happy to share an outline of that training and some of the content that we use in it. Thank you. Next I'll pivot to Deanna and then Dr Chang if you would like to talk at all about the work that you've done around that because I know that equity inclusion and diversity for the physician group is part of your work. So Deanna one of the questions that has come in has been about the listening sessions that you've been talking about. Can you talk about those what does that look like how are they formatted. So the listening sessions, it's very interesting. They truly are what they're called they are listening sessions and I actually started hosting them shortly after the Floyd murder, and it was a really heavy time our employees were having a hard time. I started with our business resource groups and we brought them together on a call, obviously virtual, and we start by really acknowledging what's happening in the world what's happening with regard to COVID but also the Floyd murder the protests and just acknowledging what is going on and how challenging this time has been more so than I think many people can remember. And then I shared a personal story, and I will be honest for me. That story is for those of you who may not know I joined KP Northwest in January. I'm originally from the Bay Area. And so the Northwest and Portland is very different from San Francisco, where I was born and raised. And my challenges with being up here my family being back in the Bay Area, and trying to lead and support our employees at Kaiser, during the civil unrest. When I go home, I have to have conversations with my three African American sons about what's going on. And that's a real challenge. That is exhausting at times. I am fearful for them all the time. I feel like I've never actually experienced, right, thinking about what could happen to them. And that's how I start them. It's making a personal connection. And that provides an environment and a venue for people to open up and start sharing what they're what's on their minds. And from there really and truly the conversation takes care of itself. But a listening session is truly that giving someone the space and the opportunity to be able to share who they are and what they're struggling with and how they're processing. And we know that for those who are not minorities, they are welcome they are allies they disclose that no they haven't had to deal with some of the struggles that others have, but they want to support and they don't know how best to do that. And that in and of itself is a contribution to the listening session. We've gotten wonderful reviews, our employees really like it. We've had, I said I started with our business resource groups. Our entire HR department has been involved, our senior leadership teams, they've held listening sessions for their groups as well. And they've been really well received. We've learned a lot to your point. It's very open and so being able to hear that personal experience and understand the context of you know that people are operating in and what, you know what you've experienced. And sometimes I think especially if you see a leader, maybe you make an assumption that it hasn't been as hard and and I think that's what we're trying to learn to do is not make those assumptions and to really understand and hear from people what their experience has been and what they need for support. Did you have anything you'd like to add around the position group or the work we've done in that in this space where your microphone. You think I would figure that out by the end of the seminar. Well, Gwen's already given a great recap of the unconscious bias training. And I would say that a lot of the work that we've been doing is education is just really knowing that we all have so much to learn. And so we're very proud that just this past month we launched an online learning series called practicing catch. And the catch stands for cultural agility through cultural humility. So it's really curriculum designed to think about how can we provide culturally responsive care. And it offers just very practical tips about, you know, understanding what's the history of bias in this geographic area so understanding all of the displacements of African American neighborhoods for building highways just displacement of Jewish neighborhoods for building public parks and the impact that's had on those communities and the generations that have followed. So we've given just knowledge about our specific geographic area. We also have modules about how do you best use an interpreter so if you need to pull in an interpreter to communicate with the patient. What are some best practice tips. And then we also have best practice tips around really asking about what matters to you, understanding where the patients coming from. A series of knowledge base, as well as communication tools, and a way for us to open up our mind and really think about what it is to have a growth mindset, and really meet our patients out where they are and best be responsive to them. Thank you, Dr Chang. I'd like to thank the audience thank you for your active participation we've had some great questions I think we've shared a lot across the board and I hope that you have found it helpful. I know we all look forward to working with you and the rest of our community as we try to advance this work and we really work towards both short and long term change. I'd like to take the opportunity to invite you to complete the survey I know I've mentioned it a couple of times but we really do get better when we get your feedback. And if you would like to just lavish on the compliments for me I'm totally fine with that as well so it doesn't all have to be bad. So please take the survey. Please, if you would like us to send you the book happy to do that just provide us your name and address where you'd like it sent and we'll do that. And then finally, if you are interested in experiencing Kaiser Permanente firsthand by taking a virtual experience KP with one of our physicians. It's a great way to be able to see the facilities, even in these times when we're trying to socially distance and make sure that we keep our facilities safe for our members so please contact your account manager or you can also include that in the survey as well and we'll make sure that someone reaches out to you. So, thank you again for your participation and I'd like to turn it over to Dr Chang to close us out. And so really today is the beginning of a conversation and we hope that you've really learned some new ideas that you can take back to your organization to continue the conversation and think through what are your pillars and how can you really optimize your business model and really recruit for diversity so that you can continue the future of your business as well. Tiana they made a very clear business case of why diversity is so important to your bottom line. And, and we also know that the future of our demographics is very different. We expect whites to be a minority within the next 10 years or so in America. And so this is the reality that we all are living with. And so we need to embrace this and earlier I mentioned about having this growth mindset. And really what that means to me is that mistakes are our teachers and mistakes are not setbacks but there are teachers. And I purposely told you that story about me sending the patient the wrong language information because that really did lead to a systems change. So if we think of every mistake that we make, you know, and my story is one of many mistakes that I've made. But if we think of every mistake that's happened, and how can we really put a systems change to address it, then we'll be making very powerful changes over time. Okay, so I really welcome you to think about that. Because this can also feel like a scary space, you know people don't want to make mistakes, because they are afraid maybe then they come across as racist or sexist or biased, but the truth is, we all carry bias to some degree. And a lot of it is unconscious. And some of it is conscious. And so mistakes will happen. And we need to embrace that and really own it and do something with it though. So I would say do something with it would be the key. And so again, thank you so much for carving out time today to have this conversation with us. We loved all your questions and we definitely welcome more. So I just want to leave you with a quote from the Reverend Jesse Jackson. Inclusion is not a matter of political correctness. It is the key to growth. It is the key to growth. Thank you all and be well.