'We had to begin to change behaviors': Novant Health CEO Carl Armato on making diversity and inclusion a core value

Embedding diversity and inclusion into an organization in a sustainable way can be a challenge. However, Winston-Salem, N.C.-based Novant Health has made it part of its strategy from the board-level down.

Recently, Novant Health's board of trustees was one of five boards in the nation honored by the National Association of Corporate Directors with its NACD NXT recognition. The recognition commends board practices that "promote greater diversity and inclusion, ultimately fostering long-term value creation."

Here, Carl Armato, president and CEO of Novant Health, discusses how Novant and the board have incorporated the values of diversity and inclusion, what his key learnings have been and how he ensures open dialogue among staff and leadership.

Editor's Note: Responses have been lightly edited for length and clarity.

Question: What are some of the key ways Novant Health is promoting diversity and inclusion?

Carl Armato: We've been on a journey. We decided as a team that diversity and inclusion would be fully embedded into our everyday work. When we decided that, we began by actually making sure we added diversity and inclusion as one of Novant Health's five core values. We really believed that diversity and inclusion had to start at the top of our organization, which meant our board of trustees. And so, I've been really intentional in partnering with our board chairperson as well as our nominating governance committee to seek board members who reflect the communities we serve.

I'm really excited that we've taken our 19 board members, including myself, and begun to really diversify by bringing on people with new backgrounds, including those with financial, but also academic, nonprofit, military, political and medical experience that are of different ethnicities, which has really brought a unique perspective to our overall board conversation.

Then, we really started to focus on our executive team. I thought our executive team's diversity had to be really thoughtful. And it had to not just be about color or race, but it had to really be about different backgrounds, experiences and really expanding our representation of women. I'm proud to say that nearly half of our executive team members are women and over half of the executive team represents non-Caucasian ethnicities.

Once we made changes to our board and executive team, we really began to embed diversity, inclusion and equity throughout our strategic plans, throughout our organization. We began to aggressively look at our workforce to make sure not only the leadership but also our core workforce began to reflect the communities we serve.

Q: Can you describe some specific initiatives promoting diversity and inclusion in your organization?

CA: We brought the whole board of trustees and engaged them in a half-day training session with a consulting organization, called White Men As Full Diversity Partners, whose mission is to transform mindsets and behaviors, and to help organizations sustain truly inclusive cultures.

We also brought our entire leadership team, from senior vice presidents and above, to that [training] with the White Men As Full Diversity Partners. And it made a huge difference in how we began to look at not only embedding diversity and inclusion into the organization, but how we were going to embed it into each workday and job.

In just three years, we started to see that we were establishing real metrics. We were measuring diversity and inclusion and equity both in our annual goals and our long-term goals. We began to tie senior VP and executive vice president compensation to those metrics.

Again, our board ensures that every agenda where we are presenting, we're actually reporting on the impacts of diversity, inclusion and equity in those conversations.

The other thing that was very helpful was that, I hired a chief diversity, inclusion and equity officer and put her on the executive team at the highest level in the organization.

Q: What are some common mistakes healthcare organizations make when trying to implement diversity initiatives?

CA: Embedding diversity and inclusion is about a behavior change and recognizing biases that we all have and we all bring to the table.

When we put a stake in the ground and said we were going to embed diversity and inclusion and equity inside of Novant Health, it meant that we had to begin to change behaviors. And change the historical way that we did business.

So, for example, we created the LIFT program, also known as Leveraging our Internal Female Talent. For me, it was a program to increase the number of female team members who would be change-ready and resilient and ready for new leadership capabilities inside the company. We promoted 45 percent of the women who went through the program into higher scopes or executive level positions.

Another thing is actually setting real metrics. That's a learning for me, if you really want the organization to reflect the community you serve, from your leadership all the way through the workforce, the only way you close the disparity gap is by measuring it. As soon as we started measuring that we started to face these healthcare disparity issues head on.

For example, Novant Health was winning awards for quality and safety. And yet, when I started to look at it by demographic, by ethnicity, by different ages, and all the different characteristics of diversity and inclusion, we started to see real gaps. A great example is our pneumonia readmissions. We actually had some of the lowest readmission rates in the country, but when we drilled down, we found readmission rates for our Caucasian compared to our African American population were actually a lot lower. African Americans had a 6 percent higher readmission rate for pneumonia after discharge.

When we started to drill down on that, not only did we change some of our behaviors in how we educated patients in the African American community, going out into the community to understand what can we do better, to improve those outcomes, but overall we closed the gap and then we lowered our readmission rates for pneumonia for all populations in all demographics.

Q: As a leader, how do you make sure the workplace is an inclusive space? How do deal with complaints, if they arise?

CA: Here's the beauty of beginning with transparency. Novant's board, executive team and myself, we truly hold open dialogue with the 30,000 people that work for the organization. That could be via the phone, webcasts… or social media correspondences where we have discussions about diversity and inclusion. What's working? Where can we improve? Where are voices not being heard?

The other thing is that we created business resource groups that represent every demographic. These groups are not only internally focused, having conversations with our internal team, but they are also externally focused into the community. So for example, the Latino business resource group can not only internally understand what our team members need, but more importantly, what is it that Latinos in our community would want to see us do to improve the remarkable care we are known for.

Q: How do you make sure the health system's mission to promote diversity and inclusion is ingrained in the culture at your institution? How do you make sure employees emulate this mission?

CA: We have what I call the North Star for Novant Health — it's the mission, vision and values. So values of diversity and inclusion, teamwork, personal excellence, courage and compassion, all of those things are reinforced in not only the strategy we lay out, but where we spend our money, how we respond to community needs. Then, more importantly, we connect every team member to the mission, vision and values, and how they bring those to life in every interaction, each and every day regardless of where they work and how they contribute.

In addition, we recently started an upward mobility scholarship program to offer financial support and professional development for team members who are CNAs who are interested in pursuing their RN licenses. That's an example of us investing in our people to make sure they understand that we are committed to helping them bring to life the mission, vision and values that we're known for.

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