Shared values and experiences between health care providers and their patients related to their ethnicity or race can positively impact health outcomes. Achieving this cultural concordance is the aim of an initiative at UCSF Benioff Children’s Hospitals that aligns caregivers more closely with the patients and families they serve.
“When a family comes in, they want to feel understood because they're going through what is possibly the worst time in their entire lives,” said Brandie Hollinger-Quao, MSN, RN, director of the hospitals’ PICU. “It’s imperative for us as an organization to meet them where they are — whether it's their language access needs, their ability to converse directly with their providers, or their need for a psychologically safe space to receive care.”
Hollinger-Quao co-founded We Belong in 2021 to enhance diversity among the organization’s nursing ranks through three primary strategies:
- Standardizing hiring practices.
- Improving retention of nurses who are black, indigenous, or persons of color (BIPOC).
- Expanding diversity recruitment practices.
Standardizing hiring practices
Benioff Children’s started by assessing the uniformity of its hiring practices. It produced eye-opening results. “We uncovered sweeping variability in how people were hiring across the organization,” Hollinger-Quao said. Implementing a standard, consistent process for interviewing and hiring nurses ensured even application of the organization's diversity initiatives. The process includes a diverse staff selection panel trained in managing implicit bias. In addition to representing all areas of diversity, such as age, race, and gender, the panel typically consists of nurses at various levels, individuals in similar roles, a member of the unit’s DEI committee, and at least one representative from each shift. All new nursing applicants are required to complete a diversity statement.
Improving retention of diverse nurses
The We Belong team worked with the clinical nurse promotion committee on both campuses to reduce variability in the promotion process. To provide consistency and transparency, Benioff Children’s updated and standardized the clinical ladder at its Oakland campus, outlining a clear and structured path for nurses to advance within the organization. “It helps people feel like they have an opportunity for professional growth within the organization,” said Areon Williams, RN, MSN, PHN, We Belong co-facilitator and medical nurse manager at Benioff Children’s Hospital in Oakland. “It shows we want to support them, which makes them feel like they belong.”
Expanding diversity recruitment practices
The We Belong team actively recruits BIPOC nursing candidates within the community and offers opportunities for them to learn and grow into health care roles. They work with local high schools and nursing programs to identify potential applicants, helping build a pipeline of future nurses. The team held a nurses summit in conjunction with Cinnamongirl, a Bay Area organization aimed at empowering girls of color with educational and career opportunities, and they hosted a cohort of girls for hands-on nursing training and Q&A panels with nursing professionals and leadership. “These are all kids who are thinking about becoming nurses, so it was a great opportunity for them to see people who look like them doing this work — it feels attainable,” Williams said.
Keys to success
Hollinger-Quao and Williams said data quality is key for an initiative like We Belong, not only for quantifying results but for informing recruitment and retention policies. Further, solid data enables buy-in from senior leadership.
Beyond strategic considerations, conducting such an effort requires personal fortitude. Hollinger-Quao and Williams said much of the work must be balanced with “regular” job responsibilities.
Not only will there be challenges and uncomfortable conversations along the way, but it’s crucial to understand that results don’t materialize overnight. “It’s taken many years to arrive at our current state and it will take that many years or more to realize lasting change within our organization,” Hollinger-Quao said. “You must be willing to be in it for the long haul.”
