by Terri Cooper, Global Health Care Sector Leader and Chief Inclusion Officer, Deloitte LLP
Inclusion and equality are important forces impacting health care systems globally. Last month the UK government, following legislation introduced in April 2017, made it mandatory for organisations with 250 or more employees to report annually on their gender pay gap.1 The first annual publications shows that for all NHS trust staff, the mean gender pay gap in hourly pay is 15 per cent and the median is 17.4 per cent. While most NHS trusts have gaps that favour men, a few have pay gaps that favour women.
Two characteristics make these findings especially important for the NHS. First, around three quarters of the NHS workforce is female; and second, the NHS is struggling to recruit and retain enough workers to deliver services. If women working for the NHS are missing opportunities to progress and improve their skills because, for example, of the way that career breaks or part-time working are treated, then there is a major problem for the service as a whole. These factors may help explain some of the morale and retention problems amongst NHS staff we identified in the UK cut of our Time to Care report.2 Earlier this week Deloitte’s Global Health Care Sector Leader, Teri Cooper considered how technology and changes to work culture might expand roles for women working in hospitals; given this might be a way of helping to reduce the gender pay gap. While the article has a US take, I thought it resonated strongly with what we are seeing in the UK and therefore timely to share her article with you.3
In Terri’s own words
Health care is an exciting and dynamic field—it is why I’ve been focused on it my entire career. The health care sector is on the cusp of incredible change, where everyone from executives to hourly employees could be impacted. This transition will likely be driven by two emerging, but powerful forces:
- inclusion - in an inclusive environment, everyone in the organization feels that they can be themselves, and can bring their unique perspectives to the table
- new technologies - hospitals are beginning to adopt emerging technologies, such as artificial intelligence (AI) and cognitive analytics.
These two trends can impact the overall workforce, but also could have specific implications for women—potentially altering roles, job satisfaction, and retention.
Why inclusion is essential for health care
The nation’s hospitals collectively employ fewer than 2 million men, but employ nearly 5.5 million women. While women make up roughly 75 per cent of the overall hospital workforce, they represent only 26 per cent of hospital CEOs. Moreover, women make up 27 per cent of hospital boards and 34 per cent of leadership teams.4
These numbers are specific to hospitals, but the trend is not unique. Many industries are struggling to cultivate diverse and inclusive cultures. For health system leaders in particular, recruiting and hiring the right staff is a priority, according to a recent Deloitte survey of health system CEOs. CEOs told us that workforce recruitment and retention is one of the top issues they lose sleep over. Retention might be the bigger issue given that some hospitals face significant turnover. In response, many hospital leaders are trying to develop a more effective strategy for retaining staff.5
Inclusion can be a make-or-break factor for today’s workforce. In another recent Deloitte report of employees, 80 per cent of survey respondents indicated that inclusion is important to them when choosing an employer. Moreover, 39 per cent of all respondents said they would leave their current organization for a more inclusive one.6 This trend has not gone unnoticed—69 per cent of executives rate diversity and inclusion as an important issue.
Six traits of inclusive leadership
What can leaders do to foster an inclusive culture in their hospitals? To truly shift forward, we should challenge organizations from the top down, to potentially redefine leadership, and rethink the role that each of us can play. What were once considered soft skills are often now seen as critical for leading an organization. Inclusive leadership can be essential for organizations to advance their inclusive cultures. We have identified six traits of inclusive leadership:
- Commitment: Treat everyone with fairness and respect, foster environments where team members can be themselves by modelling authenticity, and empower each other’s well-being.
- Courage: Engage in tough conversations when necessary. Identify opportunities to be more inclusive, take ownership, and engage others.
- Cognizance of bias: Be aware of unconscious biases so decisions can be made in a transparent, consistent, and informed manner.
- Curiosity: Listen attentively and value the viewpoints of others.
- Cultural intelligence: Seek out opportunities to experience and learn about different cultures, and be aware of other cultural contexts.
- Collaboration: Create teams that are diverse in thinking.
It’s up to each of us to embody the traits of inclusive leadership and bring that to our organizations on a daily basis.
Technology could enhance some hospital jobs
The second major trend on the horizon is emerging technology. The hospital workforce is likely to be altered by technologies that can take on the menial tasks, many of which have traditionally been performed by women.7
For some types of work, this trend could lead to new opportunities, or make careers more fulfilling. Nurses, for example, typically spend more than 80 per cent of their day performing administrative tasks (e.g., paperwork, searching for medications and supplies, coordinating lab results, and even helping deliver patient meals), according to our recent paper on the ‘global hospital of the future’.8 That means less than 20 per cent of a nurse's workday is spent caring for patients. Moreover, some estimates predict that by 2025 the health care industry will need 3 million nurses—but only 2.8 million are likely to be available.
Using robotics to automate some of these tasks could generate considerable cost and time efficiencies, and improve reliability. Robots, for example, can deliver medications, transport blood samples, collect diagnostic results, and schedule linen and food deliveries. This could give nurses more time in areas where they can really make an impact, like caring for patients.
But what about other employees in the hospital, such as administrative staff or billing department workers? Robotic processes can be used for certain hospital revenue cycle and accounting/finance functions, such as scheduling and claims processing. A disproportionate number of these jobs are now performed by women. As technology takes over some of these functions, hospital leaders will likely need to determine new opportunities for the workforce of the future, and help train displaced employees to fill those emerging roles.
As hospitals invest in exponential technologies, they should also consider investing in employees by providing opportunities to develop corresponding digital skills. An augmented workforce and use of new technologies requires existing staff to manage and work alongside the robots and AI processes. Rather than replacing employees, talent and technology can work together.
According to our recent paper on the future of work, hospitals that fail to effectively merge employees and technology could face:
- A dispirited workforce with growing nursing shortages and high levels of burnout
- A marginalized ability to attract and retain highly skilled clinicians and non-clinicians
- A reduction in quality of care
- A loss of position as a patient’s provider of choice.9
Although 100 per cent of health care providers surveyed in the 2017 Deloitte Human Capital Trends report intend to make significant progress in adopting cognitive and AI technologies in the next three to five years (and 33 per cent say they consider it a priority to train employees so they can work side by side with robots and AI), none report that they have made significant progress in adopting these technologies.
Ready or not, the future is coming
There has never been a more exciting time to be in health care. As the workforce, the workplace, and the technology continue to evolve, the role of leadership will likely become more important. Hospital leaders should consider proactively addressing these issues and view them not as challenges, but as opportunities to engage the women in their ranks.
First, leaders should consider advancing inclusive cultures in their hospitals by modelling the traits of an inclusive leader and empowering others to do the same. Not only can an inclusive culture help hospitals attract and retain talent, it also can bring new and innovative ideas to the table. Second, leaders should consider ways to embed technology into everyday experiences. They should consider offering training opportunities to help staff develop needed skills, and highlight how these new roles (particularly those typically filled by women) could become more fulfilling.
Through both cultural and technological shifts, the role of women is changing in health care. I, for one, think it’s going to be for the better.
1 The gender pay gap is different to equal pay which deals with the pay differences between men and women who carry out the same jobs, similar jobs or work of equal value (which is unlawful in the UK) but shows the difference in the average pay between male and female employees within a workplace.
4 Thomson Reuters 100 Top Hospitals, 2017
5 Deloitte CEO survey https://www2.deloitte.com/us/en/pages/life-s8 ciences-and-health-care/articles/health-system-ceos.html