Driving DEI Initiatives – How You Can Succeed, ft. Deb Pappas

Deb Pappas (00:00):
So, from an EHR perspective, we still have so much work to do to be able to adjust how we actually capture data that will be reflective of not only a patient’s gender assigned at birth, but the gender that they currently identify with, as well as preferred pronouns so that we have all of that. So that when we think about our care encounters with the kids and teens and young adults that we care for, we have appropriate care.

Alan Tam (00:41):
Hello Healthcare. Healthcare organizations across the country are committed to integrating diversity, equity, and inclusion practices into their culture. How can marketing leaders today impact the brand’s ability to connect with these diverse communities as well as help drive their own DEI initiatives within their organizations? Joining me today to explore these issues is Deb Pappas, Chief Marketing and Communications Officer at Connecticut Children’s. Deb, I’m really excited to have you on the podcast. Welcome.

Deb Pappas (01:11):
Thanks so much, Alan. Great to be here.

Alan Tam (01:13):
Deb, you’re the Chief Marketing and Communications Officer. That is quite the task. What do you do as the Chief Marketing and Communications Officer at Connecticut Children’s?

Deb Pappas (01:25):
Sure. I’m responsible for our branding and our marketing and communications across all of our different stakeholder audiences and really focused on helping our organization grow as a health system across the region.

Alan Tam (01:38):
Let’s talk about DEI strategies initiatives. You recently spoke about this, and I know it’s a passion of yours. What are some of the initiatives that are underway within your organization at the moment?

Deb Pappas (01:50):
I’ll start a little bit by giving a bit of context in terms of where we started and the framework we’ve used and then get a bit more into what’s current, if that’s okay.

Alan Tam (02:00):
Wonderful.

Deb Pappas (02:01):
So when we began this journey, it was about three years ago in terms of having a more formalized DEI set of initiatives, but it really grew out of having a lot of listening tours and conversations across our organization that led us to do a DEI audit. And by that I mean, similar to team member engagement surveys that many health systems conduct, this was one focus entirely on DEI. And it was really intended for us to be able to better understand what is our current state, where do we have the biggest gaps and opportunities, and then how does that help us focus and prioritize our work. Because of course, we can’t boil the ocean out of the gate. We really wanted to have some data to inform our strategy.

(02:45):
So with that first study that we did just three years ago, it really helped building our key areas of focus in terms of our work force, which is our team members, our workplace, which is our culture, and then our marketplace being our patient families and our community members. From there, we then built it into a 9-pillar framework, and that ranges from strategic staffing, to education and awareness, metrics and analytics, patient healthcare inequalities.

(03:20):
In essence, there are three key people who lead each pillar, an executive champion. So for example, I happen to be the executive champion of the Education and Awareness pillar. And then we’re paired with another team member leader along with an HR leader. So, they really help ground floor up to define the areas of focus and work based on the DEI data. And then that all goes into our overall plan so that we can look at how does that get embedded. So this is not just something over to the side or a separate thing. It’s not a project, right? This has got to be embedded as part of our culture and who we are.

(03:59):
In fact, we just rolled out our next five-year strategic plan, and our DEI work is embedded within that. And equally, it’s embedded in our organizational scorecard in terms of, so how are we performing against some of the KPIs that we’re tracking? Also, looking at how we embed it in goals. In fact, all of our leaders have to have at least one DEI goal that they’re measured by on an annual basis. And then how do we bring that forward for even team members to optionally have a goal that they can incorporate into their performance.

(04:33):
All of that then builds into, from a marketing and from a communications perspective, how do we build that plan to support all the DEI work, including the messaging, architecture, the types of programming that we provide across the year. And then equally, how do we look at embedding that in our own work in terms of how we show up as a brand, both for our internal communications as well as our external communications with patient families and referring physicians? So, it really kind of has run the gamut, and we’re approaching that third survey in the next couple of months that will enable us to see how we’re pacing and measuring against some of these key areas of focus.

Alan Tam (05:16):
That is amazing. I’m completely blown away by the level of integration that you and your organization have already had with these initiatives. I think that’s something that more healthcare organizations need to do, and you guys have really set the stage for how it should be done. I want to share more of that. And getting it to where it’s currently at today, there must have been some amazing challenges that you faced. What were some of those internal as well as external challenges as you got this program off the ground?

Deb Pappas (05:55):
Yeah. Well, I have to say it’s a testament to not only our leaders and our leadership team, but our team members. Because I think one of the keys has been, it can’t only be top down and executive driven. Of course, you have to have executive buy-in and commitment to really be able to walk the talk and to have the staying power. This can’t be a flash in the pan. Again, it’s not a project. This has to have sustainability. It has to be embedded and authentic to your culture. And I think we have always at Connecticut Children’s had such a strong culture to begin with that that made it that much more approachable, even though everyone is learning at the same time, right?

(06:35):
While we started that work where some of the challenges were also in, it can’t just be top down driven. There was some areas of pushback and concern about we have to let areas of the organization that may be further ahead in their thinking really help drive some of the definitions. And in fact, when we rolled out our first organization-wide education and training, which was required for all of us, it was focused on bystander intervention. One of our areas of our organization were really the ones that spearheaded that work and then brought it forward, and then we piloted it further, tweaked it a bit, and then rolled it out work wide.

(07:15):
So I think being able to be open and really listening as well as tapping those team members that have the lived experiences to really help shape and inform and not just be trying to push something across the organization that really doesn’t ring true for people. So that’s definitely been one of the areas. And I think one of the other challenges, and it was interesting, some of the poll data that we saw today during the panel, I was actually shocked by, I expected more organizations already had dedicated MarCom staff on DEI. No. No, not the case. Because I feel like one of our challenges as an organization, while we have 1/5 of our team members in communications time focused exclusively on DEI, we don’t have dedicated full-time staff anywhere, even in, we don’t even have a chief diversity officer. Our SVP and Chief Human Resources Officer is also our Chief Diversity Officer.

(08:18):
So part of the challenge is, when you don’t have dedicated staff, how do you do all this work? How do you take it on? Because we’re all doing it as part of our roles. And with that, some of the challenges around when we look at our work across these nine different pillars, there are some inconsistencies that, let’s face it, not everyone is moving as quickly as others may be. So you have that, you might not be making as much progress as quickly as you’d like. And it varies because again, at the end of the day, everyone’s doing this as their additional area of focus. But then equally, we feel as though it has to be all of our jobs. Because even if we did have dedicated DEI team members, we can’t then stop doing our work individually because that’s like it’s defeating the whole point because it really truly needs to be embedded in how we roll, how we think about our work, how we show up for each other. So again, continuing to learn because just like everyone else in the session, we’re all in different stages and places in our journey.

Alan Tam (09:31):
What’s been your biggest surprise as you’ve gone through this process?

Deb Pappas (09:35):
I think for me, the biggest surprise has been just the level of groundswell and engagement. Maybe not so much from a surprising standpoint because I would hope that that would be the case, but the level of proactiveness. Case in point today, I got an email from one of my team members proactively reaching out and wanting to run or host an authentic conversation, is what we call them, at one of our upcoming department meetings on gender bias.

(10:07):
Now, she wasn’t told to do this, asked to do this. This is just, again, the kind of momentum that it has created so that it really kind of takes on. It’s more organic, I guess, and it’s built into how we think and how we do our work. So I think that for me has been really exciting to see, because certainly because of my additional role as that executive sponsor on the education and awareness pillar by default, I’ve been a really strong proponent and been really proactive about bringing things, whether it’s to my executive team and hosting a DEI conversation on allyship or being one of the leaders that would go out and use the self-service tools and then talk about how other leaders can take advantage of these things, again, to bring it local, because we all need to be practicing that. So again, for me, the surprise, the delight has been more around just how much uptake and engagement that we continue to see and all the different either content or programming that we bring forward.

Alan Tam (11:09):
Excellent. Earlier, you talked about at the conference integrating DEI into your organizational culture.

Deb Pappas (11:19):
Right.

Alan Tam (11:19):
What were some of the key takeaways and insights that you received from the audience and the other panel members?

Deb Pappas (11:27):
Yeah. So interestingly, I think in part of the poll data, it was a bit of a split in terms of how many of the organizations have really formalized it in terms of tied to their department or organizational goals, or even have a formalized process of how they go about incorporating DEI into their marketing and communications. So I thought it would’ve been higher, honestly.

(11:53):
So I think in terms of how we all go about integrating it, one of the key takeaways was, even if you have a formalized way and approach to build it in, it can’t become a check the box. It really does need to be that it’s just part of how you think, it’s part of how you do a content strategy or how you think about your different audience needs and how you’re serving up content for them appropriately.

(12:21):
So for me, that was probably one of the key things, is again, even if you’ve reached that point of having it be more part of how you plan and then how you execute, it can’t just become robotic. Again, it’s got to be authentic to your organization. And then also it’s going to vary based on where you sit geographically too. It was interesting because all, the three of us between California and North Carolina and Connecticut, again, you also get different challenges based on geographically where you may sit and where your patient population may live.

Alan Tam (12:59):
So do share some of those key differences. I’m curious as to the impact of geographies on these types of initiatives and programs.

Deb Pappas (13:09):
Yeah. So someone had shared some of… They didn’t identify which state or location, but an organization that was a publicly funded, a health system, was having to remove all forms of even diversity mentions on their website. And again, to me, that is non-controversial, yet things that will affect what you can do in terms of your proactive communication.

(13:43):
On the flip side of that, when we think about pediatrics, there’s been so much intense political discourse around gender-affirming care in this past year. And for us in Connecticut fortunately, where we are in New England, although others were not as fortunate, some of the children’s hospitals in this country obviously had horrific things in terms of bomb threats and just awful hostile violent behavior occurring both on social media and otherwise. So you do really have to think about saying the course despite all these obstacles that are put in front of you and this kind of hate behavior that goes on. Again, different geographies or different populations, whether it’s pediatric or adult, being able to continue to hold firm on the things that you know that you’re doing the right thing for your patients, or in our case for the kids and teens and otherwise, and making sure that our providers also feel supported and safe. So it’s really created all other different forms of acting out that who would’ve thought that we’d find ourselves in some of these situations.

Alan Tam (15:02):
Right. I’m curious, in addition to geography, how technology impacts DEI initiatives as well.

Deb Pappas (15:11):
Yeah, and that’s a great question, and that’s one of the challenges I should have pointed out as well, because data has been a challenge for us. And in particular, I’ll point out two different systems, if you will, EHR and ERP.

(15:27):
So from an EHR perspective, we still have so much work to do to be able to adjust how we actually capture data that will be reflective of not only a patient’s gender assigned at birth, but the gender that they currently identify with, as well as preferred pronouns so that we have all of that so that when we think about our care encounters with the kids and teens and young adults that we care for, we have appropriate care.

(15:59):
Equally, our IS team is doing a lot of work on improving the capture of race, ethnicity, and language and making sure that that’s embedded in the EHR as well as we’ll support research, health research and health equity. And then equally, there’s a statewide initiative that this aligns beautifully with. But that’s, again, we’re on a journey to be able to get to better data there.

(16:26):
Equally, we’re in the process of rolling out a new ERP system towards the end of the year. That will really help us in a number of ways, both in terms of when we think of supply chain and suppliers and how do we get better diversity across our suppliers, and then equally with our own team members. How do we get fine-grained data about, “Okay, are we doing a better job in terms of workforce and strategic staffing and having more diversity in our staff? How does that look with physicians? How does it look with nurses? How does it look with team members or leaders?” And so because we don’t like our credentialing process right now, our data on physicians is inconsistent. We don’t really have good fine-grained data to cite, “Have we in fact moved the needle to be able to improve our diversity of physicians?” We have early indicators that for nursing and for leaders, we’ve started to move in the right direction, both for gender and for race, but it’s still too early.

(17:28):
So in terms of our data on nursing and leaders, it have definitely been able to demonstrate that it is moving in the right direction. Still inconclusive at this point, but it’s all with the desire to be able to get to a place where we have more of a dashboard. And again, once we have the ERP and we have more of that fine-grained data, we should be able to have that larger view that cuts across all of our different pillars and what we’re working against to be able to demonstrate, “Are we tracking?” Because certainly we still have a lot more work to do in terms of our workforce planning and being able to have a much more diverse set of team members.

Alan Tam (18:07):
As you collect this data, how are you incorporating it back out to your communities and your communications?

Deb Pappas (18:16):
So in terms of our internal data at this point, we’re not. Although what I will tell you is we’ve been definitely getting a lot of interest and attention with our continued expansion as a health system and being in the process of building a new tower over the coming years, is, “Okay, what does that workforce look like for that new tower? Or what do the contractors and vendors and all of the construction personnel, what does that look like?” So being able to, again, from a supply chain and supplier perspective, how can we put the right programs in place to in fact have a much more diverse set of vendors that we work with? And then equally, hiring hundreds of both clinicians as well as non-clinical staff. How can we also ensure that we attract a more diverse set of team members? So there’s definitely going to be more need for that level of reporting and transparency externally as well. But right now we have a lot of work to do even internally to get to the place of having those dashboards and easy to grasp analytics handy.

Alan Tam (19:24):
Right. So how does that translate to the impact and success of these initiatives? How do you measure that? What are the right KPIs that you’re using today to say, “This is working” or “This is not working”?

Deb Pappas (19:38):
Yeah. So I’ll break that into internal and external in terms of some of our KPIs and measurements. So our biggest one internally is our annual DEI audit. So with that, it really does go after measuring, “Do you have a sense of belonging?” At the end of the day, I have a sense of belonging at Connecticut Children’s. It also gets into things like, “I believe that as a team member, if I speak up, leaders are going to listen and take meaningful action.” As a patient family, “I believe that they will receive respectful, appropriate care regardless of who they are and where they come from.” And then similarly, for team members, “I believe that as a team member, I will be treated with respect regardless of who I am and what role I’m in.” So those are some of the key questions that kind of bubble up to the top. But in essence, this audit will tell us year over year how are we performing against a whole host of measures and then break it down by different cohorts of team members.

(20:49):
In our audit last year, we had improved by four points. It’s on a 100 point scale. We’ll see how we land. We’ll be doing it mid-year this year in terms of what that looks like, but that’s certainly one of the key measures. Then there are more things like more, I’ll call it engagement and activity measures. So on our ongoing programs that we run, whether it’s training and education or speaker series or even content on our intranet, what does that level of attendance or participation look like? What is the engagement rate with content that’s published? So it really does have a combination of those different measures. And then externally, with all of our marketing and communications content, it’s more of the traditional digital metrics around, whether it’s our blog, our pediatric health hub, our website, or other content that we’re producing, social media, the impressions, the engagement rates, click-through rates, open rates, and the like. So we’re always looking at that as well to help identify where there’s really interest in other topics, and that really fuels our editorial planning as well.

Alan Tam (22:07):
So when you shared it with me that at the top level you increased and improved by four points, is that good? What’s the baseline there?

Deb Pappas (22:18):
It’s a great question. It’s not where we want to be yet. So will we ever be at a 100%, or at 100 I should say? One could aspire and certainly that’s our aspiration. But we’re not satisfied yet with where… I mean, we’ve improved, but we still have a run ramp to be able to do more.

(22:42):
So what we’re going to do as well, we’ve been talking about after we do this next audit, is to do a bit of, not a pause, but let’s do a bit of a look back and look forward and have another strategic planning session around not only how did we perform, but cross all the body of work that we’ve done, what’s worked, what hasn’t worked, and where do we need to go next based on the latest findings. So I think we continue to have an opportunity to learn from not only the quantitative feedback, but also qualitative feedback.

Alan Tam (23:19):
So as you’re looking at this and some of the metrics and measurements that you have, how do you grow and measure the trust that you’re building through these initiatives in the community? How are you tracking that? What are the right metrics and KPIs there?

Deb Pappas (23:37):
Yeah. So that one’s a little bit tougher. I’ll answer it both in terms of our brand and how we measure that through our consumer brand research, and then give you a different example through some of the specific DEI initiatives that are going on.

(23:53):
So through our brand, our annual brand survey, we have consistently been able to measure the attributes that are attached to our brand. And even before we embarked on this DEI journey, we’ve always been focused on making sure that our brand and our brand campaigns and our brand content really are representative of the kids that we care for. So from the get-go, it’s always been about diversity. That said, when we look at some of those attributes, it’s around trust, and trust comes through in a big way. What we’ve really tried to focus on is really topics and content and even digital kits and what we do through our pediatric health hub, and otherwise bringing the content on different DEI topics to families, to parents, to really help not only educate and inform them, but how do they have these conversations with their kids. Or when their kids are coming to them with questions, how are they able to support, again, their learning through that?

(24:53):
So that’s been a good way for us to be able to continue to keep a pulse on, how are we resonating with our target families? Then in terms of some of the work that we’ve been doing as an organization, in North Hartford, the north end of Hartford, is aligned with a grant that we received. We’re in our second year. It’s a five-year, $30 million grant from the US Department of Education, and it’s called the North Hartford Ascend Pipeline. And basically what that means, I know it’s a mouthful, is this whole initiative is all focused on improving the developmental and educational outcomes of kids that live in one of the most economically challenged neighborhoods in the country. So this north end of Hartford, there’s about 575 families, primarily Black and Hispanic. The focus here with all the work is to really have that cradle-to-career investment and improving the outcomes for these kids.

(26:02):
Why this has to relate back to trust? I’m getting there. So when this work was started over a year ago, the first year was focused entirely on planning. And now we’ve been moving into more of the starting the execution. But early on, our leaders that were running the community town halls got some pushback in terms of the trust deficit, is what they were feeling. Meaning that there was some skepticism in the community based on a combination of past work that the city had attempted to do as well as politics in the local community, and the net of that being that they really were not trusting Connecticut Children’s as we embarked upon this work. And then the learnings through all of that early on shifted the dynamic to make it one of much more of a co-creation, meaning that as the planning ensued, it was about bringing the community members, community leaders into the process, into the governance of the work, co-creating agendas, co-leading the community town hall meetings. So now fast-forward in year two, it’s a completely different dynamic.

(27:23):
And so I think our leadership that has spoken extensively about this work has really been about, you got to really kind of go slow to go fast because you’re only going to be able to go as fast as trust is built and really building those relationships and making sure that we have that co-creation model so that you do have the trust. And so I think two totally different examples, but that’s where the trust equation has been a huge learning and really a key requirement for our ability to take on this body of work.

Alan Tam (27:59):
Right. That’s amazing. And I can’t believe the progress that you guys have made so far and all the insights that you’ve gleaned. It’s also sad to hear that not a lot of healthcare organizations have gotten this off the ground. What would be your advice to these folks who are trying to get it started and get it implemented?

Deb Pappas (28:22):
We had attendees at the panel today too that were still much earlier on in their journey. So I think, again, no, it’s not a one size fits all, right? So I think what’s important is you need to start somewhere. But most importantly, two of the three of us on the panel had done those DEI audits to kind of get that baseline. And I thought that that really truly was, at least for us, so helpful because again, unless you have oodles of resources, where do you start? How do you prioritize? How do you make meaningful change and meaningful impact? So I would say if you’re able to do that.

(29:05):
Now, we didn’t do it. We worked with an external partner. Some health systems have done that in-house, and that’s great too, but being able to at least have some level of data to help inform how you put together your strategy and plan. And then certainly having that dual buy-in. It’s not just top down. It’s how do you engage your team members across all different roles so that they feel as though their voices are heard and they are part of that creation. And honestly, also making sure that there’s going to be sustainability. So whatever we start, we have to make sure that we see it through because you’re going to be called on the carpet otherwise because everyone’s watching.

(29:52):
So there’s so much attention, and honestly, pent-up demand in a good way that it’s important that any organization wherever you start, don’t take on too much. Be able to get some work and some progress under your belt and then build from there because I think once you see some of that engagement, it’s easier to kind of get that flywheel going. And also get other team members involved. I think that’s the beauty of it. Now, we have a lot of team members across the organization serving not only in those pillars, but we have a DEI advisory board now that was a application-based process. So we’ve got team members that serve to both inform what we do or what we should do, as well as be consultants to what we put in front of them to get their feedback and perspective.

(30:40):
So I think the most important thing is really to make sure that you’ve got your collective partners, even if you don’t have that dedicated DEI, leader or staff, but really be able to have that core team that’s going to have the energy and passion behind it to see it throw.

Alan Tam (30:58):
Yeah, I really like hearing that in all the partnerships that you’ve been working on. I think collaboration is definitely key to the success of these types of programs. As we look in the horizon and as you look at the remainder of the year, what’s next for you in these initiatives?

Deb Pappas (31:17):
Yeah. Well, I think certainly once we conduct this next DEI audit, it will be that opportunity for us to do a step back and do that look back, look forward, and to recalibrate to see where do we… Obviously we’ve had a lot of different things already running those things that we want to continue to prioritize, or do we still have gaps that we haven’t made meaningful change and meaningful progress against? And how do we double down on those areas? So I think that’ll be really key for us in terms of the what’s next.

(31:48):
And then certainly, end of the year when we get up and running with a new ERP and make some more progress on the data side of the equation, always data comes into our marketing conversation, but I think that will be a next frontier as well, because building that dashboard, having more visibility and transparency. Because while we do embed it into our strategic plan and our organizational scorecard, we want to have it such that it can live right there on the internet and be kind of that real time view of how are we performing and where do we still have those opportunities. So I think that at the core, we’ll be continuing to execute on much that we’ve started, but I’m sure there’ll be new things as we take this next pulse check.

Alan Tam (32:39):
Amazing. Amazing. Again, I’m just ecstatic about what you guys are doing, and I applaud you for your efforts. And thank you so much for sharing these stories.

Deb Pappas (32:50):
Yeah. Happy to, yeah. The team sport.

Alan Tam (32:53):
Absolutely. For those in the audience that want to continue this conversation and learn more about these initiatives and understand how you got them off the ground, what’s the best way for folks to reach you to continue the conversation?

Deb Pappas (33:10):
Oh, always happy to have a conversation. That’s one of the best things, honestly, about being in healthcare, is the level of sharing that we all do. So I’m happy to have anyone reach out to me by email, is probably the best way. Always happy to share lessons learned and to help anyone else who’s looking to solve some of the same challenges that we are.

Alan Tam (33:30):
Awesome. What email can they best reach you at?

Deb Pappas (33:35):
Yes, at dpappas@connecticutchildrens.com.

Alan Tam (33:37):
Wonderful. And do you have a LinkedIn profile?

Deb Pappas (33:40):
I do, yep. And that works as well. Yep, yep.

Alan Tam (33:42):
Wonderful.

Deb Pappas (33:42):
Another good way.

Alan Tam (33:43):
So Deb, thank you so much for sharing all this knowledge. For those of you that want to continue the conversation with Deb, definitely do reach out to her on LinkedIn or via email. She has an immense wealth of knowledge around DEI and the work that she’s done has been incredible, especially for healthcare organizations. With that being said, thank you for tuning in today and until next time, hello.

Outro (34:10):
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