Diversity and inclusion: Lessons from the field

Having led workplace diversity and inclusion work for more than a decade, Rich Robles witnessed a dramatic shift in the conversations he was having about the topic two years ago. After the events of 2020 brought national attention to health and justice inequities, questions about why an organization would need a diversity and inclusion strategy were replaced by questions of how. “Leaders, I’m finding, are eager to do this work.”

In 2021, Robles joined Boston Children’s Hospital as vice president and chief diversity officer. Work was already well underway to ensure an inclusive, bias-free environment for patients, families, and team members. The hospital had established the Office of Health Equity and Inclusion in 2017. In 2020, Boston Children’s issued its Declaration on Equity, Diversity and Inclusivity: six goals that elevate health equity, diversity, and inclusion as an enterprise priority. 

Working collaboratively with colleagues across Boston Children’s, Robles is a part of an organization-wide effort to create a culture that attracts and retains a diverse workforce and benefits from diverse perspectives. “We are working to build a culture where everyone can be themselves at work with a high sense of belonging,” he says.

In this article, he talks about key aspects of equity, diversity, and inclusion work at Boston Children’s and offers advice for leaders looking to initiate similar work in their organizations.

Data is a key component in diversity work.

“We are basing our work on facts, not hunches,” says Robles. To make informed decisions about diversity, Boston Children’s is gathering demographic data on its approximately 16,000-person workforce. This massive effort will offer a view of:

• Boston Children’s workforce through the lens of diversity: including age, gender, race and ethnicity, military status, and disabilities
• which groups are represented (or underrepresented) at all levels of the organization
• how the organization’s leaders compare to the rest of the workforce

The driving goal is to ensure that when patients and families come to Boston Children’s, they can see themselves reflected in their healthcare team. “When we understand who we are, we can ask ourselves ‘Is this who we want to be?’”

Diversity and inclusion can be uncomfortable.

A diverse team can foster a more representative work culture. But work to enhance diversity and inclusion can lead to uncomfortable conversations about “hot-button” topics that managers may instinctively avoid for fear of setting off discord and anger within their team.

“These conversations are tough,” acknowledges Robles. Some leaders may feel very far from their comfort zone. “The thing that has worked best to prepare leaders for these conversations is giving them a safe space to practice.”

Robles coaches managers to approach potentially uncomfortable topics with humility and open ears. For instance, if crimes against a targeted group are in the headlines, a leader might first acknowledge that some team members may be affected by the news. Then give people a chance to share their thoughts and experiences.

Be prepared for a range of emotions: from sad to angry to indifferent.”

“Be prepared for a range of emotions: from sad to angry to indifferent,” he advises. Some people may have a lot to say while others may not want to speak at all. Some people may feel validated by the conversation, others might consider it threatening. To make room for every viewpoint, Robles suggests listening and thanking each person who speaks. It often helps to reinforce why equity, diversity, and inclusion are central to the organization’s values.

Biases are human. Question your biases.

“We all have biases, it’s natural,” says Robles. Unconscious bias, however, may unfairly shape one’s initial reaction to a colleague, patient, or patient family. When held up to the light, biases can lose their power to drive discriminatory words and actions, but first they must be uncovered.

To this end, Boston Children’s is working to identify biases — in policies, procedures, and personal beliefs. For instance, Robles and the talent-acquisition team are examining hiring processes with the following questions in mind:

• Are job descriptions written so that any qualified person can see themselves as a viable candidate, or is the language biased toward certain populations?
• Are unconscious biases affecting the way hiring managers evaluate and select candidates? 

This is not, Robles points out, a matter of quotas. “We are always going to hire the best talent that we can find. But our strategies are going to match our aspirations to employ a workforce that may reflect the populations we serve.”

Unconscious biases can also harm retention. Unquestioned preconceptions may play out in a lack of recognition for high-quality work, qualified people getting repeatedly passed over for promotions, or microaggressions that leave individuals feeling singled out or ridiculed based on their identity.

To ensure people from a variety of backgrounds can envision a career at Boston Children’s, Robles and others are building a work culture in which biases are recognized and difference doesn’t mean exclusion. The effort requires face time, and a good part of his days are filled leading group trainings and workshops and in one-on-one conversations. “The thing that keeps me up at night is how are we going to continue reaching 16,000 people?” he says.

The future of diversity and inclusion

“This is an exciting time to be at Boston Children’s,” says Robles. From its Declaration on Equity, Diversity, and Inclusivity, to the bystander-to-upstander trainings, to the public commitment of President and CEO Dr. Kevin Churchwell, the hospital is a leader in equity, diversity, and inclusion. “Equity, diversity, and inclusion are part of our DNA.”

In the future, I want us all to be so inclusive that we don’t need a diversity and inclusion team in place.”

As much as he loves his work, Robles envisions a day when his role is no longer necessary. Success will mean reaching a point where people who look, sound, or move differently can integrate into positions suited to their talents and aspirations. “In the future, I want us all to be so inclusive that we don’t need a diversity and inclusion team in place.” 

Learn more about equity, diversity, and inclusion initiatives at Boston Children’s Hospital.