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Leadership Lessons From Kim Byas Sr., PhD, MPH, FACHE, CEO

Abstract 

Creating and sustaining a culture of belonging in health care organizations is pivotal for improving employee satisfaction, patient outcomes, and overall organizational performance. This article explores the importance of belonging and how leaders must set specific strategies for fostering an inclusive environment.  It also examines the economic benefits of a culture that nurtures belonging and provides recommendations for incorporating belonging into an effective DEI (Diversity, Equity, and Inclusion) program. 

Introduction 

Belonging is a fundamental human need, essential for thriving both personally and professionally. In health care, where relational dynamics between caregivers and patients are crucial, fostering a culture of belonging is imperative.  Yet, this focus is overlooked, absent, and missing because several insights are missing.  For example, empirical studies indicate that racial concordance—where patients and providers share the same racial or ethnic background—significantly enhances health care outcomes (Saha et al., 1999).  This phenomenon is intricately linked to a sense of belonging, acceptance, and empathy. 

Given controversies surrounding DEI, many health care organizations struggle to embed DEI principles effectively.  Even more challenging are organizations that struggle to fulfill DEI objectives through the inability to retain individuals recruited with the intention of reflecting a diverse workforce.  In part, this frustration is often correlated to the inability of organizations in creating environments where all employees feel they truly belong (Dobbin & Kalev, 2016). 

The Importance of Belonging 

Imagine adding blueberries to chicken noodle soup.  While blueberries are healthy and taste fantastic, they do not belong in chicken noodle soup.  Similarly, any organization—especially health care settings—must foster a culture where everyone feels as if they belong.  Building and sustaining such a culture requires intentionality and congruence between actions and policies.  This process must begin with leadership at the very top and permeate through every level of the organization. Most importantly, fostering an organizational culture of belonging requires intentional policies, measurements, and evaluation tools linked to financial incentives that support this culture. 

Therefore, DEI must transform into DEIB where the emphasis is on creating a culture of belonging.  Such an organizational culture leads to increased job satisfaction, reduced burnout, and lower turnover rates (Barnes et al., 2021; Schroyer et al., 2021).  Moreover, diverse workforces that reflect the patient population can drive higher market share and foster stronger community relations (Alsan et al., 2019).  

Leadership Strategies 

Leadership plays a critical role in fostering a culture of belonging.  Effective leadership must model inclusive behaviors, communicate commitment to DEIB, provide ongoing training, and create safe spaces for dialogue. Specific strategies include the following. 

Integrating DEI into Operational Practices 

For DEI principles to be effective, they must be integrated into daily operations in the following ways. 

Measuring Success 

To gauge the success of belonging initiatives, the following qualitative and quantitative measures are essential. 

Financial Incentives 

Implementing the following financial incentives can further support a culture of belonging. 

Conclusion 

By intentionally adding belonging to DEI efforts and by fostering a culture of belonging, health care organizations embrace an important and strategic imperative.  This step, however, requires intentional efforts, congruent actions, and strong leadership.  By implementing specific policies, measuring progress, and providing financial incentives related to a sense of belonging, organizations can create environments where all employees feel valued and supported.  Focusing on the addition of belonging enhances job satisfaction and reduces turnover.  This, in turn, leads to better patient outcomes and overall organizational success. 

References 

Alsan, M., Garrick, O., & Graziani, G. (2019).  Does diversity matter for health? Experimental evidence from Oakland.  American Economic Review, 109(12), 4071-4111. https://doi.org/10.1257/aer.20181446 

Barnes, D. C., Lesley, M., & Clarke, C. P. (2021).  Organizational belonging and employee turnover in health care: The mediating roles of burnout and job satisfaction.  Journal of Healthcare Management, 66(6), 445-457. https://doi.org/10.1097/JHM-D-20-00036 

Byas Sr., K. (2024).  Case Study: Engendering a culture of belonging in health care organizations. Personal document: CHEF Event for July 11, 2024. 

Dobbin, F., & Kalev, A. (2016).  Why diversity programs fail.  Harvard Business Review. Retrieved from https://hbr.org 

Hunt, V., Yee, L., Prince, S., & Dixon-Fyle, S. (2020).  Diversity wins: How inclusion matters. McKinsey & Company. 

Saha, S., Komaromy, M., Koepsell, T. D., & Bindman, A. B. (1999).  Patient-physician racial concordance and the perceived quality and use of health care.  Archives of Internal Medicine, 159(9), 997-1004. https://doi.org/10.1001/archinte.159.9.997 

Schroyer, C. C., Zellers, R., & Abraham, S. (2021).  The impact of a culture of belonging on nurse retention and turnover in health care.  Journal of Nursing Management, 29(4), 523-532. https://doi.org/10.1111/jonm.13176 

Smith, M. W., Jaffe, K. A., & Lewis, C. (2023).  Sense of belonging and its impact on turnover intentions among health care professionals: A multi-site study.  Health Services Research, 58(1), 98-111. https://doi.org/10.1111/1475-6773.13877