[SOUND] Welcome to our session today, I'm Diane Spiegel, Executive Coach and author of this course. We're very fortunate to have with us today, Rupal Koshy, who I'm going to ask to introduce herself, from Kaiser Permanente. She is going to be talking about I mean in process case study in the work they're doing around diversity and inclusion. Welcome, Rupal. >> Thank you, Diane. So, I'm Rupal Koshy. I work at Kaiser Permanente. I am the director of learning and leadership development there for all of Southern California. So, we oversee from Antelope valley all the way down to San Diego, all of their Kaiser permanent medical buildings as well as our hospitals. I'm excited to be here with you. >> Terrific. So, if you can share with us a bit about the genesis, how did this process begin for Kaiser permanente to become so focused and so directive about diversity and inclusion inside of your organization? >> Thank you, Diane. So from its inception, I've been with Kaiser Permanente now for about a little over two years. And since I've been there, there has been an extremely strong focus on equity, inclusion and diversity, both from an employee perspective as well as a provider perspective. So for our members, our patients and our physicians. So, this year, as everyone knows, we've had a ton of challenges, especially with Kobe and then the disparity treatment that brought upon some marginalized groups within our communities. So that was our first eye opener with equity, inclusion and diversity. And then with the murder of George Floyd and the fight for social justice just across the country, which brought it more to the forefront. >> Terrific. So with all of those environmental things happening along with this entire COVID process, where did you begin? How did you begin going? Okay, we really want to be able to share these key messages, share with us how you got to that? >> Sure, so for a long time, we've been trying to get leaders as well as their physicians to go through mandatory training, whether it's unconscious bias training, provider training, our basics when it comes to equity and inclusion and diversity. And there was a huge focus on equity. And what does equity mean from an health care provider perspective as well as from an employer perspective? So, they're already initiatives underway, until it took some time to get up to speed and make traction and make progress on some of those. We were slow. Then the murder of George Floyd happened, and the Black lives matter movement as well as the fight for social justice nationally, Kaiser permanente took a very strong stance. And the stance was we stand behind Black lives matter, and as an employer, we're going to make this a more inclusive environment for our employees and then as a provider, we're really going to focus on the disparities that exist within our communities. So when that first happened, our CEO, brought together, we do have actually ahead of equity, inclusion and diversity, which is rare for a lot of organizations. So, he sits on the board as well as he's a direct report to the CEO. So that office got together and said, what are we going to do? What are we going to do for our employees and what, how does this translate to our members? So they went, at our senior leadership, regional presidents along with our CEO, and did listening tours. And these listening tours were only targeted to African American and Black employees. So if you were not African American or Black, you are not allowed to be in these listening tours. And all they did was listen. They asked questions. They asked what their experiences within Kaiser Permanente, what their experiences as a member within Kaiser Permanente as a physician within Kaiser Permanente and what they heard really surprised them. And especially being an organization that puts so much emphasis on EID. >> So, if you were just kind of getting the top line of what they were surprised to hear, what might those things include? >> So, they included things like lack of appreciation for the Black experience, Black history, unconscious bias, micro aggressive behaviors by co workers as well as members, as well as leaders. The lack of promotional opportunities for a variety of different reasons. We tend to be an organization that's very network and relationship driven, and when that happens, you have relationships with people like you, and so it leaves out a whole population of individuals. So, I think not that they were blind to what was going on, I don't think anyone sat down to truly listen. We implemented solutions but never really listened to the experience of our employees. >> So, it really changed the parameters of On which you guys were working. It really Open that up, Correct. So you took that information and you populate that into actual workshop training. Give us the highlight of what those workshops or like sure, so we did a couple things. So in order to target some of the lack of knowledge around black history. >> So when we started out, there was there were a lot of arguments, and this was for the black community as well as the immigrant community as well as the Latin X community, you know, indigenous all all the way around when we started. Even the black community did not understand their own history is what we learned because we are not taught that history in school, we do not make it publicly available. And so there was a lot of incorrect assumptions made around the opportunities that are available for certain populations within our community. So we started off with black history, African American history, from slavery onto today, and it's astonishing when you look at the statistics and the policies and measures that were put in place to really marginalized a particular population within our community. So we started with that we started with doing a lot of research. Fact checked everything you know, came up with counter arguments, addressed those. So we went through and we literally held nothing back. And so to date, there was a lot of hesitation within Kaiser Permanente, as well as other organizations to really go out there and say the truth, say that structural racism exists within our corporations and it exists within society. And this gave us the opportunity to really be in your face about it up front and say that these are all the hurdles this particular population goes through. And here is why. And it is not their fault. It is our fault as a society and structurally in the way were set up. So we started off with that one, and it just grew from there that that we started in Southern California with small pockets. We got more and more and more requests for that one. It went nationally, so that particular module, it just resonated across the board because it was about education. It was just educating people on the X experience that black Americans go through in this country, and it was extremely African American black focused. There was no other. We did talk about some of the other disparities that exist, but the focus of this one was definitely the African American experience. So when you when you think about the reaction you got from the audience, is, was a part of it? People, actually. And again, how some pride, if you will, about looking back at the history and what people had to endure and have survived in order to even be where we are. Was that one of the things you found happened for people? And then that opened up the conversation to a different level? Absolutely. So we started with the premise of our CEO. Our senior leader said you as a leader are responsible to go have these conversations as a leader myself and well versed in this area. Those air difficult conversations to navigate, and it is easy to say the wrong thing. And a lot of times leaders do not happen because they do not want to offend or they do not want to seem like they don't know so well. The feedback we got Was My goodness, I did not know this was their experience. If they were. The black employees are African American employees, they said Finally, someone is educating on our behalf, and it opened up the conversations. It opened up the dialogue, and that is what we were trying to do, and it opened it up with empathy in a place of I want to hear you. I want to listen. I want to know more because we gave them a baseline of what exists. And I think you bring up such a great point. I think part of the hard thing is for people to start the conversation. It is not always that they do not want to, and then it is not always that they are not aware of it. But it is a really difficult conversation. So through your workshops have you found that has also been? It is starting to spread out a bit where leaders are listening and going. Okay, I can do this now I have more confidence. Did you find that to be a you know, a result of 100%. So the way we decided to take a different approach. And when you look at equity inclusion and diversity traditionally and what is taught it, everyone is different. Everyone has challenges, you respect everyone's views. That is typically where we stop unconscious bias. We have. We all have them. They are not bad. We all have them and we just need to be aware of them. When we started doing research around what really impacts and organization when it comes to this, we found that those trainings I actually have a reverse effect. They actually end up creating. more attention within the workplace and with unconscious bias training just your generic unconscious bias training. We've learned that it actually creates more vice because you are. It's just on top, top of mind for you. So we were trying to do something different that would create the conversation starter and really have an impact and in our view, the way we approached it. WAAS The only way to change this is to have conversations thio get to know people. It z difficult to hate someone up close, right zio get to know people and to understand their experiences and understand that their experiences are not equal to yours. So we started with the education piece. Like I said, it's a Siri's and the second one we rolled out is on bias, and we purposely don't call it unconscious bias because a lot of the bias exists. It's on the surface. We know it's there. It's really not unconscious. But we just don't know. Why are we? Don't stop to think Wow, I'm really acting on something that's not fact based. So as we approach the bias training, we talk about how bias has continually perpetuated racism and structural racism. So it's a very racial bias. Focus, training and we ended with. Here are things you need to do as a leader to check your bias. And so we say we all have it and here's how it comes out and it comes out through my progressive behaviors. But you, as a leader, have the responsibility at every decision point to change it. And so we put the onus on the leader, And emphasize that we know we have structural issues. We know we have practices and policies within Kaiser Permanente that don't encompass equity or inclusion or diversity. Right? And so you, as a leader, have the power to make those decisions every day that shifts that cycle. So we give them a tool at the end with five questions that they need to ask every time they make a decision. Thanks to consider, and a particular different stance that we took on that one, which is more relevant to the health care space, is why we see so many marginalized groups, especially our Latin acts and African American black communities that have diseases that are completely preventable, like heart disease and diabetes. And so what is it that's causing this? So we do a lot of focus on what we call Alice static load, which is, you know, the It's basically stacking of stress after stress after stress on the body and how your body reacts and you're not able to regulate your stress hormones. So we do focus a little bit on the health side of it. Of, you know, have this bias really impact someone's health, especially when it comes to preventable diseases. And why are we seeing such, disparities when it comes to health care with different populations? So it's interesting because not only does it impact the way that we work and that we lied and what happens, it actually impacts people's health. There actually is. A is a very tangible result of that. Were you guys able to put together some metrics? Are you using any kind of whether it's employee engagement survey to say, What's the impact on our organization with this direction? Yes, so we just started, so we're we haven't been able to do any long term impact with it, but we have our baseline numbers that we're working with, so we're starting with promotional like you know what? To our labor pools are what do our recruitment polls look like as we're recruiting and promotional opportunities? What? You know. So we were targeting. Here's our baseline. Here's where we've started And then there are metrics that need to be increased for each of our talent acquisition processes, and then internally, we're looking at promotions and then we're looking at our engagement survey. So we do. Pulse survey that goes out every quarter on DSO we started. We have our march and then, you know, our second quarter and then now we're looking at our third quarter and the impact some of these interventions I've had with our engagement surveys. So we're just starting the metrics process because we just began this work. But we do have evaluations. Just are level one evaluations, you know, at the end of our trainings and those have they come out phenomenal. And the feedback we've gotten has been great. We've also done a survey on Has the conversation increased? So, host some of these interventions are your leaders having conversations with you around racial issues, racial disparities within the workplace, as well as within the health care system great. That is, that is really dynamic work. Before we wrap up people, Do you have a particular story that you'd like to share up? Some. Something that somebody said to you and said, Wow, this is really making a difference. And employees somebody in one of groups? Sure. So we do a program, a leadership development program where we've inserted this as part of this leadership development program and we had a group of physicians. So we put them in cohorts and we had a group of physicians that came to us and basically said they didn't realize it. They had no clue their physicians. And they deal with these health care issues every single day. And they had no clue that so much of the health disparities that exist are preventable. So it's just nice to know that we're making an impact not only for employees but for our members. And that our physicians are going out there with a greater vantage point, a greater sense of empathy on our communities that we serve. So it's just it's great to see the impact internally as well as externally within the community. >> Well, thank you so much for sharing all that this really important work you're doing it makes a huge difference to your point, not just to our employees and the populations, but for all of those that you served your members. So I wish you all who are listening into this podcast today I wish you all the best of luck as you implement your own programs. I hope this provided you some great inspiration. It certainly did for me. Thank you. >> Thank you.