By Marie Hubbard, Senior Program Manager and Dr. Sunita Mutha, Director

Photo: Healthforce Center staff volunteering at the San Francisco-Marin Food Bank in October 2023, from left: Kyoko Peterson, Sofia Sandoval, Melissa Lucas, Khadijat Alli, Xenia Mendez, Marie Hubbard, Vaishnavi Vaidya, Janet Coffman, Sunita Mutha, Sutep Laohavanich, Beth Mertz, and Liwam Nerayo.

Equity is a core value at Healthforce Center at UCSF. This value is visible in our mission and vision and demonstrated in the work we prioritize and our efforts to create a strong and agile organization that is enriched by diverse perspectives and ideas. The recent launch of our health workforce policy initiative, which will accelerate progress toward a health care workforce that better reflects California’s demographics, is a prime example of how we continue to create a collective force for health, equity, and action.

As an organization, we strive to amplify the voices of those who are underrepresented and we pursue work that centers equity. Over the last three decades, we have accomplished much through our research, capacity-building programs, consulting, and evaluation efforts, while also nurturing an anti-racist workplace.

We are excited to take this opportunity to share with you some milestones of our journey to advance diversity, equity, inclusion, and belonging (DEIB) within Healthforce Center. We invite you to consider how your organization is centering equity and how our experiences may be similar or different than yours.

Initiated and led by staff, in 2020, we engaged in a three-part series involving discussions of what anti-racism means to each of us and what actions we can take to support a more equitable working environment. The high levels of staff engagement in the series were bolstered by campus-wide initiatives at UC San Francisco to address DEIB and the broader shifting social climate related to racism.

This confluence of forces spurred us to do more. Our initial efforts led to larger organizational changes and investments, including:

• Improvements to our recruitment and onboarding processes, which have resulted in our team today being a majority of people of color.
• Redesigned programs, such as the California Improvement Network, and leadership program curricula to ensure participants have awareness, knowledge, and skills to advance health equity, address health disparities, and promote anti-racism.
• Creation of a paid internship program for underrepresented individuals in health care.
• Addition of an equity-focused metric to our organizational dashboard.

Over the course of 2021-22, a grant from Cedars-Sinai catalyzed our work to deepen our efforts. This funding supported development of an action plan, two additional DEIB training sessions for staff, creation of a set of organizational agreements for an equitable culture, and development of a guide to help us ensure equity is centered in all our programs, processes, and policies.

From these experiences, we learned that structural changes to recruitment and onboarding processes were effective and that programmatic adaptations help increase our capacity to advance DEIB. We also learned it was difficult to sustain a paid summer internship program due to funding limitations and we had to end the program.

This early work informed our decision to invest this year in creating a post-doctoral scholar position, tied to our new health workforce policy initiative, to contribute to developing more BIPOC health workforce researchers. This five-year program will provide talented individuals with mentoring, networks, and resources to grow their research careers.

Our recent journey has reinforced the importance of DEIB work and fueled our determination and commitment to keep advancing equity in our workplace. While there is more to do, here are three takeaways that we hope will inspire your organization to assess your own progress.

1. DEIB work requires commitment to change. Racism permeates our nation’s history and is present in our biases, processes, and structures. Our organizational efforts have taken staff commitment, time, and organizational resources. DEIB work is ongoing and it requires consistent attention to be ready to adapt and pivot to continue to improve. We’ve intentionally changed processes to ensure good intentions are not left to chance or individual commitment. For example, our revamped recruitment and onboarding processes have successfully increased the diversity of our team members and are now our new status quo.
2. Organizational resources are essential. Prioritizing DEIB efforts requires dedicated staff time to advance these priorities, re-evaluate when an approach has failed, and keep the organization moving forward on the journey. This learning led us to designate dedicated time for a staff member to lead and advance our DEIB work. We have also learned equity thinking must be consistently infused into existing programs, processes, and policies. Our progress as an organization helps us to inform and evaluate where to allocate resources and efforts for this work.  
3. Failure is learning. DEIB efforts, from staff-led initiatives to organizational action plans, all contribute to staying agile and creating a strong organization rich with diverse perspectives. Not all efforts will succeed and there may be a need to pivot when trying a new approach. For example, we created a guide to help our staff navigate how to integrate equity effectively and consistently into everyday work, but it was never adopted or used. Through trial, effort, and reflection on the process we undertook, we learned that our initial approach wasn’t a good fit for our organization’s needs. We are now re-evaluating how to best ensure that equity is embedded in our work.

Committing to changing an organizational culture to advance equity takes effort, time, and resources. We believe it’s worthwhile and essential for Healthforce Center. Despite the challenges along the way, we remain enthusiastically committed to this journey because of the results we’ve accrued and what we’ve learned. We see that our staff and faculty are embracing efforts to strengthen a workplace culture that enables all staff to be their best selves and that brings diverse lived experiences and perspectives to further improve health care in California.

Our efforts in 2024 will continue to advance our anti-racist values, and to support a culture that engages in growth. Our ask of you is, are you holding up the mirror and assessing your commitment to health equity and advancing health disparities? We’d love to hear your experiences and reactions to our story.