Mount Sinai Hospital (MSH) is a large patient care, teaching and research hospital affiliated with the University of Toronto. Since 2007, Media Corp Inc. has named MSH one of Greater Toronto’s Top Employers. MSH seeks to be a national leader in all of its diversity and human rights programs, and to have a staff team that reflects the diverse patients they serve.
In November 2006, the hospital approached an external consultant to help them with a workforce survey to learn more about their staff, in terms of characteristics like race, ethnicity, disability, sexual orientation, age, gender, education, languages and place of residence. MSH was the first health care institution in Ontario to do such a broad workforce census.
Some factors that led MSH to do this census included:
- A desire to provide equitable access to care that took into account a range of language and cultural needs given the socially diverse urban area the hospital is located in
- Concerns that some groups were underrepresented in upper management jobs
- A desire to understand the makeup and needs of its workforce, measure the success of its diversity efforts, and apply this understanding in future plans
- A history of serving members of society who faced discrimination and exclusion
- The goal to be a great place to work, teach, research and volunteer, where patients could get the best care and staff could reach their potential in an environment that was inclusive and free of discrimination.
Facing the challenges
When planning how best to collect the data, MSH had to get the support of many different stakeholders, for a project that was asking for sensitive, confidential information. They had to think about healthcare workers’ desire for anonymity because of strong concerns about privacy and fear of discrimination, especially based on sexual orientation or psychiatric disability.
On the logistics side, they had to survey 5,000 staff, including many who worked shifts and did not regularly use a computer.
Preparing for the workforce census
For the past seven years, MSH’s Diversity and Human Rights Office (DHR), under the leadership of the Hospital’s Diversity and Human Rights Committee and Marylin Kanee, MSH’s Diversity and Human Rights Advisor, had done extensive work to advance human rights issues and foster an organizational culture of inclusiveness and equity, which earned the trust and support of senior leaders, particularly the President and CEO. This trust and support was a key element as MSH prepared for the survey. Activities before the survey included:
- Involving all departments in creating the census
- Working with a steering committee at all stages
- Making the census voluntary, anonymous and confidential
- Working with managers and recognized role models in the hospital as key communicators
- Involving the communication team in all meetings and review of communication materials
- Designing an extensive communication strategy that included posters, pay stub inserts, newsletter ads, staff letters from the CEO and other hospital leaders, and frequently asked question handouts.
Administering the workforce census
MSH’s workforce census was launched from May 14 – 27, 2007, with an extra week added. The census included 50 questions. Staff could fill out a paper copy, use laptop computers that were made available at key locations throughout the hospital, or complete the census on computer at home. Staff who filled out the census were eligible to win prizes if they filled out a ballot and dropped it off in a drum in the main lobby.
DHR staff and committee members were on hand to answer any questions or concerns, and to assure people that the census was confidential and anonymous. An external consulting company administered the census, collected and stored the data, and reported the overall results to MSH. No one at MSH saw the individual responses.
Workforce census results
A total of 2,475 or 55% of employees completed the census. When comparing to general census statistics for the Toronto Census Metropolitan Area, the MSH workforce was judged to reasonably represent the community it serves. For example:
- Staff represent more than 100 culture and ethnicity categories
- 57% can speak a language other than English
- 38% are members of racialized groups
- 6% identified as having a disability
- 5% identified as gay, lesbian, bisexual, questioning or Two-spirited and 1.1% identified as “transgendered” (GLBTTQ).
As well, one-third of foreign-trained immigrants were less likely to be using their credentials in their jobs (21%) than people educated or born here (34%). And while there is much diversity in the lower and supervisory staff levels, diverse groups (especially racialized persons) were underrepresented in upper management positions.
MSH widely reported the results to staff in many formats, ranging from intranet articles to information forums.
Acting on the results
MSH is using the data to find where there are gaps between the make-up of its existing workforce and that of the City of Toronto. It is developing targeted programs, policies and initiatives to identify and deal with barriers. It has put a new Fair Employment Opportunity policy in place, and is working to help foreign-trained staff get their credentials recognized here.
To improve access for people from marginalized groups, MSH conducted focus groups with patients, and is implementing Accessibility for Ontarians With Disabilities Act (AODA) Customer Service Training. To promote respectful treatment of GLBTTQ members of the hospital community, MSH developed an anti-homophobia/transphobia communication campaign and posters and brochures promoting “equity is good for your health.” MSH partners with TRIEC to provide mentors to internationally trained professionals and is building relations with organizations that find employment for people with disabilities and recent immigrants. They are integrating human rights and diversity competencies into hiring, performance appraisals and succession planning.
Best practices and lessons learned
Some best practices and lessons learned by MSH include:
- Having strong leadership that promotes a culture of respect, inclusion and equity
- Having the support and testimonials of recognized role models in the organization
- Making people and resources available to run an extensive communications strategy
- Making the census as easy and accessible to complete as possible
- Ensuring the census has a manageable number of clear questions
- Making the census anonymous limited the ability to identify gaps and track progress in units and branches
- Offering creative incentives for taking part (such as refreshments and prizes)
- Giving people a chance to speak about their questions and concerns
- Sharing the census results
- Regardless of the participation rate, use the census as a valuable education process to learn about the organization and raise awareness.