02_Audio_041624_OneLabSummit2024_PowellBaker

DANA: I'll begin with sharing my slide here. Let's see. Thank you for all the hearts. I love that. Thank you. All right. And I do apologize in advance, as I do have an active storm going here. So let's hope that our connection stays good. But again, yes, we're going to talk about today the role and importance of the DEIAB, so diversity, equity, inclusion, accessibility, and belonging or belongingness in the public health laboratory workforce.

And of course, in that discussion really focused on advancing health equity. That's what I'm sure everyone can see. My slides. OK? Thumbs up? Perfect. The applause. Yes. Thank you. All right. So first and foremost, again, happy Lab Week. As I was sharing with our teams yesterday, this is our national holiday, right? Where we get to not only just recognize the efforts of our workforce, but just the amazing contributions to what we do in saving lives every day. So I applaud you and commend you for all the amazing work that our workforce is doing.

So again, happy, happy Lab Week. And as was already introduced, you got a sense of my background, but I always love to share, of course, my pronouns, she/her/hers. And the fact that I just love learning and part of that learning journey for me has been just really expanding my understanding of diversity, equity, and inclusion, and how it really plays a really significant role in the work that we do as not just as a workforce, but even as individuals in our day-to-day work in the laboratory workforce. And so I've been a long time advocate when it comes to DEIAB and just really excited to give this talk to you all today. 
And just as a quick disclosure, I do not have any financial disclosures or conflicts of interest with the presented material in this session. And so just a quick review of today's objectives. So today I hope attendees will be able to describe DEIAB, again, diversity, equity, inclusion, accessibility, and belonging, including its role in the public health laboratory workforce. And this is also-- This is not just exclusive to public health laboratory workforce, but also to our clinical laboratory workforce as well.

Explain the importance of lab and workforce development initiatives as it pertains to our workforce, and just discussing different approaches for advancing health equity in the work that we do, especially among those underrepresented or marginalized populations. And again, identifying opportunities to successfully integrate DEIAB into the training and education of our workforce. And so for anyone who's ever been to a Baker talk, I always love to include a quote.

And so I thought that this quote, although brief, really resonated with me from Dr. Paul Farmer, in which he briefly but importantly stated that "equity is the only acceptable goal". And I feel like this is truly applicable to the work that we do within the laboratory workforce, that our contributions are testing. All that work really goes toward advancing equity among not just our patients, but collectively our communities. But first, I just wanted to give an overview of just some terminology, but also just the different dimensions of diversity as it may be a part of the work that we do day to day. 
And just thinking about how we are doing work to shape our future laboratory workforce, and in thinking about diversity and inclusion in particular, how these two concepts really have been identified as crucial for workforce development and the improvement of our overall public health and well-being. And really with diversity and inclusion, we're able to, through increasing that or recognizing the need, to have increased diversity, equity, and inclusion, as well as accessibility have to include that in there as well. That's really important.

This will help to further strengthen and develop our workforce. And really what us collectively striving towards that goal to be more inclusive within the laboratories, and, of course, ensuring that we are more reflective of the diverse communities that we serve. And so I want to start with talking about health equity and just making sure that we all have a shared understanding of what that means. And I like this description from the World Health Organization, in which they described equity as the absence of unfair, avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically, or by other dimensions of inequality.

And so truly, health equity is achieved when everyone can attain their full potential for health and well-being. And so we want to make sure that everyone has the resources necessary to help fulfill their own quality of health, but also improve their well-being, irrespective of where they are, in the sense of socioeconomic status, geographical location, and so forth. And so really, one of the descriptions that saw with equity that really spoke to me was that equity is a process, whereas equality is an outcome of that process.

And then also, we can't talk about health equity without discussing social determinants of health and, of course, health care disparities, as I feel like those two are really pertinent to this conversation. And so just quickly, going through those descriptions here, as far as social determinants of health has been described as the personal, social, economic, and environmental factors that determine unequal and avoidable differences in health status. And then health equity is really more so referring to those differences in health and in health care between those groups, stemming from those broader inequities.

And so as it has been described here by CDC with regard to disparities, these are preventable differences. And this is in the burden of disease, injury, violence or opportunities to achieve optimal health. That's often experienced by socially disadvantaged populations. And so, again, what is the work that we can do collectively to help mitigate disparities and really advance health equity from the contributions of our profession. And we'll talk about that more, how it does continue to persist here in the United States in particular, and I'm sure in other parts of the world.

And so if you're not familiar with Healthy People 2030, I absolutely encourage you to definitely look into this really important resource and initiative. And there should be a link added to the chat so you can read up more on this. But Healthy People 2030 does include social determinants of health among its leading health indicators. This is an area of focus for Healthy People 2030. And with it being one of the five overarching goals, we really want to work toward creating social, physical, and economic environments that promote attaining the full potential for health and well-being for all. 
And some other examples of social determinants of health, just so you kind of have this idea of what I'm talking about when I keep saying that, is really looking at examples of safe housing, transportation, and thinking about transportation to and from, whether that's medical appointments or even the inclusion of laboratory testing being a part of that transportation. The different aspects or levels of education, work or job opportunities, income, as that all can impact medical insurance as well. The ability to have access to clean water, clean air, quality, nutritious foods.

All things that are necessities for our day-to-day living that unfortunately everyone does not have access to. And then importantly, just really thinking about health literacy. And that's a phrase or a term that we've heard, probably more so in recent years. But when I hear health literacy as a laboratory professional, I think about interpretation of laboratory data and really understanding what that means and the implications of that on someone's health and well-being. And especially now that patients have more direct access or immediate access to the laboratory results.

And unfortunately, consulting Dr. Google, if you will, when they are trying to interpret their lab results, what opportunities exist for us as a profession to really help with that understanding of what laboratory data means and how it does impact their overall health and well-being quality of life. And so with that foundation set of just talking about advancing health equity, what does it mean to really discuss or explore social determinants of health and health care disparities?

I thought it was important to tie that into workforce, right? Like, what does that mean for us? And in this article, essentially-- I'm just going to read the quote directly as I felt like it was just really profound, and that "people of color often face challenges in accessing equitable health care. Disparities in health care pose a very real moral and ethical social justice dilemma for society, and prevent efforts to improve the nation's health and manage escalating health care costs".

So really, going back into those social determinants of health and the implications of that, but that also a diverse health care workforce is necessary as a means to help care for an increasingly diverse patient population. And given that we have evidence of an increasingly diverse patient population, it is really important to have this discussion around what diversity, equity, and inclusion means for us as a workforce and increasing that to, again, be more reflective of the patients and the communities that we are serving. 
And so transitioning into this discussion of workforce diversity in particular, we touched on DE&I, but I really want to talk more about belonging or belongingness, because this also speaks to not just the recruitment aspect, but the retention. So although some agencies have-- Or organizations have really focused on increasing the diversity of their applicant pools and recruiting more individuals from diverse backgrounds, what does that mean in terms of retention and of that individual feeling like they have a sense of belonging, or that sense of a meaningful connection, not just within the organization but within the workforce as a whole?

And so in belongingness, looking at working with teams where individuals feel included, seen and valued as a part of that workforce diversity, then feeling appreciated for their contributions, not just within their role, but to the organization itself and to the workforce as a whole, able to show up authentically, fully as themselves, and feeling accepted for showing up authentically as their full selves. And all of that is really going to speak to not just retention for the organization, but also the retention for our workforce. 
As many of you know, we have workforce shortages across both medical and public health laboratories. And so this is something that may seem small, but it's actually a value, great value, especially to those who do come from diverse backgrounds. If they're lacking that sense of connection and belongingness, not just to the organization, but to the overall body of work, then that's going to impact retention for us as a profession. And so I love this description from this particular article that I was reading where "if we fail to consider inclusion and belongingness, the sustainability and long term impact of diversity initiatives will be limited".

And I would actually go beyond that and saying that not only the initiatives will be limited, but also the opportunity to retain quality personnel that really are effectively contributing to the work that we're doing will definitely be impacted. So this is something that you definitely want to consider when it comes to DE&I, that not only are we focused on diversity, equity and inclusion, but the outcome of that being, that that individual has a sense of belonging within the organization and within our workforce.

And so I like to bring in dimensions of diversity anytime I'm doing a talk, because I know that in some spaces DE&I seems to be really just centered around race and ethnicity, which is very important-- I do not take away from that. That is immensely important, especially when we're talking about underrepresented or marginalized populations. But there are also other dimensions that we really need to talk about when it comes to the impact of the work that we do day to day, and what we have to even take into consideration in laboratory testing.

So definitely age, gender, sexual orientation, mental and physical abilities. Those are all considered a part of those primary dimensions or those things that we initially maybe see or are visible to us. But also factoring in those secondary dimensions are really important too when we talk about the diversity of our communities or the diversity of our patient population. Did they formally serve in the military? Or do they currently serve in the military? What is their work experience? Their education level?

Income, touching on that socioeconomic status. Religion can definitely have an impact on not just laboratory testing, but treatment plans. Depending on certain religions, there may be certain medical interventions that are not acceptable. And so what are the alternate solutions or alternate treatment plans when it comes to that or alternate testing that we can do. Geographical location, which really speaks to transportation and access as well. What does that look like? And even looking at organizational roles and so forth.

And so one of the dimensions here that I like to call attention to as well is the work content or our professional field. And so of course, you might have heard a lot of these discussions around professional identity, and I'm not going to take that full dive into that. That's a whole other hour that we could talk about professional identity, really more than an hour. But as laboratory professionals too, and just looking at our work, how does that contribute to our dimension of diversity and our identity and our occupation, and how we see ourselves, and how we identify ourselves as well. 
And so just all of this comes together to really make up who we are as individuals, but also how are we meeting people where they are and helping to advance health equity in the work that we do. So we'll talk about that a little bit more. All right. So I've kind of given a foundation somewhat, so I hope that will help as we kind of steer this conversation more into workforce stuff and really looking at a couple of different reports that actually really do support this discussion around fostering that increased diversity, equity, and inclusion.

And so, one of the reports, if you're not familiar with it, is the Siemens report that came out a couple of years ago, which was a study that really looked at the challenges that we're facing as clinical laboratory professionals, and explored how to meet the current and future needs of the workforce. And in this study, there were three overarching areas that really stood out as an outcome of this report. So increasing visibility—

So of course, we're doing that lab week, but we need to do it all year long, as far as this really increasing the visibility and the awareness of our profession and what we do. But also improving recruitment and retention was definitely highlighted as a part of not just our current, but also future need in the workforce. And here, right here, at number three, focusing on diversity and inclusion in the laboratory. And so that's really paramount to the work that we're doing. And of course, that point of it helping to advance and contribute to the advancement of health equity.

And if implemented, these actions will contribute towards strengthening the career paths into laboratory careers and fields. And so transitioning that into the 2021 wage survey that was published by ACP at the end of 2022-- This is a biannual survey. And I think this one is really important as well. When we have the discussion around workforce and DEIAB, as this does provide a good snapshot of what is happening in terms of wage survey, but also just the demographic makeup of those respondents completing these surveys.

And I'll just take a quick little soapbox here, where I know survey fatigue is real, especially in this day and age. But if there's any opportunity to complete a wage survey, a vacancy survey, anything workforce-related survey, I as a laboratory professional want to encourage you all, because I've endured that survey fatigue as well. But I encourage participation in these surveys because this is what gives us that snapshot of what is happening in our workforce.

And if we don't have individuals completing these surveys, it's harder to really capture that and really to be more reflective and inclusive of what's happening across our field. So that's my quick little soapbox there. But for this survey, these results really help to serve as that basis for us just really looking at what needs to happen with regard to recruitment, retention, education, advocacy and so forth. And this also included that increased focus on visibility, recruitment, retention and diversity.

And so just a couple of the distributions I wanted to share as a part of this discussion on DE&I. And from those that responded to the survey, you'll notice that quite a number of people fell within that 25 to 44 age bracket, as far as the number of individuals that responded to the survey, which when you compare it to our understanding or numbers when it comes to the laboratory workforce, this is pretty close to representing that age diversity, if you will, of the makeup of the workforce.

So just kind of getting a sense, or snapshot, again, of where we fall in the sense of age range. So think that's really important to gather, especially when we're looking at the number of individuals that are entering the profession. And again, this is an opportunity, as I stated earlier, as far as saying that having more increased participation in surveys just so that we can have just more of that information contributing to the information that we're seeing here as well. And then, also looking at ethnicity, where most of the participants self-identified as White.

So that was right around 72.5%. Of participants or respondents here. And keep this in mind when we look at public health here in a little bit. And then in terms of education, that being also a dimension of diversity. I thought that was important to consider where most of the respondents fell here as far as having a bachelor's degree with about just over 15, 16% or so that have advanced education here.

OK, so now we're going to look at public health laboratory professionals. And with PH WINS, this is the public health workforce interest and needs survey. So this is actually conducted every three years by the Beaumont Foundation and the Association of State and Territorial Health Officials. And actually, the next iteration of that, I believe, is due to launch this September in 2024. So again, I believe that link is being shared here in the chat, but I would encourage you to also look into this, just for your own awareness of this survey, and the data that they collect regarding workforce demographics, as well as training needs, professional engagement, satisfaction and other areas as well.

But this is the only national survey that is representative of local and state government, public-health workforce employees in the United States. And I wanted to pull some information as it related to laboratory professionals out of that particular survey. And so here, if we were to compare what we see in clinical or medical laboratory workforce and with public health laboratory professionals, about 52% of those that responded to this survey fell within that similar age range, I would say, so over half within 31 and 50 years of age.

With race and ethnicity, we have just over 50%, so 56% that self-identified as White. So you have a little bit of increased diversity here in terms of respondents within the public health laboratory workforce. And then about 72% of lab professionals identified as women. So, of course, this is something that we've known about our workforces, whether it's clinical or public health laboratory workforce, that it tends to be primarily comprised of women. So opportunities there in terms of recruitment as well.

And educational attainment is similar as far as about 43% hold a bachelor's degree with actually a higher percentage of advanced education here, as far as those that hold master's and doctoral degrees. And of course, this is of those who were surveyed, so the respondents to the survey. And so in addition to that demographic information, what I thought was really interesting about this particular survey was them really looking at perceptions about organizations. And thought it was really telling just to see that 68% of laboratory professionals perceive DE&I as agency priorities. 
And so I thought that was really great, that for at least over half of these participants, they do perceive DE&I within their employers organization as a priority, with 72% indicating that supervisors respect all employee backgrounds. So that also would speak to what was discussed earlier as far as inclusion, but also hopefully that sense of belongingness that some of these respondents may feel or perceive. And then, they also touched on health equity, which I thought was really interesting as well.

And so just in the sense of those respondents being aware of health equity and what that concept is, you have about 57% that had, I would say, an enhanced awareness of that, which is great, but again, an opportunity to increase that awareness just across the workforce of the profession itself. But then, when we looked at confidence, as far as now, how do I apply this to the work that I do? Now, that was a little bit lower as far as very confident being 38%. And so again, I see this as opportunities to—

Great, we have some awareness here of what health equity is. Now, how do we increase our confidence to where we're able to successfully apply this to the work that we do? And very similar with social determinants of health, where they also indicated their level of awareness and their sense or level of confidence regarding that topic or concept. So you had about 47% that were like, yep, I'm very aware of social determinants of health, whereas then we saw that lower percentage or lesser percentage with that level of confidence in applying that to the work. So again, opportunity to really increase that.

Oops, I clicked too fast. So coming from just looking at all that data, which I know is a lot of information, but, you know, we're scientists, we love data. So hope you all are OK with that. But as we look at all that information, what does it mean when we talk about DEIAB? And I think it helps to essentially lay that framework or that foundation of where we are, but also where we have opportunities to go and grow, but how do we go about doing that? How do we not only enhance our awareness when it comes to health equity and social determinants of health, but how do we strengthen our confidence and our self-efficacy when it comes to being able to actually apply those concepts to the work that we do every day?

And with any time I give a talk and I'm approached by an individual about, well, how do I go about this? Where do I even begin? And I'm like, you know, it starts with us on the individual level. And when I say us, that includes me too. I had to do a lot of that work and really increasing my own understanding and knowledge when it came to these concepts. What kind of workshops, training, professional development opportunities are you able to leverage just so that you are increasing your own understanding?

For me, I'm like, that's not anyone else's responsibility necessarily to teach me, unless I'm enrolled in a class or something like that, but what is my motivation and intrinsic factor of just wanting to know more, just so that I could be effectively applying this in the work that I'm doing every day. And so using myself as an example, I sought out those opportunities for additional training. As soon as I became aware of a professional development opportunity that would support me going back to school and attaining a certificate in DE&I. I did that.

I always try to attend conferences or opportunities to where I could just be a sponge and just learn more. And so that's where I encourage the starting where you are, because you have a sense-- I would hope that you have a sense of where you are in terms of your understanding related to these concepts. And be encouraged to seek that out, but even reach out to people to say, hey, do you have any recommendations or resources for this?

And so that's part of a lot of the links that are being added to the chat today too, as far as just helping to share that information. But then when we go beyond that individual level, now, what are we doing as an organization? And so, that's something where anywhere I've worked. I've intentionally sought out, well, what are we doing with regard to DE&I? And how are we as an organization integrating that into the work that we're doing?

So if there's a committee, if there's a task force, if there's an initiative, a project, big or small, I'm not saying go out and change the world, but just finding a way just to not only increase my awareness of what we're doing as an organization, but opportunities for me to plug-in and just help to contribute to that work. But also that's another learning opportunity for me as well. So I always encourage that, just being aware of what your organization is doing. Or is there an opportunity to do something if nothing is being done right now?

So bringing that conversation to the table. Now, what are we doing as a laboratory workforce? Let's move it up a little bit. I think that's really important as well, to look out externally to see what's happening. And so, one of the, I'd say, more recent exciting developments is the recent formation of the medical and public health laboratory-- I want to get this right. Coalition. Workforce coalition. And so, it's the medical and public health workforce coalition that is this forming of over 20 different associations, APHL included. Shameless plug.

But just being a part of that conversation of looking at workforce in general, what does recruitment and retention look like in terms of needs for both medical and public health laboratory workforces? What does an increasing diversity and inclusion look like in advancing health equity? This is all part of those conversations. So as a workforce, it's really exciting to see, to look out and see that that's happening, that there are different steering committees, groups that are forming or have formed within different professional associations.

So really look to that too and see what they're doing, and it's an opportunity to volunteer and plug-in and be a part of that work. And then looking to what's happening within your community, are there opportunities within where you work, where you reside? Are there barriers and challenges there when it comes to health equity? And how can laboratory be a part of that conversation?

I always advocate for lab getting a seat at the table. There are so many conversations, even regarding DEIAB, that we haven't been able-- I felt like we've been a little later to the table too, as far as being included as a part of this conversation. So again, it's just really exciting to see these different groups come together, especially with our workforce coalition, where we're having more of these conversations, where we're being invited to more tables to represent the work that we're doing. And so we're getting there. 
And so I definitely encourage people to become a part of that, or at least become aware of what's happening in those spaces. So let's talk more about just workforce development and, again, just the benefits of diversity when we talk about our workforce. And so in a previous report, some of the benefits that were listed, including that improved access to health, quality care for our underserved and underrepresented populations, really having that increased or larger pool of trained professionals from underrepresented communities, because that will also lead to that increased diversity of our workforce. 
And overall, greater patient satisfaction. I know I have probably on a later slide, but I'll just bring it up here. Whereas when you have that increased representation on your health team, especially within the laboratory workforce, that increases that diversity of thought, diversity of solution, inclusion of that discussion around problem solving-- And that would include treatment approaches or how we may address certain barriers or issues when it comes to diagnostic testing. So all of that.

As we're creating and a really, I would say, bringing together those solutions for our patients, it helps to improve their overall satisfaction with their treatment and care. Improve patient provider relationships. Also that increases trust and communication. As many of you, I'm sure, know there are definite marginalized populations and communities, where medical mistrust is still very prevalent. And so how do we increase that trust and through that increased communication between patients and providers. So this is another benefit of that increased diversity.

And also increasing the likelihood of patients accepting and receiving evidence based medical care, and ensuring them that is what we're providing, that we are leaning more on best practices, leaning more on evidence-based medical care, that we bring science to the table. And so knowing that data and that information is really driving a lot of the care and the work that we're doing, is also really important for our patients to be aware of and that overall improved health, and, of course, well-being. And so again, just thinking about the work that we do, we generate the data that is used to demonstrate the impact on health equity.

But let's not diminish or decrease the value of the work that we are doing as a workforce. They are using the data to help drive the decisions, to drive what algorithms or treatment plans, protocols, and so forth are happening. So the work that we do is really vital when it comes to advancing health equity, and it gives us an opportunity to become more actively engaged in advocacy work and policy-making within laboratory science and ultimately within health care and public health. And also examining the role of laboratory testing practices and systemic issues directly impacting underrepresented populations.

So even the discussions around whether it's race-based laboratory test or other systemic issues that have arisen over the years regarding that, we're able to use or examine how the lab plays a role in helping to dispel or debunk what the significance of those tests are, what's the scientific basis for those results, and how that data can help support that increased quality of care for our patients and communities. And then also developing those strategies to help reduce or mitigate health disparities.

And also, of course, improving access to appropriate laboratory testing. Thinking about the social determinants of health, not everyone can just hop in their car and go have laboratory testing performed. So how can we increase those opportunities for point of care or home testing, or those telehealth communications, and possibly even lab being a part of that. So just exploring those different opportunities to even engage in a professionally with our other members of the health care team to let them know of these options, or just have discussions around alternative plans for that.

So that way we're optimizing that quality of care, but also satisfaction with patient care, keeping those social determinants of health in mind. And so I will always argue, as a laboratory professional myself, that the equity work cannot be left to someone else to do. We can't say no, it's another profession's job or that falls under another professional rules hat. This is a part of our scope of practice. Again, we generate the data. We're knowledgeable. We are experts in the work that we do. And we have something to say. 
As a southerner, I know that was a thing that we always say, the south has something to say, but I love to apply that to our laboratory professionals. We have something to say when it comes to health equity and how we advance that, and how we improve that. And we have that direct understanding of how we can help improve coordination of laboratory services across health care systems, as well as across public health systems, increasing that diverse representation in our workforce, again, as a part of our pathway building. And being able to integrate cultural competency and understanding with health equity indicators will also impact our performance metrics.

So just all things to take into consideration when we have this discussion. And so just now just moving into more of opportunities to develop ourselves professionally when it comes to training and education for laboratory professionals. So I think it's just really important to establish what that culture looks like with us, whether that's organizationally or even as a workforce. And so even asking ourselves individually, what is your commitment to DEIAB? And whether that's to, you know, I want to contribute to the advancement of health equity, I want to help address barriers and challenges when it comes to laboratory testing, I want to help mitigate health disparities.

Whatever that commitment is, what is your commitment to that? And does your commitment align with your organizational partners? And so not just looking internally, but also looking externally to see how that commitment aligns. And also take into consideration what is the vision of DEIAB for your team? And do you have any continuing education or professional development opportunities that are accessible to your team?

And if not, what are those opportunities to reach out and connect with others to seek out those opportunities that may help support the development of your team. And has there been an opportunity to create objectives, goals, values or statements even related to DEIAB? Just so that collectively there's a shared understanding of what that commitment looks like and how we're shaping the culture of DEIAB within our respective teams or organizations.

I'd like to use this as an example from APHL, that this is built into our core values as an organization. And so, you know, as a part of our looking at our commitment to our community, to innovation, scientific, and professional integrity, we also have diversity, equity, inclusion, accessibility right there. And this is accessible on our website. So that we embrace, promote and model a culture of diversity, equity, inclusion, and accessibility, and recognize it as essential to the work we perform in the communities we serve.

So it's there in black and white. So collectively, we have an understanding of what that value is, and we know that it's integral to the work that we do every day. And also looking at just promoting DE&I or DEIAB and increasing representation in the workforce, so what are the benefits beyond and including improving patient outcomes, increasing that employee satisfaction and building stronger communities? Which is really important to our overall arching health equity goal.

But increasing access and reducing those barriers to advancement opportunities. So reviewing what, what your practices look like internally for recruitment and retention, but also how are you increasing or encouraging more diverse applicants or individuals from diverse backgrounds rather to apply and to seek out opportunities with your organization? And also fostering more inclusive work environments. So always really champion ensuring that before we go out and just recruit for the sake of recruiting, let's make sure the environment is ready and that we've created an environment that is inclusive and welcoming when we bring in individuals from diverse backgrounds, instead of doing that work the other way around.

Because we want them to immediately plug in, connect, have a sense of belonging in the workplace and on the team. So also consider that inclusive messaging about programs and, again, just sharing upfront, what does advancement opportunities look like, what does that career ladder or pathway look like for that individual. And getting more into this recruitment and retention practice, when we're looking at recruitment, reviewing those job advertisements and posts and where we're posting.

Are we posting in areas where we can increase our pool of candidates? Revisiting what job descriptions look like just to make sure our language is inclusive there again, and that we're effectively communicating the requirements or expectations of the role. Reassessing those interview questions. I encourage people don't leave questions or use the same set of questions for 10 years. Always revisit that and see is there an opportunity to update it, to improve it.

As we talk about DEIAB, that work, that work is ever evolving, terms are changing and evolving, so we just want to make sure that we're timely and relevant when it comes to any particular documentation, such as interview questions that we're using. And I've already touched on the use of inclusive language. Revisiting what those onboarding materials may look like. Are we paying fair or equitable compensation rather? Are our dress code requirements inclusive?

So that way if individuals want to wear their hair in a certain style or wear certain clothing that may be more reflective or indicative of their culture or their background, or their sense of identity even, is that really a barrier if they want to wear certain things in the work that they're doing? Just being mindful and just having those conversations about that. Reviewing the competency assessments. That's the same thing. So if you've been using the same annual competency for years and maybe some of the questions are slightly outdated, especially when we look at ethnicity and some of the laboratory testing that is performed, there are some practices that we've come away from, but questions in the competencies are still there.

Revisit that and make sure that those, again, are up to date and relevant and reflective of evidence based practice. And as you're doing that, reviewing the language in your standard operating procedures or policies and also handbooks. And then, when it goes to retention, looking at how we do performance reviews, are these equitable? Reviewing benefits and compensation, and if there are opportunities to have different scheduling options, let's explore that and have an open dialogue about it.

What does it mean in the sense of operations and performance? I know that there's going to be a different train of thought, depending on probably when some of us enter the workforce or probably how some of us enter the workforce. And so our impression and understanding of what a schedule should be and look like has potentially evolved at this point. So let's just be open to having that conversation and looking to, of course, industry again to see what is best practice to help inform a lot of that decision making as well. 
Mentorship. I cannot overemphasize. It's so important and crucial to professional development. And so ensuring that mentorship is a part of that retention effort, so that person feels like-- or that individual feels like they have that ongoing guidance and support from a mentor can really speak to that sustainability and continuance of their work with the organization. And recognition programs are really important. OK, I'm looking at my time too. So professional development, let me get into that. That's really important too, as I speak to the ongoing training and education needs.

DEIAB can be a part of that training as well, especially if that's the culture that you've decided that you really wanted to engage and implement within your organization or within your team, having those discussions, again, around what career advancement may look like. And again, competency-based training can be a part of that consideration for professional development. Just really still expanding on this inclusive recruitment practice when it comes to our workforce diversity by employing those better or enhanced, inclusive recruitment practices.

This will help expand opportunities for us to recruit more qualified individuals from diverse backgrounds into laboratory science. And even when we look at the bottom line, in terms of another benefit of workforce diversity, it was in this report from McKinsey and Company that the most-- or the more diverse that companies are, it's more likely that they will outperform less diverse peers on profitability. So it speaks to the bottom line of just profits, operations, organizational performance, and so forth.

So it does impact that bottom line when it comes to the work that we do. And then I want to call this out to not necessarily toot our horn, but I will a little bit here, when it comes to recognition and visibility. And so last year, we applied for this opportunity to be recognized as an inspiring program in STEM with insight into diversity. Just really highlighting the work that our programs are doing with that intentionality of increasing the diversity of our workforce through our fellowship and internship opportunities through public health laboratories.

And we were noted as an honoree last year and recognized for that work. And there's a link being added to the chat now, because I would love to see more labs, more lab organizations. They have specific requirements where even nonprofit organizations can apply, because I know there's a lot of associations and organizations doing some really impactful work when it comes to increasing diversity within the laboratory workforce. So instead of being hidden as much as we are, this is an opportunity to increase visibility for the programs and the work that we are collectively doing.

And so know this application is open now. I didn't want to just keep it to ourselves, because, again, we are coming up together, we need that increased visibility and just increased awareness of the work that's happening in the laboratory workforce. So definitely consider this as a potential opportunity to receive recognition as an organization. And so with that, just additional strategies for implementation of DEIAB. So again, I cannot overmentioned, overstate that increasing your understanding of the topic is really important.

So it starts with you. It starts at that individual level. But then also going back and reviewing the organizational mission, vision, goals, and policies. There's nothing in place to initiate the conversation about why we don't have anything in place, and there's an opportunity to put something in place. Engaging in active listening is really crucial when we're having these conversations. So that way we're just being mindful of how collectively our thoughts and our perceptions of DEIAB may be a part of the work that we're doing.

But also writing a statement or a practice about your approaches. When you're doing that work, include your team, so that way they are able to offer their input and insights. Again, going back to that diversity of thought, you want to be really inclusive of that. And really being able to communicate. This speaks to science communication, being able to effectively communicate the value of not just our laboratory workforce, but DEIAB and our role in helping to advance health equity in regards to that. But when you're able to communicate the value, it helps to improve productivity.

Of course, again, it helps to foster that diversity of thought when it comes to decision making and problem solving, and so forth, troubleshooting. But again, it does enhance your recruitment and retention for your team. And so here I have another dump of resources that can be added to the chat. But I just thought that these were some great tools just to be aware of. So if you haven't had an opportunity to utilize the inclusion inclusive communication tool provided by the CDC, this is a great conversation starter for your team, when we're looking at inclusive communication and what that can look like, as we are having these conversations about health equity.

Recently there was a racial justice competency model that was published for public health. And this may also be useful for those in the medical laboratory workforce as well. So I would say not just exclusive to that, but take it again as a resource and opportunity to see what's happening in that space. Even the national academies has some great resources, some great videos even, when it comes to this conversation of DE&I, but also health equity. And then CMS, if you're not familiar with their framework for health equity, I definitely would encourage you to take a look at that, as that can help shape and inform the work that you're doing within your respective organization.

And CMS does actually have a health equity conference coming up, too. So that's something that you may want to explore or consider, whether it's the virtual or in-person opportunity. So to summarize this talk, it was just a good opportunity just to look at, as a workforce, what we need to do when it comes to reimagining what DEIAB can look like for us, but also how we can potentially act upon integrating this into the work that we do, especially with that goal of helping or contributing to the advancement of health equity.

This is work we're already doing, but now we're being more intentional about it, and saying how we are effectively contributing to advancing health equity and mitigating or decreasing health care disparities. Recognizing that creating an inclusive work environment is an ongoing developmental process-- And it is an ongoing process. We can't just implement one thing and say we fixed it. It's going to be continual or continuous.

And so, being inclusive of the individuals that are involved, but also looking out again externally to see what other professional organizations may be doing, committing to building awareness, to increasing visibility, but also increasing our understanding when it comes to workforce diversity. And ultimately, when it comes to acting and being intentional, developing that plan for implementing DEIAB into our work, and integrating those not just evidence-based practices, but what's been determined as best practice. 
Because by employing those, we're actually doing that tremendous work of improving the quality of lives and the quality of health and well-being for our patients and communities. So with that, those are my references. I thank you all, again, for this opportunity just to share some-- I know there's a lot of information, but I hope it was helpful in the sense of resources and materials. And now I will transition back to Dr. Branch for our Q&A.

DR. BRANCH: Thank you, Dana. We'll take a few minutes to answer as many questions as possible. If we do not get to answer your question today, we'll do our best to respond via email if your question was not submitted anonymously. If you have any questions after today, please just email the OneLab inbox at OneLab@CDC.gov. So let's get started. We have a few questions.

I think this will probably help everyone. Given that some institutions may work in states that have proposed or passed recent anti-BIA legislation, how can organizations-- Or not addressed DE&I in the workplace.

DANA: Yeah, thank you for that. That's really important, especially given our current climate right now when it comes to laws that are being-- or bills that are being proposed and laws that are being enacted when it comes to this. I would suggest initially to seek out your legal team or your legal representation at your organization, just to receive added guidance toward what does that mean or what's the impact on us as an organization, or even just the verbiage that we're using when it comes to this work. 
I know some organizations have obviously shifted towards using a different set of terminology when they are having this discussion around DEIAB, or they've really just enhanced their focus to say, you know, well, we're focusing on advancing health equity. And that ties into what's happening at not just at a local level, but on a national level when we talk about advancing health equity and connecting that to the work that organizations such as like CMS, what they're doing, and how does that also connect with health care disparities.

So they've kind of couched it in those spaces, but initially I would say definitely consult with your legal team, and possibly even seek out the work that's happening in other professional organizations where they do have advocacy groups or groups that work with policy makers. So that way you're also getting that up-to-date and credible information regarding the legislature in your state.

DR. BRANCH: Great. Let's see this one. I think this is a pretty good one. Do you feel that monitoring the medical and public health laboratory workforce is adequate using current practices? If not, what is the biggest gap you see to strengthen our ability for external advocacy?

DANA: Yeah, that's a good question. I don't think we have just one big gap. I think there's a couple of opportunities. The thing that stands out the most to me is our workforce shortage and how can we increase, not just the overall number of individuals coming into the workforce, but also increasing the diversity of those individuals entering the workforce. Because I think that will help us with just gathering more ideas and suggestions for how we can increase our visibility and increase awareness of that work. 
But also that that's on us that are in the field already to help contribute to that increased visibility. if I look at early on in my career, I was really focused on showing up in the lab, doing my job and going home. And go home. That's it. And there's nothing wrong with that, because I know we're putting in long hours. It's hard work. It is. And especially, if you were like me doing second and third shift, that's literally what you did.

Your life revolved around just being able to show up to the lab, doing your job, and doing it with quality and accuracy, and going home and sleeping until your next shift starts. 
DR. BRANCH: Right.

DANA: At some point in that journey, I had to say, I know I'm passionate when it comes to not just increase. We need more people, I need more team members, but also I need to increase the representation that of our workforce that is more reflective of our communities. How are we expanding information or just awareness about our workforce, and not just to the high performing school districts, but to those that may be lesser performing school districts. And so just being more inclusive of those other communities, because every community needs lab services.

We all utilize it. So how do we also connect better with those communities to bring them into the fold and help us address these barriers and challenges that we have when it comes to DEIAB, but also the work of our laboratory workforce? And so I see that there are a couple of different opportunities that we can go. And some of that is going to take some of us coming out of the walls of the lab a little bit more, and bringing more people in, and just kind of tooting our horns, but also increasing the visibility of the work that's happening within our field.

Did I answer that question? I want to make sure I answered it. 
[LAUGHTER]

DR. BRANCH: I think this is one that probably every person who's worked in the lab has asked. Was there any observation or information on laboratory representation on management team? Because, in a sense, they don't-- I'm assuming they're talking about how management doesn't really change in the laboratory. People kind of just stay there forever if they do, and that the management team, they're just there for several years.

And there's no advancement. So I think that that's kind of what they're maybe talking about. 
DANA: Right. And I'm going to turn that into what other opportunities may exist to be able to develop even as a leader. If you don't mind me pivoting it a little bit in that direction, because I've worked in labs where that was the case, where the lab team was that leadership team for years, even in some cases decades. And so that was the established, I would say, structure. And being one of those that was really wanting to grow as a leader and just wanting to grow my skill set, that's where volunteering and professional organizations really helped me.

And I'm not saying that as just an employee within a professional association or being-- I'm very active in professional organizations for that reason. That's where I really gained a lot of my leadership skills and leadership experience. So being able to start as a volunteer and at one level, but being asked to chair committee or lead a council, or be a part of a board of directors even. It was constantly evolving to where I then realized the skills I'm gaining here are actually transferable to my day-to-day work.

And so, that's where if you're feeling like there's a ceiling there or a cap there for you, let me encourage you that there are other opportunities that I know it's going to feel additional to the work that you do every day, but instead of it feeling-- It didn't feel like a burden or extra. It felt like, oh, I can breathe. I can show up to work, not as frustrated, and have an outlet for-- Or a space where I could gain that skill set, that I could still kind of practice what I'm gaining here into and implement that into my everyday work, until that opportunity does arrive where I can actually then transition into a leadership role.

So that has been my journey. And so that's something that I would advise, that don't let that feel like that you're now limited, that there are other ways to also gain that experience.

DR. BRANCH: Great. Let's see. This is a good one. Do your initiatives include measures to help with diversity in rural areas?

DANA: That's something-- So even if I were to speak to-- the programmatic work that even I do with academic partnerships and looking at how do we promote these opportunities for public health laboratory, internships and fellowships, where we're also mindful of that dimension of diversity when it comes to geographical location. And so definitely, looking at how rural versus urban are also included into that. And we do essentially monitor for that and track for that, and seek out those opportunities to not only—

If I think of areas that I've visited for-- even career fairs to promote opportunities, everything hasn't been big cities. There's been a fly into an airport, drive out an hour or two hours, and promote at this smaller location or smaller entity. It doesn't mean that they're lesser valued. We value those smaller communities and those rural areas, just as much as we value our larger or bigger cities as well, because, again, that's being inclusive and ensuring that we're more representative of the communities that are being served.

DR. BRANCH: Great. Let me see this. This is a good one. Does diversity also include those with mental health challenges?

DANA: Absolutely. I don't even hesitate on that. Absolutely. That I would actually consider as really a primary dimension, because that's also going to-- And I say this because when I think of individuals, and have some that are very close to me, that have expressed similar barriers when it comes to just not just mental capacity, mental well-being, or even disabilities associated with, you know, neurodiversity disorders or so forth, there's more work that we need to do in that space to be more inclusive of that. 
And it really speaks to me just even having loved ones and immediate family members where we can go into spaces, more spaces now, where there may be quiet rooms or conferences that are mindful of that aspect of diversity as well when they are doing their conference planning or annual meeting planning. And there's still opportunities for us. I'm not going to say where we're at, where we need to be with that across the board, but there are definitely opportunities for us to improve and get stronger and be more inclusive when it comes to that.

So, yes, absolutely. Hands down.

DR. BRANCH: Well, this will lead me into my final question. Do you have any recommendations for professional development activities that people may consider increasing their knowledge about DEIAB? 
DANA: Yeah. But as I mentioned during the talk, I decided to pursue a certificate in DE&I. So I actually did that through Cornell University. But that's not the only institution that offers that program. There are a number of really good institutions and programs that do offer certificates in DE&I. So I would definitely encourage people just to do their own research and look at the curriculum itself to see if it aligns with your areas of interest. And even looking at the duration of it.

Pricing, of course, is always important too. So always take that into consideration when you're looking at even your employer benefits, if there's an offering for professional development. I'm a firm believer in utilizing that benefit, and I've encourage my team to use that benefit. So if that can somehow contribute towards the cost of your professional development, I definitely encourage that. And of course, attending conferences. As I mentioned, the CMS Health Equity conference, that's coming up soon, but there's other conferences that may have a DE&I track or have specific workshops and training as a part of their conference offerings. 
So definitely look into those opportunities and everything's not in person now. Completely leverage the virtual opportunities that are happening too, because I get that. Especially as laboratory professionals, we can't always get that time off or that time away from the lab. And so if there is an opportunity, even connect with a local or regional group that is hosting a session or an event, even if it's just one presentation, that's one presentation that you're adding to your bill.

So I consider that all professional development, whether you're sitting in a course, virtually attending a course, or showing up for a talk or a presentation on it.

DR. BRANCH: Thank you so much, Dana. And I hope that everyone enjoyed learning about DEIAB. So I will proceed to the next session.

DANA: Thank you so much.

DR. BRANCH: Thank you.

INTERVIEWER: Thank you both. We are offering one PACE contact hour for today's webinar. PACE certificates are.