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• W3114704718 abstract "Central MessageEstablishment of a diversity training program must start with financial buy-in from the institutional leadership. Put your money where your mouth is. Commit to action and long-term change.See Article page 1782. Establishment of a diversity training program must start with financial buy-in from the institutional leadership. Put your money where your mouth is. Commit to action and long-term change. See Article page 1782. The killing of George Floyd was the spark and coronavirus disease 2019 the fuel for a conflagration of social unrest. The injustice discussion has risen from the streets to the C-suites, and tangentially leaders across professional sectors are responding. Cardiothoracic surgery is not immune to this awakening. Until now, there have been few opportunities for underrepresented minorities and women to enter our specialty, be sponsored, and be promoted to leadership positions.1Ortmeyer K.A. Raman V. Tiko-Okoye C. Espinosa J. Cooke D.T. Erkmen C. Women and minorities underrepresented in academic cardiothoracic surgery: it's time for next steps.Ann Thorac Surg. November 5, 2020; ([Epub ahead of print])Abstract Full Text Full Text PDF Scopus (20) Google Scholar, 2Ceppa D.P. Ikonomidis J.S. Timsina L.R. Boden N. Kane L.C. Donington J.S. STS 2019 workforce report: ad hoc analysis of women in cardiothoracic surgery.Ann Thorac Surg. October 15, 2020; ([Epub ahead of print])Google Scholar, 3Backhus L.M. Fann B.E. Hui D.S. Cooke D.T. Berfield K.S. Moffatt-Bruce S.D. Culture of safety and gender inclusion in cardiothoracic surgery.Ann Thorac Surg. 2018; 106: 951-958Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar The lack of role models is one deterrent to a diverse workforce and diverse leadership, but institutional support compounds the racial and gender disparities by failing to appreciate the value to health care. Ortmeyer and colleagues4Ortmeyer K.A. Raman V. Tiko-Okoye C. Espinosa J. Cooke D.T. Starnes S.L. et al.Goals, organizational change, advocacy, diversity literacy, and sustainability: a checklist for diversity in cardiothoracic surgery training programs.J Thorac Cardiovasc Surg. 2021; 162: 1782-1787Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar propose timely modifications to the recruitment of trainees and the education of the program leaders about Diversity and Inclusion (D&I). In their “Checklist for Diversity & Inclusion in Cardiothoracic Surgery,” they provide action items to effect change.4Ortmeyer K.A. Raman V. Tiko-Okoye C. Espinosa J. Cooke D.T. Starnes S.L. et al.Goals, organizational change, advocacy, diversity literacy, and sustainability: a checklist for diversity in cardiothoracic surgery training programs.J Thorac Cardiovasc Surg. 2021; 162: 1782-1787Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar The checklist outlined in their article is actually more of a toolkit. The former category would be a highway, whereas the latter contains the instruments for repair. All the contents of their toolkit are essential for sustainability; however, a modest revision and a prioritization of organizational change is required. First, to effect change, the institutional leadership, or “top-down support,” must commit to the change. Delete “ideally” from “…ideally compensation for invested effort” and remove “could” from “Faculty…could receive compensation for these actions.” The statement “Training programs and sponsoring programs must support and compensate individuals demonstrating commitment to diversity” is spot on. Financial compensation allows the drivers of implementation to actually have the time to accomplish the G.O.A.L.S. of their program. Often surgical education and participation in hospital committees are deemed softer and less valuable than clinical time. Addressing diversity cannot fall into that bucket. Establishing a D&I program also is an opportunity to implement health policy training to future cardiothoracic surgeons so they have the skillsets to effect health care equity.5Sola O. Kothari P. Mason H.R.C. Onumah C.M. Sánchez J.P. The crossroads of health policy and academic medicine: an early introduction to health policy skills to facilitate change.MedEdPORTAL. 2019; 15: 10827Crossref PubMed Scopus (5) Google Scholar Given that health care outcomes improve with workforce equity,6Gomez L.E. Bernet P. Diversity improves performance and outcomes.J Natl Med Assoc. 2019; 111: 383-392Crossref PubMed Scopus (301) Google Scholar let's cover all the bases. Second, recognize a sea of change. Business, finance, and legal sectors are openly addressing the D&I problem: they appreciate the financial value to structural change7pwcIncreasing diversity in the legal ranks.https://www.pwc.com/us/en/services/assets/pwc-increasing-diversity-in-the-legal-ranks.pdfDate accessed: December 12, 2020Google Scholar,8CEO ActionHow are CEO Action signatories collaborating to advance racial equity?.https://www.ceoaction.com/Date accessed: December 13, 2020Google Scholar and are investing appropriately. Editors and scientific researchers are demanding change. Kibbe and Freischlag9Kibbe M.R. Freischlag J. Call to action to all surgery journal editors for diversity in the editorial and peer review process.JAMA Surg. 2020; 155: 1015-1016Crossref PubMed Scopus (51) Google Scholar banded together 108 journal editors to commit to metrics and transparency. Scientists have stated the importance of proactively placing disparities experts on National Institutes of Health study sections instead of a meritocracy for reviewers.10Carnethon M.R. Kershaw K.N. Kandula N.R. Disparities research, disparities researchers, and health equity.JAMA. 2020; 323: 211-212Crossref PubMed Scopus (54) Google Scholar Don't make it a DIY toolkit. The leaders of health care systems need to put their money where their mouth is and provide the financial support for D&I programs. Start with appointing an underrepresented minority or woman to lead the charge. Compensate that individual and their team. Value their contributions with promotions. Since the C-suite is tasked with financial solvency, they should recognize a diverse workforce boosts the bottom line. Ultimately financial return may be the motivating factor but the true value is the human return. Goals, organizational change, advocacy, diversity literacy, and sustainability: A checklist for diversity in cardiothoracic surgery training programsThe Journal of Thoracic and Cardiovascular SurgeryVol. 162Issue 6PreviewG.O.A.L.S. Full-Text PDF" @default.
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