Diversity, Equity, & Inclusion at Cambridge Health Alliance
2024 Impact Report: Building Pathways to Success
Welcome & Introduction
It gives me great pride to serve in my fourth year as the inaugural Chief Diversity, Equity, & Inclusion Officer at Cambridge Health Alliance (CHA). To be part of this organization is to understand that Diversity, Equity, & Inclusion is in our DNA. From how we were founded; to how we envision the future; to the everyday work we do with our patients, employees, and communities, we lead with an equity mindset.
CHA was founded on the principle of providing excellent and equitable care to everyone, every time, with a special focus on underserved communities. This commitment is deeply ingrained in our mission and drives us to support policies and practices that improve the health of all. Our diverse patient population, with 56% identifying as racial/ethnic minorities, 44% speaking a primary language other than English, and facing challenges like poverty and housing insecurity, underscores the critical importance of meeting their complex needs with empathy and understanding.
Our commitment to Diversity, Equity, & Inclusion is more vital today than ever. This Impact Report reflects our dedication to transparency and accountability as we strive to create a more
inclusive healthcare environment. It showcases the tangible progress we have made since 2021, from our Anti-Racism Statement and related training programs like “Disrupting Bias” and “Psychological Safety,” to building talent pathways for diverse hires and aligning with our Health Equity 10-Point Plan. Sharing our data and insights allows us to celebrate achievements, identify areas for improvement, and invite constructive feedback as we improve our culture of safety through our efforts to become a High Reliability Organization.
We are proud of our accomplishments in centralizing our Diversity, Equity, & Inclusion efforts, which directly connect to our mission, strategic goals, and becoming One CHA. This report highlights our collective work to change our culture and move us closer to fulfilling our mission. We invite you to join us as we reflect on our achievements and chart our future pathways to success.
Michael L. James, MBA Chief Diversity, Equity, & Inclusion Officer
TABLE OF CONTENTS
Why is Diversity, Equity, & Inclusion
Important to CHA?
CHA’s Journey, Accomplishments, & Numbers
Analytics Diversity, Equity, & Inclusion
Infrastructure FY26 and Beyond: The Work Ahead
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“You need to believe that everyone is created equal. When someone comes in the door, they are a human being who has a medical issue. Other organizations can look at CHA as an example of how applying Diversity, Equity, & Inclusion principles and an open, welcoming environment supports the hospital as well as the people. It makes the hospital a safer place without bias, prejudice, or hatred.”
— Moishe Ragieme, Nurse Manager, Everett Hospital
Why is Diversity, Equity, & Inclusion Important to CHA?
The essence of Diversity, Equity, & Inclusion at CHA is the ability to create a work environment that embodies understanding, acceptance, and humility around the differences inherent between us.
It is not the act of purposefully showing preference for one human over another; it is ensuring that every human is seen and valued for the entirety of who they are. It is the ability to ensure that each patient is treated fairly and equitably. And most importantly, it is the ability for everyone to shift the paradigm of what inclusive healthcare means and looks like. The evidence strongly suggests that a healthcare organization that prioritizes Diversity, Equity, & Inclusion within its workforce is more likely to foster a culture of equity, leading to improved experiences and health outcomes for all patients, including those from marginalized racial and ethnic groups who often experience significant health disparities.
In healthcare, Diversity, Equity, & Inclusion activities can affect everyone. They can include prompt access to language interpreters, sidewalk ramps for accessibility, size-inclusive waiting room chairs and hospital beds, gender inclusive restrooms, trainings that help providers better understand cultural nuances, culturally and racially-attuned pregnancy and postpartum care, and much more. Most importantly, CHA believes that properly implemented Diversity, Equity, & Inclusion initiatives prevent unlawful discrimination.
CHA is not your average hospital system. The roots of the organization have critically influenced what it is today. In the late 1800s and early 1900s, Somerville Hospital, Everett Hospital
and Cambridge Hospital were all founded as healthcare institutions to serve their communities “regardless of creed, color or race.”
CHA partners with and works alongside the surrounding communities, acting as the safety net health system for everyone who lives within the service area.
Strategically, CHA links Diversity, Equity, & Inclusion to the High-Reliability Organization (HRO) effort, which comprises a set of behaviors and skills that everyone is expected to utilize to more effectively keep patients, staff, and community members safe. Behaviors like compassionate connection, understanding someone’s experience, clear communication, and respect for others build a foundation for equity and inclusion to thrive.
CHA’s Diversity, Equity, & Inclusion definition is of great importance:
At CHA, we believe diversity is the respect and honoring of our unique backgrounds, cultures, identities, and experiences. We believe equity is upheld when we meet our patients where they are today, reduce existing barriers to care, and provide resources so they can reach their health potential tomorrow. We believe inclusion is the ability for each person to fully embody the many facets of who they are, and know they are safe and supported. From socioeconomic background to language, race, and gender identity. From what you believe to who you love— all are welcome at CHA.
CHA created a set of Diversity, Equity, & Inclusion Competencies, which clearly lay out the behavior expected from employees and leaders as it relates to their actions within the organization. The competencies include:
INCLUSIVITY DIVERSITY
EQUITY DIVERSITY RECRUITMENT
BELONGING RESPECT
PSYCHOLOGICAL SAFETY
SPEAKING UP FOR SAFETY
To make the competencies more action-oriented, we infused the organizational CIRCLE Values with Diversity, Equity, & Inclusion Competencies. CIRCLE Values help concisely communicate workforce behavioral expectations, including compassion, integrity, respect, community, learning, and excellence.
In 2021, CHA identified multiple priorities in this work and created a Diversity, Equity, & Inclusion Strategic Action Plan that is used in alignment with One CHA as well as the HRO efforts. CHA moves this work forward across the organization and aligns these strategies with the Health Equity strategy where possible.
Over the past three years, CHA has focused on the following strategic priorities:
Develop Organizational Talent Pathways
Attracting and retaining top talent across all job functions is critical to CHA’s success. The focus on building a robust talent recruitment program to increase diverse hires at all levels includes:
1. Building pathways, programs and partnerships in order to more effectively retain, sponsor, and develop diverse leadership talent
2. Increasing the diversity of hiring sources
3. Implementing expectation of diverse candidate pools
4. Developing relationships with diverse schools/education programs
5. Committing to interview bias training and education
6. Developing inclusive employment branding
7. Supporting mentorship/sponsorship programs
Cultural Proficiency/Bias Prevention
CHA is building trust, equity, and inclusion by educating the workforce on cultural competencies, and preventing incidents of bias through the following initiatives:
1. Developing the organizational Anti-Racism Statement
2. Developing & identifying workforce training programs in partnership with Organizational Development
3. Hosting culture conversations, events, and speaker series
4. Developing improved methods of communicating about Diversity, Equity & Inclusion across the organization
5. Investigating incidents of bias
6. Improving bias reporting function(s)
Align with & Support CHA’s Health Equity Strategy
A critical part of ensuring workforce Diversity, Equity & Inclusion is aligning fully with CHA’s Health Equity Strategy and the Health Equity 10 Point Plan. The 10 Point Plan has three specific Diversity, Equity, & Inclusion areas of focus, including:
1. Supporting and developing diverse CHA staff members
2. Offering training and education for staff in cultural humility, bias prevention, anti-racism, and disability competency
3. Diversifying the workforce through new hires and pathway programs
Supplier Diversity
In addition, CHA developed a homegrown process to look at internal systems and find ways to better understand the demographics of suppliers, as well as how we can diversify the supplier base while improving quality.
CHA’s Journey, Accomplishments, & Numbers
CHA’s Diversity, Equity, & Inclusion work over the past few years has been dynamic. CHA has reached numerous milestones that have impacted the organization both at the highest strategic levels as well as on the ground level.
Strategic Plan & Roadmap
Our Strategic Plan priorities include: diverse hiring & retention practices for leadership diversity, cultural proficiency/bias prevention, and developing talent pathways.
Assessment
In 2021, CHA engaged in an organizational assessment that uncovered that the existing Diversity, Equity, & Inclusion operational model was inefficient. It revealed that CHA had multiple issues to address — such as convening groups who had been doing the work in disconnected ways, and shifting to doing the work in a staged fashion. It was also discovered that many employees were starting from a different level of understanding, so regular communication was crafted across the organization to engage and bring people along in our journey.
CHA Road to Equity
Diversity Recruitment
The Talent Acquisition Team is committed to hiring a diverse and talented workforce and is building numerous diversity recruitment initiatives into their everyday work. Efforts include attending many job fairs targeting diverse populations, and convening Hiring Manager focus groups to educate and inform hiring managers about the multiple considerations around diversity recruitment, interviewing, and hiring.
Organizational Anti-Racism Statement
• In the Fall of 2023, the Office of Diversity, Equity, & Inclusion began work on an organizational anti-racism statement that would solidify CHA’s commitment to becoming an anti-racist institution both internally and externally. The statement defines a set of shared values against bigotry, violence, and racial injustice; encourages self-awareness and personal accountability; and fosters a culture where people feel psychologically safe to speak up when they observe racist behaviors.
• There have been multiple events and conversations around anti-racism in conjunction with the creation of the statement. The Office of Diversity, Equity, & Inclusion held several virtual events with various expert speakers focused on anti-racism, hosted a 28-day anti-racism challenge, and created a compelling anti-racism video to accompany the statement. Currently, all employees are expected to attest to reading the statement on HealthStream. Additional events and opportunities are planned for 2025.
“A few [participants] stayed
to
ask clinical questions
related to Diversity, Equity, & Inclusion topics that are starting to emerge in their work with patients (disability access, barriers to care, trans health equity), and one student said they felt braver about asking since they’d seen your presentation and knew people in leadership care about these issues, too.”
— Training attendee feedback
Trainings/Learning Opportunities
CHA’s training and educational offerings have introduced various topics, become a safe space for grappling with and trying on new and challenging concepts, and stretched us in many directions. Learning opportunities for employees have included the following:
• Expanded “Manager Essential Workshops” to enhance leaders’ skills in alignment with HRO, Diversity, and Wellbeing. Participation ranged from 90 to 125 leaders per workshop topic, which included: Resilient Leader, Mental Health Response, Change Management, Retaining Top Talent, Emotional Intelligence, Disrupting Bias, Cultural Humility, and Storytelling.
• A robust anti-racism educational speaker series defining various aspects of racism and how to become anti-racist.
• Created new training modules around topics including Disrupting Bias, Psychological Safety, RELD-SOGI data collection and Disability-Competent Care.
• Introduced digital micro-learning tools on Being an Ally, Being an Upstander, Building Inclusivity, Cultural Humility, Microaggressions, Understanding Bias, and Understanding Racism.
• Published monthly Diversity, Equity, & Inclusion newsletter covering topics including Diversity, Equity, Inclusion, Belonging, Racism, Bias, Cultural Humility, and Psychological Safety Through Storytelling.
Integration and Other Initiatives
• The Office of Diversity, Equity, & Inclusion partners with many departments and allies across the organization to ensure the principles and practices that help develop and ensure a more diverse, equitable, and inclusive culture are integrated into each area’s workflow. Over the last few years, CHA has incorporated Diversity, Equity, & Inclusion competencies into Leader Skills and Everybody Skills in HRO, and incorporated Diversity, Equity, & Inclusion, and Anti-Racism competencies into all leader performance appraisals and new employee orientations.
• CHA completed a Disability Competency Care Assessment of the organization, which resulted in creating an online Disability Portal (as well as an internal training module for employees) to best serve those who require accommodations in various ways. In addition, CHA partnered with Work Without Limits, a disability employment organization, for support around recruitment efforts and staff training opportunities.
• CHA’s robust Multicultural Affairs and Patient Services program supports our Diversity, Equity, & Inclusion efforts in real-time every day by honoring patients’ cultural identities and language needs. Currently, CHA has 44 staff interpreters, 29 per-diem translators, and two language service contractors. In FY24, we had 652,942 interpreter-assisted encounters in 70 different languages. We translated 1,235 documents including medical records, vaccine records, patient correspondence, patient newsletters, educational materials, and much more. In addition, we identified 323 employees certified as proficient in languages other than English, including Spanish, Portuguese, and Haitian Creole.
“Anti-racism starts with me.’ If every employee says that, then you have a different outcome—more people take accountability and responsibility to live this statement every day. The work environment becomes safer psychologically, and there is support for you both as a person and as a staff member.”
— Deborah Odunze, Deputy Chief Public Health Officer, Cambridge
“The educational seminars are interesting when you hear people telling their stories. You put yourself in their shoes. It expands my knowledge and appreciation of different perspectives.”
— Nasos Phillips, Senior Director, Materials Management
Awards
While awards aren’t the goal in Diversity, Equity, & Inclusion work, it is thrilling to receive them. In the last year, CHA received the following major awards:
Designated as a leader in LGBTQ+ Healthcare Equality in the Healthcare Equality Index (2022 and 2024)
Named One of America’s Greatest Workplaces for Diversity for 2024 by Newsweek
CHA was honored with the Organization Award from the City of Cambridge at their 35th Annual Pride Brunch for exemplary work and dedication in supporting and caring for the LGBTQ+ community
Analytics
CHA believes it is critically important to tell the story of Diversity, Equity, & Inclusion at CHA not only through strategy and initiatives but also through numbers.
While 70 different languages are spoken at CHA, the vast majority of patients speak English, Portuguese, Spanish, and Haitian Creole.
The overall racial distribution of the CHA workforce is comparable to the racial distribution of the residents in our communities.
Even though, CHA’s workforce becomes progressively less diverse with the authority gradient, since FY2 there has been an increase in leaders of color in the Senior Director and Executive categories.
“We are not looking at this simplistically. To have a lasting result, Diversity, Equity, & Inclusion has to be integrated into all the work we do, including our HRO work. To become an HRO, we have to be a Diversity, Equity, & Inclusion organization. Embedded in our health equity action plan is our Diversity, Equity, & Inclusion journey. This is not a standalone strategy. We connect the dots so it doesn’t feel like everything is segmented—they’re all one.”
— Joy Curtis, Chief Human Resources Officer
Employee Data Collection
In mid-2024, CHA enhanced our commitment to understanding and celebrating the diversity of the workforce. To achieve this, CHA expanded the demographic data we collect through the “My Profile” section to include gender identity, sexual orientation, pronouns, languages spoken, and disability types, building upon our existing collection of race, ethnicity, disability status, and veteran status. CHA launched a voluntary Self-ID campaign to encourage employees to share these identities and plan to conduct similar initiatives in the future to gain a more comprehensive and inclusive view of our workforce.
Diversity, Equity, & Inclusion Infrastructure
Office of Diversity, Equity, & Inclusion
The Office of Diversity, Equity, and Inclusion is a resource for all of CHA. The Chief Diversity, Equity, & Inclusion Officer (CDEIO) and Diversity, Equity, & Inclusion Advisor work directly on all office-initiated projects, and they also act as advisors, strategists, and partners with departments across the organization who need guidance in moving their local initiatives forward.
Diversity, Equity, & Inclusion Council
The Diversity, Equity, & Inclusion Council has been in existence for 19 years, and for many of those years, stood as the “official” Diversity, Equity, & Inclusion function at CHA. Currently, the Council is made up of 25 members, each of whom serve a two-year term, and who meet monthly.
The Council’s work is guided by a set of principles that that aligns their work with CHA’s mission, vision, and values, as well as with CHA’s Diversity, Equity, & Inclusion priorities. Additional principles ensure that the Council promotes dignity and respect; and celebrates and uplifts cultural awareness, humility, and two-way dialogue with individuals who have marginalized identities.
Over the last year, the Council has had many accomplishments, including:
• Revamping the Council’s administrative framework to be more inclusive
• Ensuring CHA had a contingent marching in the Boston Pride for the People parade
• Creating and publishing an annual Calendar of Observances
• Hosting a table at LGBTQ+ job fairs
• Raising awareness of diverse cultures through increased communication and event programming
• Bringing attention to Transgender Day of Remembrance by holding a vigil
Additional Council Work and Connectivity Throughout the Organization
Throughout CHA, there are many additional Diversity, Equity, & Inclusion efforts and close partnerships with numerous departments, including the Cambridge Public Health Department.
The LGBTQ+ Health Equity Committee is a robust and active committee that works on initiatives related to LGBTQ+ patient and employee experiences at CHA. Over the past year, some of their work has included:
• Spearheading an LGBTQ+ Community Focus Groups project, which seeks to understand how CHA is doing in providing healthcare to LGBTQ+ patients
• Publishing educational fact sheets online and in Staffnet for patients considering gender-affirming care at CHA
• Collaborating to create the staff training module for Collecting RELD-SOGI data from patients
• Creating a crowdsourced Internal Guide of Gender Affirming Services for providers
The Maternal Health Equity Committee and Patient Experience of Care Committee have been active for four years. From the statement on their webpage to the inclusive artwork on the walls of their department, the OB/GYN department strives to demonstrate its commitment to Diversity, Equity, & Inclusion during every patient visit. They are also committed to looking at outcomes for patients to better understand how race and health intersect, and to adjust their policies to improve equity.
CHA’s connection with the Cambridge Public Health Department (CPHD) means CHA serves as the public health department for the City of Cambridge. CHA and the CPHD have worked together to develop race-focused retreats, affinity groups, and book readings to enhance the education of staff to best serve our collective patients.
And finally, our involvement with one of our critical strategic areas, Health Equity, is essential to the mission of CHA. Our three workforce-focused goals help us ensure Diversity, Equity, & Inclusion is not an outside effort, but one core to our very existence as a healthcare system.
CHA is proud to work with a vast network of external partners to help in various ways, including recruitment and hiring, training and education, leadership development, and much more. Partners include:
• BAGLY (Boston Alliance of LGBTQ+ Youth)
• Boston Business Journal
• Boston Pride For The People
• Cambridge Chamber of Commerce
• Cambridge Employment Program
• Conexion
• Direct Employers
• EDGE
• El Mundo Boston
• Emerging Leaders
• English for New Bostonians
• Jewish Vocational Services
• LMSA (Latino Medical Student Association)
• MA Executive Office of Labor and Workforce Development
• MA LGBT Chamber of Commerce
• MA Trans Political Coalition
• MAPS (Massachusetts Alliance of Portuguese Speakers)
• MassHire
• MHA (Massachusetts Health and Hospital Association)
• Massachusetts League of Community Health Centers
• Men of Color
• NAAAP (National Association of Asian American Professionals)
• NAACP (National Association for the Advancement of Colored People)
• NAHSE (National Association of Health Services Executives)
• NEHRA (Northeast HR Association)
• Nossa Radio
• Portuguese Times
• SNMA (Student National Medical Association)
• Somerville Community Coalition
• Student National Medical Association
• The Partnership, Inc
• Work Without Limits
• YW Boston
FY26 and Beyond: The Work Ahead
In 2025–26, CHA’s commitment to Diversity, Equity, & Inclusion will continue to expand along already established paths, as well as grow in new directions.
CHA strives to become more data-driven, reacting nimbly to the evidence gathered around program and initiative effectiveness.
In order to meet waiver training requirements, CHA will continue to provide access to several organizationwide trainings, including Disrupting Bias, Anti-Racism, and Psychological Safety.
CHA will implement the Diversity, Equity, & Inclusion efforts from the FY25 Health Equity Action Plan.
CHA seeks to increase the education and engagement of our managers, who play such a critical role in hiring, onboarding, training, and retaining a diverse workforce.
Along with supporting managers, CHA will expand our current diversity recruitment efforts as well as recruite partners. CHA will continue to strategically build talent pathways, so every employee at CHA can build the career they desire here.
CHA will more proactively engage with diverse suppliers. In addition, there will be increased internal communication about the value of working with diverse suppliers.
And finally, CHA will work to build equity in benefits programs, including new family formation benefits, and offer increased pay transparency.
“I see change in the sense that people at CHA are ready to sit down and have conversations related to Diversity, Equity, & Inclusion. In the past, people weren’t comfortable talking openly, so the conversations never happened because no one wanted to have them. Prior to these efforts, people felt like they were walking on eggshells. And we need to have more of these conversations in the future, so people are more open to talking about racism, disparities, privilege, and the immigrant experience.”
— Avlot Quessa, Sr. Dir. Multicultural Affairs, Diversity & Patient Services
“Diversity, Equity, & Inclusion are essential in guiding our vision to provide equity and excellence for everyone, every time. This report details the strides we have made and identifies areas where we can further address barriers to care for our patients and communities. By expanding the conversation and implementing these initiatives, we become better equipped to fulfill our mission to care for all who need it.”
— Assaad J. Sayah, MD, CEO
