Embracing Diversity and Equity: Interview With Nicki McCraw
Assistant Vice President, UW Medicine Human Resources
Nicki McCraw was recently honored as an “Outstanding LGBTQ Voice” at the third annual Puget Sound Business Journal Business of Pride celebration, and she has been instrumental in garnering recognition from the Human Rights Campaign for UW Medicine’s leadership in LGBTQ healthcare equality. POD talked with her about ongoing diversity and inclusion work at UW Medicine.
How have things changed since you began your position as assistant vice president for UW Medicine Human Resources in 2007?
I think UW Medicine has fantastic values. What’s changed over the last several years is that we’ve made a really concerted effort to articulate and communicate that we’re an open, diverse, and accepting place.
One thing that’s had a major impact is the LGBT Clinical Care Advisory Committee, which is system-wide and includes clinicians, leaders, staff, and even some medical students from time to time. If you look statistically, close to 80% of transgender patients report that they don’t feel safe receiving healthcare. We serve a lot of transgender patients in the Puget Sound area and we have a transgender clinic at Harborview, so we’re working to make sure that our clinicians and staff understand how an LGBTQ person might view healthcare and might fear they’re going to be discriminated against.
Take something like forms, for instance. As a lesbian, and particularly as a parent, I’ve filled out so many forms where you have to cross out “father” and write in “mother” again. We don’t want people to have to do that or have to check their gender as male or female because not everyone identifies their gender as one of those two. So, one subcommittee was tasked with looking at how we can change these forms to make our patients feel more comfortable when they come in the door.
The committee has also worked on improving the patient experience, for instance by redefining protocols so that a patient who now presents as Charlotte won’t have to sit in the waiting room and worry that a nurse may call out their current legal name of Charles, or asking our patients upon registration their preferred pronouns and their gender. I have actually now experienced that change myself as a patient. I was asked those questions, and I thought, yes!
Can you describe how UW Medicine has raised employees’ understanding of the issues facing LGBTQ patients?
A big push for the committee has been around education. We’ve gotten LGBTQ topics included in UW Medicine’s quarterly Leadership Development Institutes, and integrated as a topic in our annual competency training for UW Medicine. That presentation is fantastic. In addition to the basics about definitions and so forth, it has video clips and presents different situations an LGBTQ patient or family member might face.
Another area the committee has excelled in is outreach to let people know we’re doing this work and that this is a safe place to come. We’ve become a leading sponsor with the Greater Seattle Business Association (GSBA), which is oldest and largest LGBTQ chamber of commerce in the country.
I’m really proud of the work we’ve done through the committee because it’s made a huge difference, both in the things we’ve done with education but also, I think, in solidifying the values that we already held.
Can you tell me more about how the work you’ve described translates for employees?
We’re very visible and vocal about our support for LGBTQ rights in our own community and that includes our employee population. UW Medicine employees make up a huge contingent in the Pride Parade, and for the past five years we’ve also been raising the pride flag during Pride Week at all our facilities. We were the first health system in the country to do that, and I’ve heard from so many people and read so many posts about how much it means to people to come to the flag-raising or have the pride flag flying at their workplace.
I remember being afraid that I’d be fired because I was a lesbian. You still can be fired; not in Seattle, but in most parts of the country you still can be fired for being gay. To have your employer celebrate you in visible ways where they are inviting the scorn, potentially, of their consumers, that’s a risk, and they’re doing that in order to celebrate you? That’s a huge statement and that has happened in my professional lifetime. That’s a big deal.
What is the experience like for LGBTQ candidates or job-seekers?
From a recruiting standpoint, that’s something we’re really just starting to get our hands around, and by that I mean all sorts of diversity, LGBTQ diversity included. I was on the committee that created the Healthcare Equity Blueprint for UW Medicine in 2017, and one of the initial things we did as a result was hire a director of healthcare equity, Paula Houston.
The first objective in the blueprint is “increase diversity and inclusion.” We’ve been doing things like targeted recruiting, for instance using UW affinity groups or the GSBA mailing list, for some time. Now we’re in the process of laying out a formal, detailed plan for increasing our diversity efforts around our hiring for all UW Medicine sites.
Some people have this perception that you’re not allowed to target recruiting efforts at certain groups, and that’s actually not true.
It’s all about sourcing. You’re not saying “I’m not going to look for any other candidates.” You’re just trying to increase your pool so it matches what your community looks like. So, I understand why people have that concern and have that initial thought, but it’s not to the exclusion of all others. It’s just that you want your pool to match your community and that takes work, and if you look at the blueprint, you’ll see that work is clearly a priority for us.
It’s one thing to hire LGBTQ people, but once they’re here, how can we ensure their inclusion and engagement, and, in turn, foster retention?
At our new employee orientation, we always have a welcome from someone on the executive team, and we try to get a diverse population of leaders rotating through there. That’s just one way of letting people know we’re a diverse place.
I think you also welcome people in by making sure they know about the different Affinity Groups and about the work we’re doing. The Healthcare Equity Blueprint was distributed with a letter signed by Paul Ramsey, the CEO of UW Medicine, and Carlos Pellegrini, our chief medical officer. The letter acknowledges that, even in our own system, the right to quality healthcare is not always realized by all and that we’re committed to reducing disparities and promoting equity. That’s important — acknowledging failures, setting that tone, and saying what the values are. Those are ways to let your employees know that it is an open and welcoming place.
We also did an equity, diversity, and inclusion survey for all of UW Medicine. That was one step in our blueprint so that we’ll have a baseline for measuring our improvement, but I think it also sends a message to people, reinforcing that these are our values, and we want to hear from you so that we can improve.
What about the naysayers? What about the people who disagree with the values or with the diversity and inclusion work you’re doing?
Personally, I’m a really sensitive person, so the first thing I do is try not to read things like comments on a blog post or article. On the other hand, professionally and as more of an advocate, I try to keep the big picture in mind.
My own personal story is one that I go back to often. I grew up in rural Mississippi, well below poverty level. Some people in my family didn’t even finish high school and were extremely conservative. I came out when I was 18. That was incredibly hard and really not always very safe. I had a childhood friend whose own dad beat her up with a baseball bat because she was gay.
For me, when I send an email out to twenty-five thousand people about the Pride Parade or flying the pride flag, and I hear from one guy who says you shouldn’t be doing this, I know it’s my responsibility to respond to him in a respectful way because that’s my job. I think about my friend, I think about where I grew up, and then I think about flying the pride flag at each one of our hospitals. I just keep in mind how far we’ve come and that helps me.
I’ve worked for other employers in Seattle who have accepted me for who I am as much as they accepted all my other colleagues, but I certainly never had an employer celebrate me or my culture or my community like the UW or UW Medicine do.
Of course we want our patients and families to know that UW Medicine is a safe place, just as we want our employees and potential employees to recognize that. But you can go many places and feel safe, especially in a liberal city like Seattle. Speaking now not just of the LGBTQ population but all sorts of populations, there is a huge difference between feeling safe or accepted and feeling not just safe and accepted but genuinely welcomed and even celebrated. That is the experience we’re going for, that is what we’re really hoping to create.
