Dartmouth Health Hires First VP of Diversity, Equity, Inclusion, and Belonging

Teresa Malcolm says the "belonging" part of her job title attracted her most to the new position.

Healthcare organizations need to appreciate the benefits that are associated with diversity, the new vice president of diversity, equity, inclusion, and belonging at Dartmouth Health says.

Teresa Malcolm, MD, MBA, began her work in the new role at the Lebanon, New Hampshire-based health system on April 4.

Malcolm, who is a board-certified obstetrician/gynecologist, has more than a decade of experience cultivating inclusion in healthcare settings.

Prior to joining Dartmouth Health, Malcolm served as CEO of the coaching firm Master Physician Leaders. Her physician executive experience includes serving as a chief medical officer at Banner Health in Arizona, where she played a clinical leadership role at a tertiary care center offering inpatient, emergent, and same-day services provided by more than 1,000 specialty physicians.

HealthLeaders recently talked with Malcolm about a range of topics including: her new role; the primary diversity, equity, and inclusion considerations for a healthcare organization's workforce; and the main elements of a culture of inclusion.

The following transcript of that conversation has been edited for clarity and brevity.

HealthLeaders: How does the "belonging" element of your title fit into your role?

Teresa Malcolm: It was one of the words in the title that attracted me most to this position because belonging is the piece about how individuals feel when they are part of an organization. They feel a sense of connectedness. They feel a sense of attachment. Belonging digs into how you feel emotionally connected, to be able to say, "I belong here. I belong to this workplace." That was appealing and attractive to me because it is much more than having diverse individuals with different ethnic or racial backgrounds, or different clinical backgrounds, or just different skills.

Part of my role is helping us to explore how each of us as individuals can say, "I feel part of this. I feel I belong here." A lot of times, when people leave an organization, part of what they will say is, "I didn't feel that I belonged there." We are hoping people will feel they belong when they are part of the Dartmouth health system, whether they are a patient, an employee, a leader, or member of the community. We want them to feel that who they are is respected, honored, and valued.

HL: You are the first vice president of diversity, equity, inclusion, and belonging at Dartmouth-Hitchcock Health. What are your top priorities in this new role?

Malcolm: I want to start with listening. I want to start by understanding what is important to the members of this organization. I want to know what they think works well—what is Dartmouth Health already excelling at in the areas of diversity, equity, inclusion, and belonging? Once we identify what is working well, I want to propel that forward.

On the opposite end, I want to know what is not working. What do we need to let go of? What do we need to abandon because it may have served us well in the past, but it is not serving us well now in terms of the goals that we have for diversity, equity, inclusion, and belonging?

I want to understand what words describe this organization and what words do we want to use to describe us going forward. I want to know where we are at today, then find out where we want to be a year from now. What do we want to be able to say about ourselves one year from now after we have intensified this work?

HL: What are the primary diversity, equity, and inclusion considerations for a healthcare organization's workforce?

Malcolm: It starts with diversity and appreciating what diversity brings to the organization. Diversity makes us a stronger organization. It increases our bottom line. It attracts more individuals to the organization. It improves innovation. It improves creativity. There are many benefits from diversity alone, but it doesn't stop with just diversity.

Diversity must be activated. You must put it into place. It is not enough just to say, "We have diversity metrics, and we are going to meet these metrics." We must be able to move from just diversity metrics to a sense of inclusion. We must move to a place where people are speaking up and saying things that may have not been said before. We need to challenge the status quo. We need to redefine the culture and move beyond where we are right now.

HL: What are the primary elements of a culture of inclusion?

Malcolm: One of the primary elements is psychological safety. There needs to be a sense that you can speak aloud about mistakes and about differences of opinion. You should be able to raise objections without retribution and knowing that you will not be punished. Psychological safety allows for openness of dialogue.

Empathy and compassion are essential. We must understand the positions and perspectives of others that are different from our own. We must extend empathy to others who may not be where we are and may not share our beliefs. We also must extend empathy and compassion to ourselves if we are not where somebody else is. We are all on a journey. We are all on a continuum. We need to give ourselves grace and space as individuals, as departments, and as organizations for wherever we are on that journey and that continuum.

Another element is striving for excellence, which is different than striving to be the best. There is not an endpoint for inclusion. There is not a final destination where we can pat ourselves on the back and say, "Job well done!" There is going to be constant and continuous effort, energy, and intention that we need to put toward inclusion because we are going to be making incremental progress.

HL: What are the keys to success in coaching leaders and care teams to build a culture of inclusion?

Malcolm: People need to know that we all play a role in this work. This is not one person's responsibility or one department's responsibility. We are all responsible for this work and we all need to hold each other accountable.

We are blessed to be able to be in the positions we have and to make the kind of impact that we want to make. We need to make an inclusive culture where people feel they are a part of providing care to others. There are small things that we can do to help benefit inclusion and small things that we can do to impede it. We need to use the energy we have to make positive small changes.

HL: Diversity, equity, and inclusion can be sensitive topics for healthcare organizations. How can healthcare organization leaders be encouraged to tackle diversity, equity, and inclusion challenges?

Malcolm: It is important to remember that unless we talk about these issues, we cannot achieve change. If we cannot talk about creating an inclusive environment, if we cannot talk about racial differences, if we cannot talk about ethnic differences, if we cannot talk about gender differences, if we cannot engage in healthy and crucial conversations about our differences, then how are we going to be able to move forward as an organization?

While these might be sensitive topics, how can we expect that anything will change if we do not address them? If we come into these conversations with a level of humility—recognizing that we do not have all the answers and we are here to learn—and if we can enter these conversations with less of a desire to be right and more of a desire to learn, then we can move the organization forward.

Healthcare organization leaders need to understand that there is no absolute way that they need to engage in this work. They need to come with an open heart and an open mind and be willing to listen and to learn from people who have different perspectives.

Related: Create a Strong Workforce Through Diversity, Equity, and Inclusion