Organizational Readiness Assessment
An Organizational Readiness Assessment to Build Health Equity
within the Organization
The Building Health Equity (BHE) training team’s principles that guide our training work:
The principles that guide our team’s work are the following:
‘Inside’ work – i.e., work that we each do as individuals to understand our positionality with respect to Building Health Equity – is critical to moving forward in just and equitable praxis in our jobs and lives. This inside work requires deep reflexivity.
We are not experts, but rather co-learners in a lifelong process of understanding historical and present oppressive structures and systems, and our positionality with respect to the current status quo. In the space of this training, we consider ourselves facilitators of this process of co-learning.
In line with the above, we do not have the answers. There is no checklist we can give participants that they can check off in their quest to be ‘equitable’ or apply ‘equitable’ practices. The hard work of figuring out how to apply the ideas/approaches/tools we cover in the training is on the participants individually and in groups within their units/departments/or larger health departments.
Although changes in policy and procedures at the health department level can co-occur with the inside work, the former cannot be done well without a real commitment to the inside work. Otherwise, it is tokenistic work.
Commitment to Building Health Equity requires time (it is not a fast process) and willingness to question/explore almost everything, and to sit with discomfort. It also requires being willing to imagine and implement transformational approaches. We understand that transactional approaches may need to also occur in the short term, but they alone will not build health equity.
Commitment to Building Health Equity is inclusive of all staff at the health department. Often those that may ‘see’ the impact of disparities the most are the front-line staff. Their stories thus become powerful drivers in the quest for equitable practices.
In this work, we center the narrative, stories, and comfort of communities that historically have and currently are experiencing oppression, marginalization, and stigma. This means that we do not prioritize the comfort of dominant social identities.
Finally, at an organizational level, engaging in BHE requires some basic building blocks of readiness that we highlight below. If the organization is not currently at high readiness, then we may not be able to move forward with the basic BHE training. However, the readiness assessment can also suggest places for the organization to emphasize to increase their readiness for this work.
We acknowledge that this need for readiness before implementing the basic BHE training has the potential to further inequities between organizations. Our goal is to decrease these inequities. A list of resources to support organizations in lower phases of readiness will be shared, including other potential training by teams at the UI or elsewhere.
We acknowledge that readiness in smaller health departments may look different from readiness at larger health departments due to the limits of human and other resources, and we are committed to working with both larger and smaller health departments to do this work. The readiness assessment described below is specific to larger health departments.
Process for exploring organizational readiness: The process includes:
- Assessment tool with leadership of the health department: an assessment of the general commitment to BHE at the level of leadership of the health department, and
- Assessment survey of employees: an assessment of the environment of trust from the perspective of employees. The survey must be completed by at least 70% of employees, in a range of departments and ranks.
I. Assessment tool with leadership: The process includes a review of work already done at the health department (HD) that we consider necessary prior to engaging in BHE training. The review requires (1) a document review by our team, and (2) a discussion with leadership. The BHE/CPH team can do the work to find the answers to these questions and/or to the relevant documents if they can be found on the website. If not, we need a point person with whom to communicate. The discussion with leadership must include the HD Director, health equity champion (if such exists), and any other top leadership the HD Director wants to include.
- Level of trust that staff perceive in the organizational environment
- Perceptions of staff that their leadership has their back
- Perceptions of staff that the working environment is one where risks (to improve processes and outcomes) can be taken without damaging consequences to themselves
- Concerns over repercussions of saying the ‘wrong’ thing
- Comfort level of staff with discussions around health equity
- Commitment of staff to health equity work (or is it just the leadership pushing the agenda)
- Commitment of staff with the need for inside-work
- Perceptions of staff that the organization’s leadership is willing to commit consistent time and resources to health equity for an extended period
- Level of comfort of staff with tensions that may arise in this work
- Perceptions of staff of the extent of importance of this work? What priority does it take over other work your organization does?
- Extent of time and emotional capacity for this work
Access this Organizational Readiness Assessment as a PDF by clicking on the button below.