When Eve Higginbotham took on the role of inaugural vice dean to establish the Office for Inclusion and Diversity (OID) at the Perelman School of Medicine in 2013, her starting point was the firm belief that inclusion and diversity are foundational to stimulating innovation and creating impact in the field of medicine.

Higginbotham, who is also a professor of ophthalmology at the School of Medicine, began building up from that foundation by interviewing more than 100 key leaders and stakeholders in her first 90 days to understand Penn’s starting point.

“It was apparent early in the process that the leadership of Penn Medicine was ready and receptive for the work ahead,” she says.

An academic physician with extensive leadership experience (which includes being the first woman to head an ophthalmology department at an academic medical center in the United States) and research interests in ophthalmology, public health, and health policy, Higginbotham brings an expert scientific approach to this endeavor. One of her first decisions was to establish strategic priorities, including building partnerships and maintaining financial stewardship—and she created a scorecard to measure OID’s progress.

If the strategic priorities are the bricks, the bricklayers are the OID’s five anchor programs: the Alliance of Minority Physicians, the Penn Center for LGBT Health, FOCUS on Health and Leadership for Women, the Center of Excellence for Diversity and Health Education and Research, and the recently established Penn Center for Research on Sex and Gender in Health.

“The work of this office is to get all five anchor programs to work more synergistically together,” says Higginbotham.

Higginbotham says the anchor programs share three characteristics: Each is led by a faculty member, receives external funding, and impacts at least two touch points in the “pipeline-to-faculty status,” as she terms it. This pipeline, which begins in Undergraduate Medical Education (UME) on the clinical/MD side and Biomedical Graduate Studies (BGS) on the research/Ph.D. side, links minority students and junior faculty, not only at Penn, but at academic medical institutions across the country.

The School of Medicine brings in a diverse group of students every year, with under-represented minorities making up 20 percent of the student body—which Higginbotham says is competitive with Penn’s peer institutions—but pipeline attrition depletes this diversity to 7 percent by the time these students reach the status of standing faculty.

“We’re making progress but we have to make greater progress,” says Higginbotham. “We find that, nationally, more women and under-represented minorities will leave an institution when they’re junior faculty. We must continue to be proactive in our efforts to remain competitive.”

One of the first steps she undertook to further understand the climate at Penn was to launch the Diversity Engagement Survey which, according to the OID’s recently published Year in Review booklet, measured “the institutional climate and culture using the lens of diversity and inclusion within the University of Pennsylvania [to characterize] the inclusiveness of the academic learning environment and assess baseline strengths and areas for improvement that relate to inclusion and diversity efforts.”

The results of this survey are providing Higginbotham with a baseline metric against which to measure the effectiveness of subsequent interventions. The keystone to these interventions, Higginbotham says, is strengthening the anchor programs so they can continue to make a more inclusive culture that will effectively reduce leakage in the pipeline.

This quantitative methodology yields “an increased understanding of what works and what doesn’t work,” she says, asserting, “what doesn’t work is just looking at [minority] numbers. Generally, in academia we have been focusing on just numbers for years without looking explicitly at climate. That’s why we have such a focus on the environment, because environment matters. Enhancing the climate improves the workplace culture for everyone.

“Ultimately,” she adds, “it’s all about building a biomedical workforce that can address the needs of a diverse population, because you can’t expect only one segment of the population to understand all the diverse needs. And it’s about building this kind of workforce in an inclusive way that is meaningful and more impactful than with individual groups working alone. The literature also supports the observation that [there is] greater innovation, better patient outcomes, and more impactful science. The corporate world has long realized that greater diversity also contributes to a more profitable bottom line.”