Healthcare company governing bodies are falling behind on their own diversity, equity and inclusion goals and need to assess the effectiveness of board member policies and hiring strategies, according to the report released Tuesday.

Headhunting firm Witt Kieffer and the School of Health Management conducted a polls Executives and board members from 25 health systems representing more than 400 hospitals to assess governance trends and progress towards previously stated goals.

The survey found that while health systems are returning to strategic initiatives during the COVID-19 pandemic, focusing on diversity, equity and inclusion, most people are struggling to implement these plans. For example, only 3% of companies have appointed health equity experts to their top boards.

Governing body members remain predominantly white, male and over 50 years old. Minorities make up nearly 40 percent of the U.S. population but make up only 21 percent of board members at companies surveyed. Women make up more than half of the population but only hold 27% of board seats.

These metrics are gradually improving over time. From 2019 to 2021, the number of black board members increased by 7% and the number of women on boards increased by 6%. Asians and Latinos make up 1% and 3% of board seats, respectively. People under the age of 50 occupy only 7% of the jobs.

The report highlights the need for organizations to reconsider exclusive policies limiting board mobility and expand their recruiting efforts to reach candidates outside their existing peer networks.

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A key issue healthcare companies face in terms of board leadership diversity is low board turnover. These rare opportunities create “the pressure to find people who meet many diversity metrics,” said report author Victoria Sterfox, a research and consulting manager at the School of Health Management.

Most health systems surveyed have nearly 20 active board members, roughly double the average for S&P 500 companies, so expanding boards is not the answer, Stefox said. Instead, healthcare companies should seek to modernize policies that are barriers to achieving DEI goals. Those measures include rewriting the bylaws to get rid of legacy policies, course commitments or age restrictions, she said.

“This report clearly shows that leading health systems recognize that the traditional approach to the board nomination process can itself be an obstacle to achieving diversity goals. While all of these factors are logical from a governance health perspective, boards must Be careful that these same processes don’t hinder their ability to bring diversity to the board,” said Paul Bohne, managing partner at WittKieffer.

Rethinking operations to include virtual meetings and compensating board members could attract candidates who would otherwise not be accountable. Building internal pipelines proportional to the communities served is also a key factor, Stefan Fox said.

Top-performing companies use competency matrices to track the makeup, expertise and background of their employees, and then set clear goals when hiring, Stefox said.

In general, boards are still figuring out how to support their organization’s DEI goals, Bohne said. “It is clear that the demonstration and sharing of actionable concrete practices the board is taking is very necessary so that the board can learn from other boards,” he said.