Why It Matters
Because health and health care need improvement.
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Diversity and Inclusion

By Azeem Mallick | Thursday, April 18, 2013
In collaboration with Nigel Deen, Research Assistant, and Sandy Cohen, Research Associate.

These are words which can stir up thoughts, emotions, and opinions. They can make people uncomfortable, defensive, and cautious. More importantly however, they force you to think. They force you to reflect on your surroundings, and to look at yourself. As a nation that continues to blend new cultures, religions, and backgrounds every day, diversity and inclusion needs to transition from something we think about if the need arises to being our standard, natural way of thinking.

Corporate America is starting to realize this as well. DiversityInc’s release of the Top 50 companies for diversity included some of the most globally recognizable companies, but was lacking in health care related organizations. We know that US health care – and the stakeholders that shape it – can be slow to adopt improvements. Studies show that, on average, it takes 17 years for the public to benefit from health-related research. For whatever reason, the health care field has been equally slow in addressing the important topic of diversity and inclusion. As IHI begins its focus on addressing diversity and inclusion in the workforce, as well as the health disparities engrained in all American communities, we thought it would be useful to share some early steps we have taken to embark on this journey.

For any organization planning to address the issue, it is important to have an action plan. The action plan of the Research and Development subgroup of the IHI Diversity and Inclusion Council is based on our mission: a dedication to improving health and health care for all people. For this, our subgroup reached out to Marie Spivey, EdD., Co-Chair of the New England Regional Health Equity Council, and Vice President, Health Equity at the Connecticut Hospital Association (CHA). Dr. Spivey leads CHA’s Diversity Collaborative. Through a discussion with her, the team was able to formulate an outline of how to proceed in four steps:

 1.    Raise awareness within the organization: let our staff know that we are doing this work and invite them to be a part of this journey. Intrinsic motivation is a powerful ally to have on your side when engaging in a project of this importance, and it helps to have an inspired and energized team. Within the first several months, our announcements, activities, and standing invitation saw active contribution grow substantially.

2.       Engage Leadership: as with all our work, it is important to have the buy-in of the leadership in order to build will across the top of the organization and to drive projects to fruition. This also allows us to justify the resources needed and time allocated towards our project.

3.       Conduct research: in order for us to speak confidently on the subject of health equity, health disparities, and cultural competency we need to do our own due diligence on the topic. This is a subject that has been studied and worked on for a number of years. As such, it would be naive of us to automatically make assumptions about the field. We need to recognize the current situation, consult experts, and develop an understanding of the problem that is tailored to our workforce, community, and customers.

4.       Evaluate our systems: A fundamental law of improvement states, “A system is perfectly designed to achieve the results it gets.” Applying this belief to our own work, we will strive to analyze our own system and assess whether we are appropriately situated to deal with health equity. If we are, how can we integrate a health equity focus into all programs? If we are not, what must be done so we can better improve quality by addressing health disparities through our work?

Delving into this topic is never easy. It often takes strong commitment to the work, and the ability to continue to drive momentum forward even when it seems you have hit a brick wall. But knowing where to begin and having a course of action are all-important first steps.


Editor’s note: IHI's commitment to diversity and inclusion begins in the workplace, with the recruitment of our staff and the enhancement of our inclusive culture—a culture that connects all people, fosters collaboration, flexibility, and fairness, and enables individuals to participate and contribute to their full potential. This commitment also extends to our efforts to engage with our community as individuals and as an organization, and to ensure that our work leads to the elimination of disparities in care across diverse communities.

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