What Factors Might Contribute to Inclusive Culture

Aug 4, 2018
What Factors Might Contribute to Inclusive Culture in Health Care Organizations?

Bottom Line: Researchers compiled six factors that health care workers believe can contribute to an inclusive culture within health care organizations and promote a diverse workforce.

Why The Research Is Interesting: Diversity in the health care workforce is important for health care organizations to try to reduce care disparities, improve the cultural competencies of health care professionals and retain employees. But how health care organizations can best create an inclusive culture isn’t always clear. This study is a qualitative narrative analysis that sought to understand from health care workers – from executives to staff to trainees and students – the factors perceived to be associated with inclusion in health care organizations.

What and When: 315 narratives submitted by health care workers in June 2016 in response to an email asking for stories that reflected on inclusion at their organizations, which included hospitals, health science schools and outpatient facilities within a university-based health care system in Pennsylvania

What (Study Measures and Outcomes): Workplace experiences with inclusion, implications of those experiences, and recommendations to improve inclusion

How (Study Design): This was a qualitative narrative analysis.

Authors: Jaya Aysola, M.D., D.T.M.&H., M.P.H., of the University of Pennsylvania, Philadelphia, and coauthors

Results: Six broad factors emerged as being associated with inclusion in health care organizations; underlying them was the need to belong and to feel recognized and valued.

The six factors were:

Presence of discrimination
Silent witness (when discriminatory or insensitive actions or statements are witnessed but nothing is said)
Interplay between hierarchy, recognition and civility (differences in treatment based on status within an organization)
Effectiveness of leadership and mentors
Support for work-life balance
Perceptions of exclusion for some because of inclusion efforts
Study Limitations: The regionally limited findings may not be nationally generalizable and some groups were underrepresented in the study sample.

Study Conclusions:

Meaning: Understanding these factors provides healthcare systems a way to improve inclusivity and facilitate the retention of a diverse health professional student body and healthcare workforce to ultimately improve care delivery.

Related Material: The invited commentary, “Promoting Inclusion in Academic Medicine,” by Elena Fuentes-Afflick, M.D, M.P.H., of the University of California, San Francisco, also is available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamanetworkopen.2018.1003)