In this time of polarization and divisiveness across increasingly diverse communities, health policy and management research offers an important insight: engaging diversity meaningfully through inclusive leadership—that embraces staff across hierarchies and engages difference perspectives so that all healthcare workers of all kinds feel they can speak up and participate—can save lives. In multiple studies of quality in cardiovascular care, top performing hospitals have been shown to exhibit the capacity to embrace staff across hierarchies and engage differences so that healthcare workers of all kinds feel they can speak up and participate meaningfully in improvement efforts. Most recently, in the two-year, longitudinal Leadership Saves Lives study of 10 hospitals, the ability to adopt a culture of improvement rather than blaming was linked to significant reductions in risk-standardized mortality rates. Moreover, the guiding coalitions (ie, quality improvement teams) in six of the 10 hospitals that were most successful were distinguished in three ways that give insight about effective modes of engaging differences: (1) including staff from difference disciplines and levels in the organizational hierarchy, (2) encouraging authentic participation by the members, and (3) using constructive patterns of managing conflict (ie, having clear role definitions, working to surface minority viewpoints, and collectively revisiting the shared goal of saving lives). Based on this literature, adequately engaging a wide range of diverse viewpoints and staff roles can have a marked impact on health outcomes. Although the studies reviewed do not examine racial/ethnic diversity per se, they do lend insight into effectively navigating environments with extensive diversity of perspectives, professional identities, and experiences. Future research may assess whether these insights have application to other forms of diversity as well. In this time of extreme polarization and division globally and locally, health policy and management research has an opportunity to share evidence that could help navigate an increasingly diverse environment, at least within the field of healthcare, towards a more inclusive, humane, and life-giving approach to our collective future.
Chen PG, Curry LA, Nunez-Smith M, Bradley EH, Desai MM. Career satisfaction in primary care: a comparison of international and US medical graduates. J Gen Intern Med. 2012;27(2):147-152. doi:10.1007/s11606-011-1832-4
Page SE. The Difference: How the Power of Diversity Creates Better Groups, Firms, Schools, and Societies. Princeton University Press; 2007.
MacDonald H. The Diversity Delusion: How Race and Gender Pandering Corrupt the University and Undermine Our Culture. New York, NY: St. Martin's Press; 2018.
Kronman AT. The Assault on American Excellence. New York, NY: Simon & Schuster; 2019.
Whyte WH Jr. Groupthink. Fortune. 1952;114-117:142-146.
Janis IL. Groupthink: Psychological Studies of Policy Decisions and Fiascoes. Boston: Houghton Mifflin; 1982.
Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350-383. doi:10.2307/2666999
Nembhard IM, Edmondson AC. Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Organ Behav. 2006;27(7):941-966. doi:10.1002/job.413
Smith KK, Berg DN. Paradoxes of Group Life. San Francisco, CA: John Wiley & Sons; 1987.
Kahn WA. Holding Fast: The Struggle to Create Resilient Caregiving Organizations. New York, NY: Brunner-Routledge; 2005. doi:10.4324/9780203324066
Bradley EH, Brewster AL, McNatt Z, et al. How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interventional study. BMJ Qual Saf. 2018;27(3):218-225. doi:10.1136/bmjqs-2017-006574
Bradley EH, Holmboe ES, Mattera JA, Roumanis SA, Radford MJ, Krumholz HM. A qualitative study of increasing beta-blocker use after myocardial infarction: why do some hospitals succeed? JAMA. 2001;285(20):2604-2611. doi:10.1001/jama.285.20.2604
Bradley EH, Curry LA, Webster TR, et al. Achieving rapid door-to-balloon times: how top hospitals improve complex clinical systems. Circulation. 2006;113(8):1079-1085. doi:10.1161/circulationaha.105.590133
Nallamothu BK, Guetterman TC, Harrod M, et al. How do resuscitation teams at top-performing hospitals for in-hospital cardiac arrest succeed? a qualitative study. Circulation. 2018;138(2):154-163. doi:10.1161/circulationaha.118.033674
Curry LA, Spatz E, Cherlin E, et al. What distinguishes top-performing hospitals in acute myocardial infarction mortality rates? a qualitative study. Ann Intern Med. 2011;154(6):384-390. doi:10.7326/0003-4819-154-6-201103150-00003
Curry LA, Brault MA, Linnander EL, et al. Influencing organisational culture to improve hospital performance in care of patients with acute myocardial infarction: a mixed-methods intervention study. BMJ Qual Saf. 2018;27(3):207-217. doi:10.1136/bmjqs-2017-006989
Bradley EH, Brewster AL, McNatt Z, et al. How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interventional study. BMJ Qual Saf. 2018;27(3):218-225. doi:10.1136/bmjqs-2017-006574
Bradley, E. H. (2020). Diversity, Inclusive Leadership, and Health Outcomes. International Journal of Health Policy and Management, 9(7), 266-268. doi: 10.15171/ijhpm.2020.12
MLA
Elizabeth H. Bradley. "Diversity, Inclusive Leadership, and Health Outcomes". International Journal of Health Policy and Management, 9, 7, 2020, 266-268. doi: 10.15171/ijhpm.2020.12
HARVARD
Bradley, E. H. (2020). 'Diversity, Inclusive Leadership, and Health Outcomes', International Journal of Health Policy and Management, 9(7), pp. 266-268. doi: 10.15171/ijhpm.2020.12
VANCOUVER
Bradley, E. H. Diversity, Inclusive Leadership, and Health Outcomes. International Journal of Health Policy and Management, 2020; 9(7): 266-268. doi: 10.15171/ijhpm.2020.12
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