Article

Setting the Stage for a Business Case for Leadership Diversity in Healthcare: History, Research, and Leverage

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Abstract

Leveraging diversity to successfully influence business operations is a business imperative for many healthcare organizations as they look to leadership to help manage a new era of culturally competent, patient-centered care that reduces health and healthcare disparities. This article presents the foundation for a business case in leadership diversity within healthcare organizations and describes the need for research on managerial solutions to health and healthcare disparities. It provides a discussion of clinical, policy, and management implications that will help support a business case for improving the diversity of leadership in healthcare organizations as a way to reduce health and healthcare disparities. Historical contexts introduce aspects of the business case for leveraging leadership diversity based on a desire for a culturally competent care organization. Little research exists on the impact that the role of leadership plays in addressing health disparities from a healthcare management perspective. This article provides practitioners and researchers with a rationale to invest in leadership diversity. It discusses three strategies that will help set the stage for a business case. First, provide empirical evidence of the link between diversity and performance. Second, link investments in diversity to financial outcomes and organizational metrics of success. Third, make organizational leadership responsible for cultural competence as a performance measure. In order to address health and healthcare disparities, collaborations between researchers and practitioners are necessary to effectively implement these strategies.

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... For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. Although in the past few years, the idea of culturally competent care gained the attention of healthcare organizations as an important organizational strategy to improve quality and eliminate ethnic disparities in healthcare (Betancourt, Green, Carillo, & Park, 2005;Chun, 2009;Dotson & Nuru-Jeter, 2012), examples of organizational ethical guidelines on cross-cultural care remain, as yet, non-existent in the international literature. This means that the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. ...
... From existing research (Gushulak et al., 2011;Kirmayer et al., 2011;Priebe et al., 2011;WHO Europe MFH Project Group, 2004), we learn that the degree of sensitivity to deal with cross-cultural issues strongly depends from the organizational context, action and programs in this regard (investment in person-oriented services, increasing organizational flexibility, increasing the knowledge of migrant population experiences and existing health disparities and inequities, cultivate the interpretation of culture as one of the many dimensions of being human, training facilities for staff, provision of information, working with community organizations, providing resources for dealing with language barriers, etc.). Organizational self-assessment is an essential feature of culturally competent healthcare (Chun, 2009;Dotson & Nuru-Jeter, 2012). The surplus value of the ethical perspective is that it supplies the need for ethical guidance (Turner, 2003) in cross-cultural care by describing (1) a general framework of fundamental values and ethical attitudes that are relevant in the context of cross-cultural care (i.e. the ethical content), and (2) a concrete framework for reflection and action on four levels within the healthcare organization (i.e. the organizational process). ...
... As such, the guideline challenges healthcare professionals and management to actively focus at the theme by offering the ethical tools to develop their own ethics policy concerning cross-cultural care. Consistent with the organizational recommendations from the international literature (Chun, 2009;Dotson & Nuru-Jeter, 2012) the guideline shapes the organizational preconditions for culturally competent care to take place in the clinical context. ...
Article
In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks.
... In addition, a recent review of workforce diversity in human service organizations found that diversity is associated with enhanced creativity and innovation, improved workplace commitment, and increased retention (Mor Barak et al., 2016). There is considerable concern, however, regarding the scarcity of diversity in health care providers, executive leaders, and governance (ACHE, 2008;Dotson & Nuru-Jeter, 2012;Mitchell & Lassiter, 2006;Silvera & Clark, 2021;Smith, Nsiah-Kumi, Jones, & Pamies, 2009;Sullivan, 2004). ...
... Culturally competent hospitals also tend to be not for profit, serve a more diverse inpatient population, and located in more competitive and affluent markets (Weech-Maldonado et al., 2011). Studies have suggested greater attention to collaborations between researchers and practitioners in order to make a more direct link between culturally competent care and a reduction in health disparities (Dotson & Nuru-Jeter, 2012). It has also been recommended that research move toward a broader conceptualization of cultural competency by focusing on cultural safety (Curtis et al., 2019). ...
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In the US, a growing number of organizations and industries are seeking to affirm their commitment to and efforts around diversity, equity, and inclusion (DEI) as recent events have increased attention to social inequities. As health care organizations are considering new ways to incorporate DEI initiatives within their workforce, the anticipated result of these efforts is a reduction in health inequities that have plagued our country for centuries. Unfortunately, there are few frameworks to guide these efforts because few successfully link organizational DEI initiatives with health equity outcomes. The purpose of this chapter is to review existing scholarship and evidence using an organizational lens to examine how health care organizations can advance DEI initiatives in the pursuit of reducing or eliminating health inequities. First, this chapter defines important terms of DEI and health equity in health care. Next, we describe the methods for our narrative review. We propose a model for understanding health care organizational activity and its impact on health inequities based in organizational learning that includes four interrelated parts: intention, action, outcomes, and learning. We summarize the existing scholarship in each of these areas and provide recommendations for enhancing future research. Across the body of knowledge in these areas, disciplinary and other silos may be the biggest barrier to knowledge creation and knowledge transfer. Moving forward, scholars and practitioners should seek to collaborate further in their respective efforts to achieve health equity by creating formalized initiatives with linkages between practice and research communities.
... The IOM outlined the importance of racially and ethnically diverse healthcare professionals for optimal care for diverse patient populations, improved physician-patient communication, and greater engagement of patients in medical decision-making (Bristow et al., 2004). Further research has indicated that a lack of diversity within the surgical workforce also has implications for the pathway of future surgeons, patient-centered care and outcomes, leadership within surgery and medicine at large, and the communities served by providers and health care institutions (Diaz et al., 2020;Dotson & Nuru-Jeter, 2012;Nehemiah et al., 2021;West et al., 2018). ...
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Despite increased attention devoted to diversity, equity, and inclusion (DEI) within academic medicine, representation, lack of workforce and leadership diversity, and bias within medicine remain persistent problems. The purpose of the current study was to understand the current efforts and attention to DEI within academic departments of surgery in the United States. 251 department of surgery websites were reviewed, using a standardized data collection form and scoring procedure, accompanied by a 10 percent fidelity check by an independent reviewer. Only 16% of departments of surgery included DEI-specific information, such as a DEI mission statement or initiatives on their departmental sites, with less than seven percent of departments reporting a DEI committee. Such public information may have implications for recruitment and retention of diverse faculty and trainees, downstream effects for patient care, and could be critical to public accountability to improve diversity and create a culture of equity and inclusion.
... This "July effect" noted in ERCP-related outcomes, especially among Blacks and Hispanics, can be mitigated with new strategies. A robust onboarding process for the new recruits (endoscopy nurses and advanced fellows), frequent overseeing of the work by senior faculty and fellows, appropriate supervision in a graded fashion, and enhanced education on a hand-off and discharge processes could assist in decreasing this effect [36][37][38][39]. Additionally, a special emphasis on increasing communication between the treatment team and ethnic minority patients, incorporating race and ethnic details as a core element, developing quality improvement projects with detailed analysis of care, and familiarizing new trainees with the technical details of the ERCP and related endoscopy equipment (duodenoscope positions, biliary cannulation methods, guidewires, and sphincterotomes) before starting hands-on procedures would go a long way [40]. ...
Article
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Background We identified trends of inpatient therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the United States (US), focusing on outcomes related to specific patient demographics.Methods The National Inpatient Sample was utilized to identify all adult inpatient ERCP in the US between 2007–2018. Trends of utilization and adverse outcomes were highlighted. P-values ≤ 0.05 were considered statistically significant.ResultsWe noted a rising trend for total inpatient ERCP in the US from 126,921 in 2007 to 165,555 in 2018 (p = 0.0004), with a significant increase in utilization for Blacks, Hispanics, and Asians. Despite an increasing comorbidity burden [Charlson Comorbidity Index (CCI) score ≥ 2], the overall inpatient mortality declined from 1.56% [2007] to 1.46% [2018] without a statistically significant trend (p = 0.14). Moreover, there was a rising trend of inpatient mortality for Black and Hispanic populations, while a decline was noted for Asians. After a comparative analysis, we noted higher rates of inpatient mortality for Blacks (2.4% vs 1.82%, p = 0.0112) and Hispanics (1.17% vs 0.83%, p = 0.0052) at urban teaching hospitals between July toand September compared to the October to June study period; however, we did not find a statistically significant difference for the Asian cohort (1.9% vs 2.10%, p = 0.56). The mean length of stay (LOS) decreased from 7 days in 2007 to 6 days in 2018 (p < 0.0001), while the mean total hospital charge (THC) increased from $48,883 in 2007 to $85,909 in 2018 (p < 0.0001) for inpatient ERCPs. Compared to the 2015–2018 study period, we noted higher rates of post-ERCP pancreatitis (27.76% vs 17.25%, p < 0.0001) from 2007–2014.Conclusion Therapeutic ERCP utilization and inpatient mortality were on the rise for a subset of the American minority population, including Black and Hispanics.
... Thus, diversity applied in a top-down manner, from the board and top management teams, has become increasingly influential in organisational futures (Aggarwal et al., 2019;Miller and del Carmen Triana, 2009;Talke et al., 2011). Consequently, cultural and gender diversity has become a focal point in ascertaining the performance impact and healthcare outcomes of increasingly heterogeneous leadership teams and workforces within global healthcare supply chains (Cohen et al., 2002;Dotson and Nuru-Jeter, 2012;Fontenot, 2012). Further, definitions of gender diversity included in this review are outlined in the Table 1. ...
Article
The healthcare supply chain plays a fundamental role in addressing the healthcare needs of local and global communities. The composition of the healthcare sector, particularly regarding cultural and gender diversity, is an antecedent to effective medical healthcare management, and achieving organisational performance. Following an appraisal of the selected literature, six themes emerged in the research area of diversity in healthcare. These were cultural diversity management, gender diversity management, governance and leadership, board management, Indigenous healthcare, and healthcare workers and teamwork. Findings from the study suggest the advancement of critical elements of organisational diversity research in the agile medical supply chain, including aspects of the influences of workforce heterogeneity on board governance practices, organisational culture and climate-specific studies, organisational performance and non-performance outcomes, and diversity disparities in senior and executive-level leadership roles. This study can influence regulatory decision-making, strategic policy origination, and operational diversity management programs
... Thus, diversity applied in a top-down manner, from the board and top management teams, has become increasingly influential in organisational futures (Aggarwal et al., 2019;Miller and del Carmen Triana, 2009;Talke et al., 2011). Consequently, cultural and gender diversity has become a focal point in ascertaining the performance impact and healthcare outcomes of increasingly heterogeneous leadership teams and workforces within global healthcare supply chains (Cohen et al., 2002;Dotson and Nuru-Jeter, 2012;Fontenot, 2012). Further, definitions of gender diversity included in this review are outlined in the Table 1. ...
Article
Full-text available
The healthcare supply chain plays a fundamental role in addressing the healthcare needs of local and global communities. The composition of the healthcare sector, particularly regarding cultural and gender diversity, is an antecedent to effective medical healthcare management, and achieving organisational performance. Following an appraisal of the selected literature, six themes emerged in the research area of diversity in healthcare. These were cultural diversity management, gender diversity management, governance and leadership, board management, Indigenous healthcare, and healthcare workers and teamwork. Findings from the study suggest the advancement of critical elements of organisational diversity research in the agile medical supply chain, including aspects of the influences of workforce heterogeneity on board governance practices, organisational culture and climate-specific studies, organisational performance and non-performance outcomes, and diversity disparities in senior and executive-level leadership roles. This study can influence regulatory decision-making, strategic policy origination, and operational diversity management programs.
... 34 Organizations that invest in diverse leadership may be able to cultivate a more culturally responsive health care organization and begin to eliminate health disparities. 35 Invest in Schools That Graduate More Black, Latino, and Native Students (ie, Historically Black Colleges, Hispanic Serving Institutions, and Tribal Associated Schools) nursing 37 (Hampton University and Tuskegee University). These schools should be viewed as exemplars, and their success in diversifying our health workforce should be supported through appropriate investments. ...
... A diverse biomedical workforce is essential for excellence in patient care and has been linked to better patient outcomes, access to and quality of care [1][2][3]. However, the physician workforce in radiology does not reflect the make-up of our population. ...
Article
PurposeTo assess the perception of equity and respect in the workplace and within the SSR. We hypothesized that responses would differ by gender and minorities underrepresented in medicine (URiM) status.Methods An electronic survey was sent to 1,531 SSR members between January 2020 and March 2020 to determine perception of equity and respect. Descriptive statistics were calculated, and analysis of differences in response by gender/minority status was performed using the Fisher’s exact test. The study was exempt from IRB approval.ResultsThere were 176 responses (11.5%). Most respondents (61.9%) were between 30 and 50 years. Members identified as male (M) in 74.4%, as female (F) in 25.0%, and as “other” in 0.6%. URiM comprised 9.1% of members. Women worked more commonly in academia (p = 0.005), had the perception of unequal opportunities for leadership positions within the institution (p = 0.006), and emphasized the importance of having a mentor of the same gender (p = 0.001). URiM members were less likely to hold a leadership position (p = 0.1, trend), had a perception of unequal opportunities for leadership positions within the institution (p = 0.06, trend), and reported the importance of having a mentor of the same race (p = 0.06, trend). There were no significant differences between gender or URiM status and perception of the SSR to provide an inclusive environment and leadership opportunities (p ≥ 0.39).Conclusion While survey participation was limited and potentially biased, respondents perceived that women and minorities have fewer opportunities and are treated with lower regard in the workplace compared to male, non-minority colleagues.
... There have been calls for increased diversity in health care leadership with the expectation that it will translate into higher quality health care [51]. Although evidence to support this claim are sparse in health care, data from industry appear to support this approach [52]. There are a number of learnings/experiences, that have developed successful practices for health care organizations [53]. ...
Article
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Many health care organizations struggle and often do not succeed to be high-performance organizations that are not only efficient and effective but also enjoyable places to work. This review focuses on the physician and organizational roles in limiting achievement of a high-performance team in health care organizations. Ten dimensions were constructed and a number of competencies and metrics were highlighted to overcome the failures to: (i) Ensure that the goals, purpose, mission and vision are clearly defined; (ii) establish a supportive organizational structure that encourages high performance of teams; (iii) ensure outstanding physician leadership, performance, goal attainment; and (iv) recognize that medical team leaders are vulnerable to the abuses of personal power or may create a culture of intimidation/fear and a toxic work culture; (v) select a good team and team members—team members who like to work in teams or are willing and able to learn how to work in a team and ensure a well-balanced team composition; (vi) establish optimal team composition, individual roles and dynamics, and clear roles for members of the team; (vii) establish psychological safe environment for team members; (viii) address and resolve interpersonal conflicts in teams; (xi) ensure good health and well-being of the medical staff; (x) ensure physician engagement with the organization. Addressing each of these dimensions with the specific solutions outlined should overcome the constraints to achieving high-performance teams for physicians in health care organizations.
... 22 Racial equity in leadership must also be a high priority, as it will help institutions achieve the broader goals of delivering high-quality, personcentered care, increasing patient satisfaction, and catalyzing high-impact scientific discoveries. [23][24][25] Racial and ethnic minority individuals comprise only 11% of health care executives, 14% of hospital board members, and 19% of mid-and first-level managers. 26 Only 3.6% of medical school faculty are African American and 5.5% are Hispanic/ Latino. ...
Article
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The harsh realities of racial inequities related to COVID-19 and civil unrest following police killings of unarmed Black men and women in the United States in 2020 heightened awareness of racial injustices around the world. Racism is deeply embedded in academic medicine, yet the nobility of medicine and nursing have helped health care professionals distance themselves from racism. Vanderbilt University Medical Center (VUMC), like many U.S. academic medical centers, affirmed its commitment to racial equity in summer 2020. A Racial Equity Task Force was charged with identifying barriers to achieving racial equity at the medical center and medical school and recommending key actions to rectify longstanding racial inequities. The task force, composed of students, staff, and faculty, produced more than 60 recommendations, and its work brought to light critical areas that need to be addressed in academic medicine broadly. To dismantle structural racism, academic medicine must: (1) confront medicine's racist past, which has embedded racial inequities in the U.S. health care system; (2) develop and require health care professionals to possess core competencies in the health impacts of structural racism; (3) recognize race as a sociocultural and political construct, and commit to debiologizing its use; (4) invest in benefits and resources for health care workers in lower-paid roles, in which racial and ethnic minorities are often overrepresented; and (5) commit to antiracism at all levels, including changing institutional policies, starting at the executive leadership level with a vision, metrics, and accountability.
... [1][2][3][4][5] Research supports calls for improved DEI, as studies have shown that a diverse workforce improves the implementation of global health programs. [6][7][8] Diversity in this context refers to the composition of work teams regarding heterogeneous demographic and cultural characteristics. 9,10 Equity amounts to equal representation and issues of historical oppression and present discrepancies in influence and power. ...
Article
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Diversity, Equity, and Inclusion in the global sanitation sector have not been the subject of extensive investigation or scrutiny. However, without diverse leadership, the sector will continue to experience failure, inefficient use of dwindling resources, and overall low sanitation coverage rates, with 2 billion people lacking sanitation access. This research presents the first quantitative study of sanitation leadership demographics. The results revealed that older, white males from High-Income Countries comprised over a third of all leadership positions. This research found that two-thirds of all sanitation leaders were white, with white leaders 8.7 times more likely to hold multiple positions across different organizations than Black, Indigenous, or other People of Color. Eighty-eight out of one hundred organizations were headquartered in a High-Income Country, and western institutions dominated education data. Black, Indigenous, and other Women of Color were the least represented group, highlighting the importance of an intersectional perspective when discussing gender and racial equality. These issues must be urgently addressed if the Sustainable Development Goal 6.2 targets are to be met effectively. Institutional reform, inclusive hiring policies, and transforming individual attitudes are starting points for change. More organizational data should be made available, and further research needs to be conducted on these topics if a change is to be seen in time for 2030.
... Es clara la necesidad de formar médicos líderes capaces de aportar y trabajar en la implementación y mejora de los sistemas de salud, se han comenzado a establecer programas para la enseñanza, y modelos de liderazgo más estructurados y definidos. (Dotson & Nuru-Jeter, 2012). ...
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El Libro que aquí presentamos constituido por la Red de Cuerpos Académicos en Investigación Educativa(RedCA), lo conforman 17 Capítulos organizados en cinco partes consideradas en las siguientes tendencias o paradigmas temáticos; formación y practica docente, los Procesos académicos en el nivel Medio Superior , Liderazgo, tutoría y trabajo colaborativo, las Conductas agresivas y Ciberagresión en adolescentes y los Programas académicos como expresiones de Evaluación Institucional.
... Leveraging diversity refers to managerial practices often discussed in terms of sound business management, judgement, and expertise to assist an organization to become culturally competent (Dotson & Nuru-Jeter, 2012). A leader must know how to bring people from diverse backgrounds into their organization. ...
... As in the case of the previous theme, cultural competence has been considered in association with a range concepts and theories relating to organisations. These include, organisational culture (Casida & Pinto-Zipp, 2008;El Amouri & O'Neill, 2014;Grant, 2010;Luger, 2011;Olavarria et al., 2009;Patterson, 2013), organisational development (Applegate, 2001;Dotson & Nuru-Jeter, 2012;Gertner et al., 2010;Glover & Friedman, 2014;K. Lee, 2009;Ljubica et al., 2016;Plastrik, 2001), and organisational theory (Kraimer, Shaffer, & Bolino, 2009;Shih, Young, & Bucher, 2013;Whealin & Ruzek, 2008). ...
Thesis
Employees’ turnover has always been the main concern and interest of both academics and practitioners in the healthcare sector. Also, both leadership styles and organisational culture as the main contributors to employees’ intention to leave have always been the central focus of most scholars in different disciplines including healthcare and organisational studies. Although, there are numerous studies that have investigated the impact of both leadership styles and organisational culture on employees’ intention to leave, almost all of this research has only explored the direct relationships between these variables. As a result there is limited and inadequate attention on the indirect relationships among these variables through other major factors such as job satisfaction, organisational commitment and perceived organisational support. Therefore, this study argues that there is an absence of a comprehensive conceptual framework in this area that has explored both direct and indirect relationships among these variables. As a result, the main purpose of this study is to provide a comprehensive conceptual framework that enables researchers to investigate the mediating impact of job satisfaction, organisational commitment, perceived organisational support on the relationship between leadership styles and organisational culture with the intention to leave in public healthcare in Saudi Arabia. In the first instance and in order to achieve this study’s aim and objectives, a systematic literature review was carried out that helped and enabled the researcher to develop a conceptual framework that clearly shows these relationships. After developing a conceptual framework and hypotheses related to the relationships, a questionnaire was designed based on the existing literature in these areas and was distributed among 850 employees working in one public hospital in Saudi Arabia. Out of 850 questionnaires distributed 354 usable questionnaires were returned which provided around 40 percent response rate. The results of this study were interesting and in some respects unexpected in some areas. The findings show that transactional leadership style has no direct or indirect relationship with the intention to leave which was surprising and requires further investigation. Furthermore, job satisfaction does not act as a mediator on the relationship between transformational leadership style and intention to leave which was also unexpected and requires further investigation. On the other hand, the results of this study confirm the importance of both transformational leadership style and organisational culture on the intention to leave among expatriates in the public sector as well as the major influence of job satisfaction, organisational commitment and perceived organisational support on these relationships. This study makes several major contributions both from an academic and practitioners’ point of view. The most important contribution of this study lies in the roots of this study with the presentation of a conceptual framework that shows both direct and indirect relationships among all variables explored. Furthermore, this study also contributes to the growing literature in the area of leadership-culture-intention to leave in public healthcare systems in developing countries.<br/
... In a heterogeneous workforce where the majority of the subordinates ethnicity differs, the obstacles might be more compared to having a homogenous subordinate. Despite that possibility, demographic diversity, leadership could lead to better outcomes by enhancing creativity and promoting better group problem solving [15]. ...
... First, this study's sample came from a racially and ethnically diverse organization, allowing for the examination of leadership and inclusion in a multicultural workplace. Because few studies have investigated leadership in diverse workforces (Dotson & Nuru-Jeter, 2012;Eagly & Chin, 2010;Kearney & Gebert, 2009;Klein et al., 2011;Ramthun & Matkin, 2012), this study adds to our understanding of how leaders can leverage diversity's potential benefits. By investigating how leaders in diverse organizations can increase workplace inclusion, this study offers new insight into how to improve employee well-being, job satisfaction, and retention through creating an inclusive environment. ...
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With increased workforce diversity, human service organizations are recognizing the need to create inclusive workplaces; yet little is known about how leaders can enhance workplace inclusion. We collected data at three time points in 6-month intervals from a public child welfare organization (n = 363). Using latent change score models, we analyzed whether leader–member exchange influenced how inclusion changed over time. Results indicate that favorable perceptions of leader–member exchange are associated with increased feelings of inclusion 6 and 12 months later. Findings highlight the importance of improving leadership interactions with their employees to increase workplace inclusion.
... (Clark et al 2010). Dotson and Nuru-Jeter (2012) identified three effective strategies for leveraging on diversity to promote constructive and productive business practices. Cultural competence is used as a performance measure and organisational metrics of success. ...
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Educational researchers postulate that the increased rate of migration of students to other countries underscores the importance of sustaining academic excellence irrespective of cultural background. Many authors and researchers derived learning theories and styles based on the fact that students have different learning style preferences and are influenced by several factors. Culture is one of the major influencing factors that have determined the need to analyse the impact on learning style preferences. Thus, this study aims to investigate the relationship between cultural diversity and learning style preferences of business students. One hundred and twenty one samples were selected by non-probability convenient sampling technique. The Cultural Diversity Self Assessment Inventory and Perceptual Learning Style Preference Questionnaire were used. Descriptive analysis using Spearman Rank correlation was employed to determine the relationship between the variables and ANOVA was utilized to identify the association between cultural diversity and learning style preferences. The results found that there is a strong correlation between cultural diversity and learning style preferences. These preferences are also found to be affected by cultural values. The findings have drawn attention to facets of learning, curriculum and cultivation of advanced instructional technology in which teachers and managers play a vital role in the development of individuals from different cultural backgrounds. Keywords - Culture, Cultural Diversity, Cultural Competence, Learning, Learning Style Preferences, Hospitality and Tourism Students.
... 2. Organizational commitment to the identification and elimination of health care disparities as an integral component of QI. Racial and ethnic diversity across organizations, including leadership, can improve sensitivity and commitment to health care disparities (40). ...
Article
Racial and ethnic disparities in health care quality result from complex interactions between patient-level, system-level, and provider-level factors that affect the cascade of health care decisions. Social disadvantage represents a key driver of racial and ethnic health care disparities. In particular, patient socioeconomic status (SES), health insurance, geography, language, culture, health literacy, patient activation, and patient discriminatory experiences constrain health care access and health care decisions. In addition, separate and unequal systems of health care between states and within states contribute to health care disparities. Insufficient resources within these systems relative to the needs of the populations served contribute to unequal outcomes. Suboptimal provider communication and implicit provider bias undermine patient partnerships and shared decision-making. Progress in elimination these disparities will require continued insurance expansion, containment of rising health care costs, and a national will for ensuring health care equity through resource investment, public accountability and evidence-based, multilevel strategies.
... (Clark et al 2010). Dotson and Nuru-Jeter (2012) identified three effective strategies for leveraging on diversity to promote constructive and productive business practices. Cultural competence is used as a performance measure and organisational metrics of success. ...
Article
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Career selection is one of many important choices students make in determining their future plans and this decision will impact them throughout their lives. A number of factors play a role in deciding the choice of a career. Personality as a whole has its own impact on choice of a career for an individual. Some of the traits may be positive for some professions while others may be negative for other professions. This paper attempts to examine the effects of some of the personality factors of students on their choice of becoming an entrepreneur. Primary data was collected from a sample of 530 final year students of professional courses in Uttarakhand who were interviewed and assessed on various personality factors. The key research objective of the study was to develop and empirically link general personality characteristics of students and their career intention upon completion of their professional course. The results from this study show that personality factors such as level of faith and commitment, drive and determination, level of energy and level of tolerance of risk and uncertainty influence a student’s decision to become an entrepreneur. However, personality factors of leadership and passion are seen to be independent factors.
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Purpose: The increasing diversity among workforces - as well as the increasing diversity among patient populations served - offers a variety of opportunities and potential pitfalls for healthcare organizations and leaders. To unravel this complexity, the authors aim to holistically understand how to maximize provider and patient experiences regardless of (1) the degree to which diversity is present or lacking, and (2) the type(s) of diversity under consideration. Design/methodology/approach: This conceptual paper develops a framework that combines three organizational behavior theories - emotional labor theory, similarity-attraction theory and climate theory - with evidence from the broader healthcare literature. Findings: Authentic interactions yield positive outcomes for providers (i.e. improved job attitudes and work-related well-being) and patients (i.e. patient satisfaction) and acts as a mediator between demographic diversity and positive outcomes. Demographic similarity facilitates authentic interactions, whereas demographic diversity creates an initial barrier to engaging authentically with others. However, the presence of a positive diversity climate eliminates this barrier. Originality/value: The authors offer a conceptual model to unlock positive outcomes - including reduced absenteeism, better morale and improved patient satisfaction - regardless of the level and types of diversity present within the workforce. In addition to deriving an agenda for future research, the authors offer practical applications regarding how diversity can be more effectively managed and promoted within healthcare organizations.
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The complexity of health care today along with the drive towards value-based care are strong forces in support of growing and expanding the physician leadership workforce. Physician led organizations are associated with improved physician engagement, quality of care and cost efficiency. Physicians would benefit from more formal leadership training which incorporates a structed leadership curriculum, mentorship and on the job progressive leadership experience. Special attention must be placed on increasing the diversity of our physician leaders. There are many important characteristics to look for in our physician leaders including emotional intelligence, integrity, visioning, humility, persuasion and the ability to listen.
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Objective Gynecologic oncology includes increasing percentages of women. This study characterizes representation of faculty by gender and subspecialty in academic department leadership roles relevant to the specialty. Methods The American Association of Medical Colleges accredited schools of medicine were identified. Observational data was obtained through institutional websites in 2019. Results 144 accredited medical schools contained a department of obstetrics and gynecology with a chair; 101 a gynecologic oncology division with a director; 98 a clinical cancer center with a director. Women were overrepresented in academic faculty roles compared to the US workforce (66 vs 57%, p < 0.01) but underrepresented in all leadership roles (p < 0.01). Departments with women chairs were more likely to have >50% women faculty (90.2 vs 9.8%, p < 0.01); and have larger faculties (80.4 vs 19.6% >20 faculty, p = 0.02). The cancer center director gender did not correlate to departmental characteristics. A surgically focused chair was also associated with >50% women faculty (85.7 vs 68.3%, p = 0.03); faculty size >20 (85.7 vs 61.4%, p < 0.01); and a woman gynecologic oncology division director (57.6 vs 29.4%, p < 0.01; 68.4 vs 31.7%, p < 0.01) and gynecologic oncology fellowship (50 vs 30.4%, p < 0.01; 59.1 vs 32%, p < 0.01). Gynecologic oncology leadership within cancer centers was below expected when incidence and mortality to leadership ratios were examined (p < 0.01, p < 0.01). Conclusion Within academic medical schools, women remain under-represented in obstetrics and gynecology departmental and cancer center leadership. Potential benefits to gynecologic oncology divisions of inclusion women and surgically focused leadership were identified.
Article
Background: Research on the effects of increasing workplace diversity has grown substantially. Unfortunately, little is focused on the healthcare industry, leaving organizations to make decisions based on conflicting findings regarding the association of diversity with quality and financial outcomes. To help improve the evidence-based research, this umbrella review summarizes diversity research specific to healthcare. We also look at studies focused on professional skills relevant to healthcare. The goal is to assess the association between diversity, innovation, patient health outcomes, and financial performance. Methods: Medical and business research indices were searched for diversity studies published since 1999. Only meta-analyses and large-scale studies relating diversity to a financial or quality outcome were included. The research also had to include the healthcare industry or involve a related skill, such as innovation, communication and risk assessment. Results: Most of the sixteen reviews matching inclusion criteria demonstrated positive associations between diversity, quality and financial performance. Healthcare studies showed patients generally fare better when care was provided by more diverse teams. Professional skills-focused studies generally find improvements to innovation, team communications and improved risk assessment. Financial performance also improved with increased diversity. A diversity-friendly environment was often identified as a key to avoiding frictions that come with change. Conclusions: Diversity can help organizations improve both patient care quality and financial results. Return on investments in diversity can be maximized when guided deliberately by existing evidence. Future studies set in the healthcare industry, will help leaders better estimate diversity-related benefits in the context of improved health outcomes, productivity and revenue streams, as well as the most efficient paths to achieve these goals.
Article
Affordable Care Act legislation is requiring leaders in US health systems to adapt to new and very different approaches to improving operating performance. Research from other industries suggests leadership development can be a helpful component of organizational change strategies; however, there is currently very little healthcare-specific research available to guide design and deployment. The goal of this exploratory study is to examine potential relationships between specific leadership development practices and health system financial outcomes. Results from the National Center for Healthcare Leadership survey of leadership development practices were correlated with hospital and health system financial performance data from the 2013 Medicare Cost Reports. A general linear regression model, controlling for payer mix, case-mix index, and bed size, was used to assess possible relationships between leadership practices and three financial performance metrics: operating margin, days cash on hand, and debt to capitalization. Statistically significant associations were found between hospital-level operating margins and 5 of the 11 leadership practices as well as the composite score. Relationships at the health system level, however, were not statistically significant. Results provide preliminary evidence of an association between hospital financial performance and investments made in developing their leaders.
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This report reviews the evidence base for the impact of cultural and linguistic competence in health and mental health care on health outcomes and well-being and the costs and benefits to the system. The authors conducted a structured search of Medline from January 1995 to March 2006 to identify primary research articles on health outcomes and well-being. An exploratory search of multiple databases was performed to identify evidence related to the business case. The review of the health outcomes literature indicated that the field is in the early stages of development, with the preponderance of literature defining the concepts and identifying research questions. Some promising studies support the efficacy of cultural and linguistic competence affecting health and mental health outcomes. Evidence of decreased systems costs is not currently present in the literature. The authors identify key gaps in the current literature and specific methodological and funding limitations to be addressed.
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Research suggests that equal employment opportunity (EEO) legislation and affirmative action programs (AAPs) have been only partially successful in promoting women and minorities in the workplace. Firms are voluntarily pursuing diversity management, but only when business objectives coincide with the needs of women and minorities. Thus, the question of what factors are needed to help women and minorities advance in the workplace merits further investigation. Although top executive support is believed to be crucial to managing diversity, few studies have linked CEO commitment to diversity outcomes. This article proposes a theoretical framework for linking CEO commitment to diversity practices. Specifically, CEO commitment is expected to mediate the relationships between the leader's demographic characteristics and personal factors—consisting of values, cognition, and leadership styles—and a firm's strategic orientation toward managing diversity. This article further argues that without CEO commitment, institutional and environmental factors (e.g., legislation) are limited in promoting workplace diversity. Implications for research and practice are discussed.
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Employers have experimented with three broad approaches to promoting diversity. Some programs are designed to establish organizational responsibility for diversity, others to moderate managerial bias through training and feedback, and still others to reduce the social isolation of women and minority workers. These approaches find support in academic theories of how organizations achieve goals, how stereotyping shapes hiring and promotion, and how networks influence careers. This is the first systematic analysis of their efficacy. The analyses rely on federal data describing the workforces of 708 private sector establishments from 1971 to 2002, coupled with survey data on their employment practices. Efforts to moderate managerial bias through diversity training and diversity evaluations are least effective at increasing the share of white women, black women, and black men in management. Efforts to attack social isolation through mentoring and networking show modest effects. Efforts to establish responsibility for diversity lead to the broadest increases in managerial diversity. Moreover, organizations that establish responsibility see better effects from diversity training and evaluations, networking, and mentoring. Employers subject to federal affirmative action edicts, who typically assign responsibility for compliance to a manager, also see stronger effects from some programs. This work lays the foundation for an institutional theory of the remediation of workplace inequality.
Article
Full-text available
Employers have experimented with three broad approaches to promoting diversity. Some programs are designed to establish organizational responsibility for diversity, others to moderate managerial bias through training and feedback, and still others to reduce the social isolation of women and minority workers. These approaches find support in academic theories of how organizations achieve goals, how stereotyping shapes hiring and promotion, and how networks influence careers. This is the first systematic analysis of their efficacy. The analyses rely on federal data describing the workforces of 708 private sector establishments from 1971 to 2002, coupled with survey data on their employment practices. Efforts to moderate managerial bias through diversity training and diversity evaluations are least effective at increasing the share of white women, black women, and black men in management. Efforts to attack social isolation through mentoring and networking show modest effects. Efforts to establish responsibility for diversity lead to the broadest increases in managerial diversity. Moreover, organizations that establish responsibility see better effects from diversity training and evaluations, networking, and mentoring. Employers subject to federal affirmative action edicts, who typically assign responsibility for compliance to a manager, also see stronger effects from some programs. This work lays the foundation for an institutional theory of the remediation of workplace inequality., and four anonymous reviewers for suggestions; and Randi Ellingboe for technical and editorial assistance.
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This article summarizes the results and conclusions reached in studies of the relationships between race and gender diversity and business performance carried out in four large firms by a research consortium known as the Diversity Research Network. These researchers were asked by the BOLD Initiative to conduct this research to test arguments regarding the “business case” for diversity. Few positive or negative direct effects of diversity on performance were observed. Instead a number of different aspects of the organizational context and some group processes moderated diversity-performance relationships. This suggests a more nuanced view of the “business case” for diversity may be appropriate. © 2003 Wiley Periodicals, Inc.
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When research designed to close the disparities gap is conducted in real-world health care settings, unique sensitivities may arise, particularly when race is the focus of interventions. Researchers encountered this issue in the course of a randomized trial investigating the influence of ethnic identity (EI) among African American (AA) study participants. The study was conducted by the research programs at three health maintenance organizations (HMOs) and the University of Michigan Center for Health Communications Research, as described in this issue of the journal (Resnicow et al., 2009). This commentary describes the research partnership's concerns for the racially sensitive nature of the study and the precautions undertaken to mitigate them. The research study's experiences may be informative and insightful for health plans and research centers invested in health disparities research.
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Major demographic trends are changing the face of America's labor pool, and healthcare managers increasingly face a scarcer and more diverse workforce. As a result, healthcare organizations (HCOs) must develop policies and practices aimed at recruiting, retaining, and managing a diverse workforce and must meet the demands of a more diverse patient population by providing culturally appropriate care and improving access to care for racial/ethnic minorities. Ultimately, the goal of managing diversity is to enhance workforce and customer satisfaction, to improve communication among members of the workforce, and to further improve organizational performance. Research on diversity management practices in HCOs is scarce, providing few guidelines for practitioners. This study attempted to close that gap. Results show that hospitals in Pennsylvania have been relatively inactive with employing diversity management practices, and equal employment requirements are the main driver of diversity management policy. The number and scope of diversity management practices used were not influenced by organizational or market characteristics. The results suggest that hospitals need to adopt diversity management practices for their workforces and need to pay particular attention to marketing and service planning activities that meet the needs of a diverse patient population.
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This report presents period life tables for the United States based on age-specific death rates in 2001. Data used to prepare these life tables are 2001 final mortality statistics; July 1, 2001, population estimates based on the 2000 decennial census; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2001 the overall expectation of life at birth was 77.2 years, representing an increase of 0.2 years from life expectancy in 2000. Between 2000 and 2001, life expectancy increased for both males and females and for both the white and black populations. Life expectancy increased by 0.3 years for black males (from 68.3 to 68.6) and black females (from 75.2 to 75.5). It increased by 0.1 year for white males (from 74.9 to 75.0) and white females (from 80.1 to 80.2).
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Reducing and eliminating disparities in health is a matter of life and death. Each year in the United States, thousands of individuals die unnecessarily from easily preventable diseases and conditions. It is critical that we approach this problem from a broad public health perspective, attacking all of the determinants of health: access to care, behavior, social and physical environments, and overriding policies of universal access to care, physical education in schools, and restricted exposure to toxic substances. We describe the historical background for recognizing and addressing disparities in health, various factors that contribute to disparities, how the public health approach addresses such challenges, and two successful programs that apply the public health approach to reducing disparities in health. Public health leaders must advocate for public health solutions to eliminate disparities in health.
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The authors consider the challenges to quantifying both the business case and the social case for addressing disparities, which is central to achieving equity in the U.S. health care system. They describe the practical and methodological challenges faced by health plans exploring the business and social cases for undertaking disparity-reducing interventions. Despite these challenges, sound business and quality improvement principles can guide health care organizations seeking to reduce disparities. Place-based interventions may help focus resources and engage health care and community partners who can share in the costs of-and gains from-such efforts.
Article
This article develops a conceptual model of cultural competency’s potential to reduce racial and ethnic health disparities, using the cultural competency and disparities literature to lay the foundation for the model and inform assessments of its validity. The authors identify nine major cultural competency techniques: interpreter services, recruitment and retention policies, training, coordinating with traditional healers, use of community health workers, culturally competent health promotion, including family/community members, immersion into another culture, and administrative and organizational accommodations. The conceptual model shows how these techniques could theoretically improve the ability of health systems and their clinicians to deliver appropriate services to diverse populations, thereby improving outcomes and reducing disparities. The authors conclude that while there is substantial research evidence to suggest that cultural competency should in fact work, health systems have little evidence about which cultural competency techniques are effective and less evidence on when and how to implement them properly.
Article
Although "valuing diversity" has become a watchword, field research on the impact of a culturally diverse workforce on organizational performance has not been forthcoming. Invoking a resource-based framework, in this study I examined the relationships among cultural (racial) diversity, business strategy, and firm performance in the banking industry. Racial diversity interacted with business strategy in determining firm performance measured in three different ways, as productivity, return on equity, and market performance. The results demonstrate that cultural diversity does in fact add value and, within the proper context, contributes to firm competitive advantage.
Article
This report reviews key principles of quality (as it relates to the overall quality of the health care system and individual approaches to quality improvement); reviews evidence of the existence and root causes of racial and ethnic health disparities and recommendations to address them; and discusses strategies by which the quality and cultural competence movements could be linked. In particular, it focuses on the Institute of Medicine's six principles for designing a high- quality health care system to identify areas where aspects of cultural competence would be central to achieving high quality. It then presents a framework outlining both hypothetical and proven strategies for delivering high-quality, culturally competent care.
Article
Workplace diversity crystallized as a management sub-field only when members of historically excluded groups became serious contenders for power positions in North American organizations. This article asserts power/dominance relations between identity groups as a central factor driving diversity dynamics in organizations and questions the predominance of the trait model, which locates the fundamental mechanisms driving diversity dynamics within individuals and ignores contextual factors, including power. The author argues that it is important to draw a distinction between diversity scholarship and the individual differences tradition in organizational studies in order to retain a central focus on power relations among identity groups and avoid diluting the diversity construct to the point that any group composed of non-identical individuals becomes diverse by definition.
Article
Research findings from industrial and organizational psychology and other disciplines cast doubt on the simple assertion that a diverse workforce inevitably improves business performance. Instead, research and theory suggest several conditions necessary to manage diversity initiatives successfully and reap organizational benefits. This article reviews empirical research and theory on the relationship between workforce diversity and organizational performance and outlines practical steps HR practitioners can take to manage diversity initiatives successfully and enhance the positive outcomes. © 2004 Wiley Periodicals, Inc.
Cross-cultural healthcare involves three key issues: racial and ethnic disparities in the quality of healthcare provided to minority patients; cross-cultural value differences between immigrant patients and Western medical providers; and providing language access and assistance to limited English proficient (LEP) and disabled persons. Addressing these key issues represents a compelling diversity agenda for a new generation of healthcare executives. This article describes each of these challenges and the cutting-edge strategies that leading healthcare organizations are using to address them.
Article
In recent years, cultural competence has appeared on the agendas of the medical profession as well as other health care providers. Through semistructured interviews with staff at different types of health care institutions, we explored the motivation for and barriers against the implementation of cultural competence training. The findings show that while some progress has been made, there is still work to be done in making cultural competency an integral part of the organizational fabric of health care. National organizations need to consider their leadership role in helping health care organizations translate broad statements of cultural competence into meaningful action.
Article
This article develops a conceptual model of cultural competency's potential to reduce racial and ethnic health disparities, using the cultural competency and disparities literature to lay the foundation for the model and inform assessments of its validity. The authors identify nine major cultural competency techniques: interpreter services, recruitment and retention policies, training, coordinating with traditional healers, use of community health workers, culturally competent health promotion, including family/community members, immersion into another culture, and administrative and organizational accommodations. The conceptual model shows how these techniques could theoretically improve the ability of health systems and their clinicians to deliver appropriate services to diverse populations, thereby improving outcomes and reducing disparities. The authors conclude that while there is substantial research evidence to suggest that cultural competency should in fact work, health systems have little evidence about which cultural competency techniques are effective and less evidence on when and how to implement them properly.
Article
Initiatives to reduce racial and ethnic disparities are conceptualized as a three-legged stool. Public policy: to ensure a legal and regulatory environment designed to eliminate disparities in access and health status; clinical practice: to ensure patient satisfaction and loyalty and improve treatment outcomes through the cultural competence of clinicians; and organizational behavior: to ensure that leadership, staff, and the culture of the health services organization represents and values the communities they serve. Our review of the health services and general management literature published since 1990 reveals a paucity of research on organizational behavior. Based on our review of health services and general management organizational behavior and racial/ethnic diversity literature, we offer an agenda for future research in this area. Factors that will facilitate or inhibit the pursuit of the proposed research agenda are also identified and discussed. The literature reviewed is mainly from the United States and the proposed research agenda results from that review, which presents a potential limitation to its applicability internationally.
Article
Cultural competence has gained attention as a potential strategy to improve quality and eliminate racial/ethnic disparities in health care. In 2002 we conducted interviews with experts in cultural competence from managed care, government, and academe to identify their perspectives on the field. We present our findings here and then identify recent trends in cultural competence focusing on health care policy, practice, and education. Our analysis reveals that many health care stakeholders are developing initiatives in cultural competence. Yet the motivations for advancing cultural competence and approaches taken vary depending on mission, goals, and sphere of influence.
Article
This report presents period life tables for the United States based on age-specific death rates in 2003. Data used to prepare these life tables are 2003 final mortality statistics; July 1, 2003, population estimates based on the 2000 decennial census; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2003, the overall expectation of life at birth was 77.5 years, representing an increase of 0.2 years from life expectancy in 2002. Between 2002 and 2003, life expectancy increased for males and females and for both the white and black populations. Life expectancy increased by 0.3 years (from 77.7 to 78.0) for the white population and by 0.4 years (from 72.3 to 72.7) for the black population. Both males and females in each race group experienced increases in life expectancy between 2002 and 2003. The greatest increase was experienced by black females with an increase of 0.5 years (from 75.6 to 76.1). Life expectancy increased by 0.2 years for black males (from 68.8 to 69.0), white males (from 75.1 to 75.3), and for white females (from 80.3 to 80.5).
Background: Despite numerous reports and initiatives, progress in reducing racial/ethnic disparities in health care has been slow. The National Health Plan Collaborative (NHPC), a novel public-private partnership between nine health plans covering approximately 95 million lives, leading learning and research organizations, the Agency for Healthcare Research and Quality, and the Robert Wood Johnson Foundation, was established in December 2004 to address these disparities. Progress to date: The health plans were able to overcame initial challenges in obtaining information on race/ethnicity of their enrollees and examined their diabetes performance measure to assess disparities in care. By February 2006, the initial nine plans that had joined the NHPC progressed from focusing solely on data collection and management issues and were engaged in outreach activities to members, providers, or community or had completed capacity development for disparities work. Five plans had implemented one or more pilot interventions. Plans also addressed unanticipated challenges, such as sorting through large amounts of data to target disparities. Challenges and lessons learned: Because many of the plans are complex national entities with varying regional and departmental structures, simply achieving coordination of disparities activities across the organization has been a major challenge and, in many cases, a major breakthrough. Conclusions: The NHPC represents a model of shared learning and innovation through which health plans are tackling racial/ethnic disparities. Now that most of the plans have some data on their enrollees with diabetes and have begun targeting disparities, they want to capitalize on their collective industry strength to influence policy on issues related to disparities.
National Healthcare Disparities Report
  • Healthcare For
  • Quality Research
for Healthcare Research and Quality (AHRQ) (2008). National Healthcare Disparities Report, 2007. Rockville, MD, Agency for Healthcare Research Quality.
Report to Congress: Assessment of the Total Benefits and Costs of Implementing Executive Order No. 13166 – Improving Access to Services for Persons with Limited English Proficiency
  • Office
  • Management
  • Budget
Office of Management and Budget. 2002. Report to Congress: Assessment of the Total Benefits and Costs of Implementing Executive Order No. 13166 – Improving Access to Services for Persons with Limited English Proficiency. Washington, DC: Office of Management and Budget.
42:59 PM Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. For permission, please contact the Copyright Clearance Center at www.copyright.com. For reprints, please contact HAP1@ache.org. Implications for Firm Performance
JHM57-1-proof.indb 43 12/30/2011 12:42:59 PM Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. For permission, please contact the Copyright Clearance Center at www.copyright.com. For reprints, please contact HAP1@ache.org. Implications for Firm Performance. " Journal of Developmental Entrepreneurship 5: 209–20.
Racial and Ethnic Health Disparities: Influences, Actors, and Policy Opportunities Kaiser Permanente Institute for Health Policy Why Companies Are Making Health Disparities Their Business: The Business Case and Practical Strategies
  • K Meyers
Meyers, K. 2007. Racial and Ethnic Health Disparities: Influences, Actors, and Policy Opportunities. Oakland, CA: Kaiser Permanente Institute for Health Policy. National Business Group on Health (NBGH). 2003. Why Companies Are Making Health Disparities Their Business: The Business Case and Practical Strategies. Washington, DC: NBGH.
Health Care Management: Organization, Design, and Behavior
  • S M Shortell
  • A D Kaluzny
Shortell, S. M., and A. D. Kaluzny. 2005. Health Care Management: Organization, Design, and Behavior. Albany, NY: Delmar.
Report of the Secretary's Task Force on Black and Minority Health. Bethesda, MD: US Department of Health and Human Services
  • M M Heckler
Heckler, M. M. 1985. Report of the Secretary's Task Force on Black and Minority Health. Bethesda, MD: US Department of Health and Human Services. Institute of Medicine (IOM). 2002. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press. ---. 2001. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press.
  • L S Hartenian
  • D E Gudmundson
Hartenian, L. S., and D. E. Gudmundson. 2000. " Cultural Diversity in Small Business:
Making Change: Using Metrics to Support Workforce Diversity
  • Catalyst
Catalyst. 2002. Making Change: Using Metrics to Support Workforce Diversity. New York: Catalyst, Inc.
  • J L Dreachslin
  • P L Hunt
Dreachslin, J. L., and P. L. Hunt. 1996. Diversity Leadership. Chicago: Health Administration Press.
Kaiser Permanente Institute for Health Policy. National Business Group on Health (NBGH). 2003. Why Companies Are Making Health Disparities Their Business: The Business Case and Practical Strategies
  • K Meyers
Meyers, K. 2007. Racial and Ethnic Health Disparities: Influences, Actors, and Policy Opportunities. Oakland, CA: Kaiser Permanente Institute for Health Policy. National Business Group on Health (NBGH). 2003. Why Companies Are Making Health Disparities Their Business: The Business Case and Practical Strategies. Washington, DC: NBGH.
Report to Congress: Assessment of the Total Benefits and Costs of Implementing Executive Order No. 13166 -Improving Access to Services for Persons with Limited English Proficiency
  • E Ng
Ng, E. 2008. "Why Organizations Choose to Manage Diversity? Toward a Leadership-Based Theoretical Framework." Human Resource Development Review 7 (1): 58-78. Office of Civil Rights. 2007. Title VI Facts Sheet. Washington, DC: Department of Health and Human Services, Office of Civil Rights. Office of Management and Budget. 2002. Report to Congress: Assessment of the Total Benefits and Costs of Implementing Executive Order No. 13166 -Improving Access to Services for Persons with Limited English Proficiency. Washington, DC: Office of Management and Budget.
United States Department of Health and Human Services (HHS)
United States Department of Health and Human Services (HHS). 2010. Healthy People 2020
United States Equal Employment Opportunity Commission (EEOC) 2010
  • Framework
  • Washington
Framework. Washington, DC: Department of Health and Human Services. ---. 2000. Healthy People 2010: Understanding and Improving Health. Washington, DC: Department of Health and Human Services. United States Equal Employment Opportunity Commission (EEOC) 2010. "Laws and Guidance." Laws, Regulations, and Guidance. Accessed September 13. www.eeoc. gov/policy/.
Highlights: Governing Council Meeting. AHA Section for Small or Rural Hospitals
American Hospital Association. 2011. "Highlights: Governing Council Meeting. AHA Section for Small or Rural Hospitals." AHA (May): 1-2. www.aha.org/content/11/SR-May2011Meeting-Highlights.pdf.
Photocopying or distributing this PDF is prohibited without the permission of
  • N L Keenan
  • K A Rosendorf
Keenan, N. L., and K. A. Rosendorf. 2011. "Prevalence of Hypertension and Controlled Hypertension-United States, 2005-2008." In "CDC Health Disparities and Inequalities Report-United States, 2011." MMWR: Morbidity and Mortality Weekly Report 60 (Supplement 1): 94-95. www.cdc.gov/mmwr/pdf/other/su6001.pdf. Photocopying or distributing this PDF is prohibited without the permission of Health Administration Press, Chicago, Illinois. For permission, please contact the Copyright Clearance Center at www.copyright.com. For reprints, please contact HAP1@ache.org.