Table 2 Implementation strategies, examples, and relevant literature
DEIB implementation strategies | Examples identified by participants | Mapping to ERIC implementation strategies | Relevant literature |
|---|---|---|---|
People | |||
Talent recruitment, and retention: | - Tailor recruitment and retention policies and incorporate inclusive practices to these policies - Provide technical assistance and consultation to writing job advertisement and job descriptions to ensure language is inclusive - Change guidelines to include equitable search processes - Develop a formal implementation blueprint for how the organization will embody inclusive strategic human resource management | - Provide ongoing consultation, conduct educational meetings - Develop a formal implementation blueprint - Recruit, designate, and train for leadership | |
Employee learning: | - Develop and distribute corporate learning materials to support DEIB interventions to train and educate stakeholders - Integrate DEIB-related training into the existing corporate learning system - Develop incentives to encourage DEIB corporate learning within the organization | - Distribute educational materials - Alter incentive/allowance structures | |
Employee resource groups: | - Formalize ERGs within organization to support DEIB dissemination - Allocating budget to ERGs - Adopting ERG representation within corporate governance to serve as champions | - Use advisory workgroup - Utilize financial strategies - Identify and prepare champions | |
Formal workforce development and talent pipeline | - Develope resources that allow employees from minoritized populations to develop skills that will enhance their future job growth and enter leadership roles - Lead leadership training programs targeted at employees who are part of minoritized populations and/or traditionally under-represented within leadership - Adopt mentoring and coaching programs for employees from minoritized populations to identify | - Distribute educational materials - Conduct educational meetings - Recruit, designate, and train for leadership | |
Engaging top-level leaders: | - Promoting importance of the DEIB interventions to other health system leaders, such as the Board of Trustees and CEO through formal and informal channels - Developing one-on-one relationships with board members to share knowledge and expertise related to DEIB topics and gain support | - Facilitation - Obtain formal commitments - Involve executive board - Build a coalition | [48] |
Health Equity | |||
Reduce disparities in clinical outcomes, access, and patient experience | - Establish a committee of clinical leaders to identify barriers minoritized populations experience when equitable health care in their organizations - Inform clinical leaders of expectations regarding the incorporation of health equity into clinical care - Establish a regular operating routine for reviewing health disparities and health equity data from their organization - Identify and document what mid-level leaders and frontline staff are already doing to address disparities in clinical outcomes and access and establish future goals for these initiatives | - Build a coalition - Inform local opinion leaders - Identify early adopters - Capture and share local knowledge - Change records systems | |
Health equity research | - Creating a research center for Health Equity with a mission to support research focused on alleviating healthcare inequities - Creating systems and providing research support for clinicians engaging in health equity research - Identifying research agenda for the organization that advances the DEIB interventions | - Build a coalition - Capture and share local knowledge | |
Language translation services | - Evaluating outcomes and experience utilizing existing translational services and identifying opportunities for growth - Incorporating translation services outcome metric into organization scorecard - Conduct a needs assessment to identify opportunities for creating patient-related materials (handouts, signage, patient portals) that are easily understood and use inclusive language - Ensuring that health system translation services are equitable and accessible to all patients - Managing translational services staff | - Audit and provide feedback - Change record systems - Facilitation - Conducting local needs assessment | |
Community health outcomes evaluation | - Identifying metrics to monitor population health outcomes within underserved communities or communities with large minoritized populations - Incorporating community health metrics into the organizational performance evaluation - Reporting community health outcomes of under-served populations or minoritized populations | - Develop and implement tools for quality monitoring - Change record systems - Audit and provide feedback | [54] |
Monitoring and Feedback | |||
Board engagement | - Presenting at board meetings on key DEIB priorities and/or initiatives within the organization - Establishing relationships with board members and board sub-committees to support the engagement of boards of DEIB issues - Serving as DEIB subject matter expert to board | - Facilitation - Promote adaptability - Involve executive board - obtain formal commitments | [55] |
DEIB scorecards | - Developing key metrics that provide evidence of DEIB implementation success in the organization - Establish sources of data and reporting routine to regularly obtain data on health equity outcomes on time - Mapping data within systems to support scorecards | - Purposefully reexamine the implementation - Develop and organize quality monitoring system | [56] |
Listening sessions | - Events with organization leaders and employees present to support opportunities to voice thoughts about organizational culture and areas for improvement - Engage in listening sessions after critical events | - Conduct local needs assessments - Obtain and use patients/consumers/and family feedback | [57] |
Operational Planning and Communicating | |||
Negotiating the DEIB leader role | - Working with other organization leaders to demarcate specific responsibilities of DEIB position and determine workplan for areas of overlap between roles - Negotiate with other top-level leaders on how to partner on implementation strategies which require collaboration | - Facilitation - Inform local opinion leaders | [58] |
Building collaboration to support sustainable change | - Meeting with employees across the organizational hierarchy to support buy-in - Developing buy-in with top-level leadership team | - Build a coalition - Conduct local consensus discussions | |
Developing DEIB personnel infrastructure | - Hire and train DEIB leader direct reports - Establish staffing needs to support DEIB implementation strategies - Gain access to funding to hire DEIB staff through organization’s budget process | - Centralize technical assistance - Develop a formal implementation blueprint - Access new funding | [61] |
Developing governance structure | - Building a framework for the implementation and maintenance of DEIB interventions - Establish DEIB leadership committee and document guidelines for committee - Building routines/processes and organizing meetings that support effective decision-making of DEIB issues | - Use Advisory boards and work groups - Provide interactive assistance | |
DEIB consultation to support DEIB strategies | - Meeting with organization leaders to support other leaders’ specific DEIB priorities or initiatives - Engage in tacit knowledge to support change management processes - Serve as a consultant and subject matter expert to support systematic integration of DEIB into all levels of organization - DEIB top-level leader establishes themselves as the DEIB resource and subject matter expert | - Provide local technical assistance - Facilitation - Inform local opinion leaders - Centralize technical assistance | |
External Engagement | |||
Community engagement | - Meeting with community leaders to assess social needs and creating a plan to alleviate them - Collaborate with the organization’s existing community engagement team to identify opportunities to improve engagement with communities with large populations of minoritized populations | - Build a coalition - Conduct local consensus discussion | [54] |
Supplier diversity | - Sourcing hair and skin care that meets the needs of minorized populations - Collaborating with finance/purchasing team to diversify organization’s suppliers - Establishing sourcing targets related to engaging with a diverse group of 3rd party partners | - Mandate change - Change physical structure and equipment | |