Vassar College, Poughkeepsie, NY, USA.
Int J Health Policy Manag. 2020 Jul 1;9(7):266-268. doi: 10.15171/ijhpm.2020.12.
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.
在这个日益多元化的社会中，人们出现了两极分化和分裂的情况，在这种情况下，卫生政策和管理研究提供了一个重要的见解：通过包容性领导，真正地参与多样性，即拥抱各级员工，并吸引不同的观点，使所有不同类型的医疗保健工作者都感到自己可以畅所欲言并参与其中——这可以拯救生命。在心血管保健质量的多项研究中，表现出色的医院都表现出了一种能够拥抱各级员工并吸引差异的能力，使各种类型的医疗保健工作者都感到自己可以有意义地参与改进工作。最近，在对 10 家医院进行的为期两年的纵向“领导力拯救生命”研究中，采用改进文化而不是指责文化的能力与风险标准化死亡率的显著降低有关。此外，在 10 家医院中，有 6 家最成功的医院的指导联盟（即质量改进团队）在三个方面表现出色，这为有效处理差异的模式提供了一些见解：（1）在组织层次结构中包括来自不同学科和级别的员工，（2）鼓励成员真实参与，以及（3）使用建设性的冲突管理模式（即，具有明确的角色定义，努力发现少数派观点，并共同重新审视拯救生命的共同目标）。基于这一文献，充分参与广泛的多样性观点和员工角色可以对健康结果产生显著影响。虽然所审查的研究本身并没有检查种族/族裔多样性，但它们确实深入了解了在具有广泛观点、专业身份和经验多样性的环境中有效地进行导航的方法。未来的研究可能会评估这些见解是否适用于其他形式的多样性。在全球和当地都出现极端两极分化和分裂的情况下，卫生政策和管理研究有机会分享证据，帮助在医疗保健领域内，甚至更广泛地，以更具包容性、更人道和更有生命力的方式应对日益多样化的环境，走向我们共同的未来。
