Cultivating diversity in the advanced practice registered nurse workforce: An exemplar from an advanced practice registered nurse fellowship program.

Diversity in the nursing workforce is an important driver of patient satisfaction, adherence to care, and quality outcomes. Systemic barriers exist that prevent individuals from underrepresented minority groups entering and advancing in the nursing workforce. To advance the health of the community we serve and with grant support from the Health Resources and Services Administration, we developed a postgraduate advanced practice registered nurse (APRN) fellowship in community health. This program is a partnership between a federally qualified health center and a college of nursing. We developed a deliberate plan to recruit and admit diverse applicants who would continue to practice in our community at the conclusion of their fellowship year. Using targeted recruitment outreach, we identified new-graduate APRNs who were representative of the community we serve. Using holistic review methodology, we interviewed applicants with explicit efforts to mitigate the effects of bias towards race, ethnicity, gender, and academic affiliation. We embraced a quality-improvement ethos that enabled evolution and growth with each iteration of the program. Understanding that intention does not translate to outcomes, we undertook ongoing critique of our methods and engaged diverse resources to improve our processes. Over two admission cycles, our fellowship in community health for new graduate APRNs has demonstrated improvements in strategies to diversify the community health workforce. We will describe our process of nonjudgmental self-critique and a quality-improvement framework that can serve as a strategy to promote diversity, equity, and inclusion in the community health workforce.