Advancing Diversity, Equity, and Inclusion in Hospital Medicine

Abstract

BACKGROUND: In nearly all areas of academic medicine, disparities still exist for women and underrepresented minorities (URMs). OBJECTIVES: Develop a strategic plan for advancing diversity, equity, and inclusion (DEI); implement and evaluate the plan, specifically focusing on compensation, recruitment, and policies. DESIGN, SETTING, PARTICIPANTS: Programmatic evaluation conducted in the division of hospital medicine (DHM) at a major academic medical center involving DHM faculty and staff. MEASUREMENTS: (1) Development and implementation of strategic plan, including policies, processes, and practices related to key components of DEI program; (2) assessment of specific DEI outcomes, including plan implementation, pre-post salary data disparities based on academic rank, and pre-post disparities for protected time for similar roles. RESULTS: Using information gathered from a focus group with DHM faculty, an iterative strategic plan for DEI was developed and deployed, with key components of focus being institutional structures, our people, our environments, and our core mission areas. A director of DEI was established to help oversee these efforts. Using a two-phase approach, salary disparities by rank were eliminated. Internally funded protected time was standardized for leadership roles. A data dashboard has been developed to track high-level successes and areas for future focus. CONCLUSION: Using a systematic evidence-based approach with key stakeholder involvement, a division-wide DEI strategy was developed and implemented. While this work is ongoing, short-term wins are possible, in particular around salary equity and development of policies and structures to promote DEI.

A Path Toward Equity and Inclusion: Establishing a DEI Committee in a Department of Pediatrics

“…While comparatively limited, a review of this work reveals several recurring themes, including the importance of assessing the current DEI culture in a given space, developing a stepwise, strategic plan with specific interventions for addressing issues, and identifying specific outcomes to better track progress towards goals. In one example, Pino-Jones et al ( 2021 ) outline a framework for advancing DEI in a new hospital medicine division that focuses on institutional structures (e.g., compensation, recruitment), people, environments, and core mission areas. Similarly, Lingras et al ( 2021 ) describe their step-by-step approach for developing a DEI committee in a single department within a larger AHC.…”

Gender differences in COVID‐19‐related manuscript authorship by hospitalists during the pandemic: A bibliometric analysis

“…Fortunately, the gender parity demonstrated in the HM‐specific journals provides an optimistic counterweight to the findings in the high‐impact general medical journals and likely demonstrates the fruits of intentional effort. JHM pledged to improve authorship representation 25 ; as a result of this pledge, the journal increased transparency and began collecting and reporting data on authorship gender. As a result, they now report similar rates of male and female authors for research articles and among first (but not last) authors of solicited article types 18 .…”

“…Notably, there were fewer research author credits overall (311 vs. 813 nonresearch); JHM, in particular, had very few research-related articles or research author credits (n = 12). For nonresearch articles, the two HM-specific journals were closer to gender equity than the four high-impact journals, having both more total physician authors that were women (p < .001) and more HM-authors that were women (55.6% [30/54] vs. 25.9% [7/27], respectively; p = .01). In contrast, research articles tended to have low numbers of women authors regardless of specialty, authorship position, or journal type (Table 2).…”

Meeting the Accreditation Standard for Diversity

“…The first step is for institutions to examine their “diversity DNA” to see if existing policies and procedures need to be replaced. 20 Establishing diversity as a core value for the institution allows diversity, equity, inclusion, and social justice to be integrated into decision-making processes and leadership development as well as educational experiences that confirm DEI as everyone’s responsibility. 21…”