Creating a Culture of
Inclusion in Healthcare

Photo credit: The Gender Spectrum Collection

The issue of inclusion has been central to the transformation of healthcare in 2020. While the COVID-19 pandemic accelerated advancements in telehealth that brought greater and safer access to care to many, it has also exacerbated existing inequities faced by vulnerable populations such as seniors; people experiencing disabilities; Black, Indigenous, and People of Color; LGBTQ+ individuals; non-English speakers; and those living in poverty.

Some 25% of Americans may not have the digital tools or literacy to access telehealth services, a population that often intersects with racial groups that face disparities in health and care. For decades, minority populations in the U.S. have received lower-quality health care than their white counterparts across comparable socioeconomic, age, and health statuses.

The complexity of the healthcare system makes change feel daunting at best and insurmountable at worst. While the system is slow to evolve, introducing more inclusive improvements in healthcare can create positive incremental change at a human level.

Artefact Strategy Director Felix Chang joined the Innovation Learning Network, Centura Health, and Design Thinking Exchange (DTX) for a digital exchange discussing how to foster a culture of inclusion in healthcare. With participants spanning Kaiser Permanente, Philips Healthcare and LA County Department of Health Services, the session explored actions that innovation leaders can take to create more inclusive health systems, products, or services. These were the key takeaways:

Strengthen processes and teams

Look for opportunities to integrate inclusive values within your organization at a process and intervention level. Are there ways to embed inclusive practices in workflows, tools, and existing partnerships such as patient advisory councils or cross-discipline decision-making?

When developing interventions, consider how to ensure diverse research participant composition, avoid making assumptions about patients, and take communities of use as experts in their experience. For example, the Group Health Research Institute introduced elements of co-creation by establishing a patient panel to guide the process of developing their SIMBA decision aid. The tool helps breast cancer patients better understand and make informed decisions on their breast cancer monitoring options. As part of the experience, patients are prompted with questions to capture their values and the factors that are most important to them (such as procedure risks, duration, and cost), giving them the agency to personalize their experience and prioritize what matters most in their specific situation.

Promote accountability

Developing a culture of inclusion is only effective when it is a shared responsibility. Establish explicit definitions, commitments, and plans to ensure transparency and actionable benchmarks.

This could be at a department, project, or initiative-level, such as setting quantifiable standards for more inclusive stakeholder and patient groups in planning initiatives, giving feedback on processes when in place, and prioritizing what to improve.

Good data mining and benchmarks for measurement can help identify gaps and areas that need more focus.

Normalize inclusion at a system level

People often avoid deviating from the norm, and working toward systemic change can be overwhelming. By sharing best practices, learnings, and case studies of success, you can begin to normalize a common culture of inclusion across your team or organization.

Create excitement and interest by spotlighting inclusive work in your team or field. How might you establish a system of shared successes and lessons learned? For example, The Bill & Melinda Gates Foundation and Gates Ventures developed the Exemplars in Global Health platform, which gathers public health data and performance outcomes across the world in order to share best practices and learnings within the public health professional community. What would a similar practice look like for your team or organization? What are other examples from outside the healthcare industry that show the measurable impact of true inclusion?

Consistently celebrating how your organization and others are adopting inclusive practices creates a sense of community and shared purpose that can support continued action.

What action will you take?

Creating change in an entrenched system is neither quick nor easy, but each of us must take steps in our roles and spheres of influence that together can contribute to a sea change. By strengthening inclusive practices in teams and processes, promoting accountability, and normalizing a culture of inclusion, we can start to take important steps to creating healthcare experiences and outcomes that serve all people.