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Running head: EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 1

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Executive Summary of Organizational Diversity

Learner’s Name

Capella University

Organizational and System Management for Quality Outcomes

Executive Summary of Organizational Diversity

May, 2017

EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 2

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EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 3

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Executive Summary of Organizational Diversity

Over the last few decades, the composition of people in the United States has diversified

significantly. In 2012, more than 37% of the American population comprised ethnic and racial

minority groups. Therefore, it is important that nursing professionals take steps to develop

cultural and linguistic competence to acknowledge and address the unique needs of this sizeable

population.

The connection between multiculturalism in nursing and health care delivery will be

explored using the example of a teaching and multispecialty hospital in a major northeastern city

in the United States. The city has undergone a considerable population shift in the past 10 years;

in view of this population shift, senior leadership has requested a nurse leader to find out if the

level of multiculturalism and diversity in the hospital reflects the city’s population and promotes

good patient outcomes. Gaps between nursing practice and the hospital’s diversity policies will

also be identified by the nurse leader, and organizational changes to improve nursing diversity

will be recommended.

The Impact of a Diverse Workforce on Patient Outcomes

Diversity in a health care organization’s nursing workforce is expressed in two ways: (a)

recruitment and retention of culturally diverse nursing professionals to reflect patient population

in terms of race, gender, and ethnicity, and (b) development of cultural and linguistic competence

in nursing professionals (Agency for Healthcare Research and Quality, 2013). Cultural

competence improves patient outcomes, especially among the underrepresented ethnic and racial

groups, through culturally appropriate communication, integration of cultural beliefs into patient

care, and expanded access to services that reduce health care disparities.

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Specific patient outcomes such as quality care and patient safety are significantly

improved when nursing teams include multilingual nursing professionals capable of

communicating with non-English speaking patients (Huber, 2017). By removing language

barriers, nursing professionals are better able to understand and record a patient’s medical history

and prevent medicine administration errors. Diverse patients also feel empowered and will seek

medical treatment more often without getting intimidated or disrespected. However, it is

important to understand how the hospital integrates concepts of diversity and multiculturalism

into its practices before recommending any organizational changes.

Integration of Multiculturalism and Diversity into Organizational Practices

Health care organizations that do not follow systems theory tend to blame bad patient

outcomes on nursing professionals at the front lines of care and not on organizational factors

such as leadership (Munro & Hubbard, 2011). In the case of the multispecialty hospital, the

absence of diversity in nursing leadership has affected the way nursing professionals deliver

culturally competent care. While the hospital has taken efforts to recruit and retain doctors from

diverse backgrounds, the same has not been done for nursing professionals and nurse leaders.

Therefore, the selection process of nurse leaders should be changed to better represent diverse

patient and Nursing Professional populations. For example, the hospital should recruit more

culturally diverse nurse leaders who will be able to instill a deeper understanding of culture in

the current nursing staff.. If health care organizations have a diverse nursing workforce,

culturally competent leaders will be able to address the diverse needs of nursing professionals

through staff management policies. Such leadership will also expose structural or systemic gaps

in recruitment and retention policies that are not culturally inclusive.

Comment [A1]: Delete “also”

EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 5

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Current Nursing Recruitment and Retention Policies in the Hospital

The nurse leader’s findings suggested that current strategies employed by the hospital

knowingly or unknowingly discriminate against minority groups. They do not focus on making

the existing culturally respectful policies and facilities known to potential students or new

nursing professionals. Similarly, retention policies that manage resources and facilities for

nursing professionals show a lack of culturally appropriate staff training programs, unavailability

of diverse nursing mentors for trainee nurses, absence of facilities like prayer rooms for

ethnically diverse health care professionals and patients, and inappropriate behavior and conflict

directed at nursing professionals from diverse and multicultural backgrounds.

These gaps in staff management have lowered recruitment and retention rates. Potential

ethnic and racial minority students also perceived this lack of diversity as an absence of

opportunities for professional growth. These fallouts have particularly affected how the hospital

provides best practices care to patients from ethnic and racial minority groups. Because of the

various language and cultural barriers between nursing professionals and patients, the latter often

felt that their beliefs were disrespected, and that it was difficult to access certain health care

services (Huber, 2017; Banister & Winfrey, 2012; AACN, 2015). The following cultural

integration discussion including the nurse leader’s findings will assist in understanding how

cultural competency should start at the organizational level.

Level of Cultural Integration in the Hospital and Its Importance

A study of the hospital revealed that Whites and Christians were the racial and ethnic

majorities respectively. The number of male nursing professionals was also considerably low in

comparison to female nursing professionals. Empowerment in nursing depends on the absence of

discriminatory forces in race, gender, ethnicity, and economic status. Organizational efforts to

EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 6

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give culturally diverse nursing professionals more autonomy were short-lived as the changes did

not address systems factors (Rao, 2012; AACN, 2015; Huber, 2017). The organizational

hierarchy was also not culturally diverse as very few senior leaders were from ethnic and racial

minorities. Nurse leaders and nursing professionals who aspired to become senior leaders

perceived the existing hierarchical setup as culturally biased and demotivating, especially during

promotion cycles.

Recommendations for Improving Multiculturalism in the Hospital

The process of building cultural competence should be continuous and specific to

different ethnic and racial groups. By using systems theory perspectives, the organizational

structure and leadership style will become more responsive to patients’ multicultural and diverse

needs. One method for bringing about sociocultural changes in the hospital is the introduction of

guidelines that can serve as a resource for health care organizations and nursing professionals in

cultural competence.

Ten guidelines were developed by a task force of the members of the American Academy

of Nursing Expert Panel on Global Nursing and Health and Transcultural Nursing Society

(Douglas et al., 2014). The guidelines were designed to be adapted to any unique health care

delivery systems: (a) knowledge of cultures, (b) education and training in culturally competent

care, (c) critical reflection, (d) cross-cultural communication, (e) culturally competent practice,

(f) patient empowerment and advocacy, (g) cultural competence in health care systems and

organizations, (h) cross-cultural leadership (i), multicultural workforce, and (j) evidence-based

practice and research (Douglas et al., 2014). As the guidelines are also influenced by systems

theory, nurse leaders and nursing professionals will be able to apply them to current diversity

EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 7

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issues. The nursing professionals will also be able to change the way organizational systems

accept multiculturalism and diversity.

Approaches to change like the cultural competence guidelines provide a structured

approach for nursing professionals to improve their skills, knowledge, and attitudes. By

considering organizational and individual performance factors, which are important concepts in

systems theory, multiculturalism and diversity will be championed as priorities in quality and

safe patient care.

Conclusion

Health care organizations have realized the strong connection between having culturally

competent nursing staff and positive patient outcomes. As a result, they have begun special

programs and reforms to become culturally competent. However, the changes to nursing

leadership and staff are not systemic because organizations do not follow a structured and

evidence-based approach like systems theory and cultural competence guidelines. Organizations

should also consider the different points of view because problems in executing reforms in one

part of the organization can affect other parts as well. These steps help nursing professionals

move beyond simply tolerating their diverse patients and colleagues and develop an in-depth

understanding of multiculturalism and diversity. Such a transition will definitely improve patient

outcomes in racially and ethnically diverse and disadvantaged groups and make health care more

inclusive.

Comment [A2]: A paragraph should be at least 3 sentences in length.

Comment [A3]: This paper was very well written and scholarly. The

criterion in the scoring guide was

thoroughly addressed. I saw many

positive things while reading this

assessment – be assured this is a

wonderful document.

EXECUTIVE SUMMARY OF ORGANIZATIONAL DIVERSITY 8

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References

Agency for Healthcare Research and Quality. (2013). What is cultural and linguistic

competence? Retrieved from https://ahrq.gov/professionals/systems/primary-

care/cultural-competence-mco/cultcompdef.html

Banister, G., & Winfrey, M. E. (2012). Enhancing diversity in nursing: A partnership

approach. Journal of Nursing Administration, 42(3), 176–181.

https://dx.doi.org/10.1097/NNA.0b013e3182480a97

Huber, D. L. (2017). Leadership and nursing care management (6th ed.). Philadelphia: W. B.

Saunders. http://dx.doi.org/10.7748/nm.21.6.13.s14

Munro, E., & Hubbard, A. (2011). A systems approach to evaluating organisational change in

children's social care. British Journal of Social Work, 41(4), 726–743.

https://dx.doi.org/10.1093/bjsw/bcr074

Douglas, M. K., Callister, L. C., Hattar-Pollara, M., Lauderdale, J., Pacquiao, D. F.,

Rosenkoetter, M. (2014). Guidelines for implementing culturally competent nursing

care. Journal of Transcultural Nursing, 25(2), 109–

121. https://dx.doi.org/10.1177/1043659614520998

Rao, A. (2012). The contemporary construction of nurse empowerment. Journal of Nursing

Scholarship, 44(4), 396–402. https://dx.doi.org/10.1111/j.1547-5069.2012.01473.x