Hospital Leadership Diversity and Strategies to Advance Health Equity.

BACKGROUND: Diversity in hospital leadership is often valued as important for achieving clinical excellence. The American Hospital Association surveyed hospitals about their actions to identify and address health disparities. The survey asked about the degree of representation of racial and ethnic minorities and women among executives and board members. METHODS: The survey contained 78 items in four domains: Leadership and Strategic Planning, Workforce, Data Collection, and Reducing Disparities. All items were standardized and pooled within each domain to construct four variables. Logistic regression models were used to assess the difference in domain scores, for each domain, between hospitals with (a) high and low representation of people of color in the C-suite, (b) high and low representation of women in the corporate (C-) suite, (c) high and low representation of people of color on the board, and (d) high and low representation of women on the board. RESULTS: Hospitals with more diverse boards with respect to race and ethnicity had significantly higher scores for all domains, indicating that these hospitals were pursuing substantially more strategies in all domains. In contrast, more racially and ethnically diverse executive suites were associated only with the Data Collection domain, while hospitals with a higher percentage of women in executive positions had lower scores for all domains except Data Collection. CONCLUSION: Hospitals with greater representation of racial and ethnic minorities in leadership positions had greater commitments to diversity initiatives. However, hospitals with women-particularly white women-in leadership positions reported fewer diversity initiatives. Future research is needed to examine the mechanisms and causality behind these associations.

Perceptions of Culture of Safety in Hemodialysis Centers.

Staff members, physicians, nurse practitioners, and physician assistants from a sample of hemodialysis facilities in Network 6 (North Carolina, South Carolina, and Georgia) and Network 11 (Michigan, Minnesota, North Dakota, South Dakota, and Wisconsin) completed a 10-item assessment with modified questions from the Hospital Survey on Patient Safety Culture, with an emphasis on safety culture related to vascular access infections. A composite score was constructed, which was the average of the percent-positive scores of the items. Overall, scores were high, indicating a positive patient safety culture. Composite scores varied by role type, with nurses, patient care technicians, and other technicians reporting the lowest composite scores. Network 6 participants reported higher scores on two of the survey items. Fewer staff within a facility were associated with higher composite scores.

Patient and family engagement: a survey of US hospital practices.

BACKGROUND: Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known. OBJECTIVE: We report on a survey of hospitals in the USA regarding their PFE practices during 2013-2014. RESULTS: The response rate was 42%, with 1457 acute care hospitals completing the survey. We constructed 25 items to summarise the responses regarding key practices, which fell into three broad categories: (1) organisational practices, (2) bedside practices and (3) access to information and shared decision-making. We found a wide range of scores across hospitals. Selected findings include: 86% of hospitals had a policy for unrestricted visitor access in at least some units; 68% encouraged patients/families to participate in shift-change reports; 67% had formal policies for disclosing and apologising for errors; and 38% had a patient and family advisory council. The most commonly reported barrier to increased PFE was 'competing organisational priorities'. SUMMARY: Our findings indicate that there is a large variation in hospital implementation of PFE practices, with competing organisational priorities being the most commonly identified barrier to adoption.