How should health service organizations respond to diversity? A content analysis of six approaches

• Published in: BMC health services research Vol. 15; no. 1; p. 510
• Main Authors: Seeleman, Conny, Essink-Bot, Marie-Louise, Stronks, Karien, Ingleby, David
• Format: Journal Article
• Language: English
• Published: London BioMed Central 16.11.2015; BioMed Central Ltd
• Subjects: Analysis; Australia; Clinical Competence - standards; Community Participation; Cultural competence; Cultural Diversity; Culture; Delivery of Health Care - organization & administration; Delivery of Health Care - standards; Equality; Ethnic Groups; Europe; Health Administration; Health care access; Health Informatics; Health Personnel - standards; Health services; Health Services Needs and Demand; Healthcare Disparities; Humans; Insurance, Health - statistics & numerical data; Medicine; Medicine & Public Health; Minority & ethnic groups; Multiculturalism; Multiculturalism & pluralism; Nursing Research; Organizational Culture; Organizational Policy; Organizations - standards; Patient Participation; Patient Rights; Public Health; Quality of Health Care; Research Article; Terminology; United States; Workplace multiculturalism; Australia; Cultural competence; Responsiveness; Equity; Healthcare organization; Quality of care; Diversity
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-015-1159-7

Background Health care organizations need to be responsive to the needs of increasingly diverse patient populations. We compared the contents of six publicly available approaches to organizational responsiveness to diversity. The central questions addressed in this paper are: what are the most consistently recommended issues for health care organizations to address in order to be responsive to the needs of diverse groups that differ from the majority population? How much consensus is there between various approaches? Methods We purposively sampled six approaches from the US, Australia and Europe and used qualitative textual analysis to categorize the content of each approach into domains (conceptually distinct topic areas) and, within each domain, into dimensions (operationalizations). The resulting classification framework was used for comparative analysis of the content of the six approaches. Results We identified seven domains that were represented in most or all approaches: organizational commitment, empirical evidence on inequalities and needs, a competent and diverse workforce, ensuring access for all users, ensuring responsiveness in care provision, fostering patient and community participation, and actively promoting responsiveness. Variations in the operationalization of these domains related to different scopes, contexts and types of diversity. For example, approaches that focus on ethnic diversity mostly provide recommendations to handle cultural and language differences; approaches that take an intersectional approach and broaden their target population to vulnerable groups in a more general sense also pay attention to factors such as socio-economic status and gender. Conclusions Despite differences in labeling, there is a broad consensus about what health care organizations need to do in order to be responsive to patient diversity. This opens the way to full scale implementation of organizational responsiveness in healthcare and structured evaluation of its effectiveness in improving patient outcomes.