The Importance of Diversity and Inclusion in Determining the Quality of Health Care Services (WITHDRAWN)

Background:  Hospital providers have been tasked with the challenge of ensuring that the demographic representation of their workforce matches the diversity of the populations they serve. With increased workforce diversity, organizational leaders are recognizing the need to create inclusive workplaces to leverage diversity’s potential benefits (e.g., increased job satisfaction and retention), yet little is known about whether diversity and inclusion are associated with the quality of hospital care. The current study examined a conceptual model of the influence of diversity and inclusion on hospital innovation, job satisfaction, and the perceived quality of health care provided to pediatric clients.

Method: Data was collected in July 2015 from a Pathology and Laboratory Medicine department in a very diverse urban pediatric hospital. To test the conceptual model, multi-level path analysis was conducted using Mplus 6.1 statistical software. All variables measured were taken from previously validated instruments.

 Results: Out of 300 departmental employees 277 agreed to participate (92% response rate) constituting 21 different within-department work teams (M = 10, SD =  6.58, range = 5-25). In terms of race/ethnicity 50% of respondents self-reported as Asian, 25% as Caucasian, 17% Latino/a, 5% as African American, and 3% as Pacific Islander or mixed race/other. Approximately 69% of participants were female and 31% were male, 49% of the sample had a Bachelor's degree, 14% graduated high school, 12% had a Master's degree,  10% had an associate's degree, 10% had an MD and 5% a doctorate degree or PhD. Model fit statistics of the multi-level model indicated an excellent fit to the data (χ² = 17.319, df = 16, p > .05; CFI = 99; TLI = 99; RMSEA = .02, 90% CI = .0, .07). Direct significant associations were found between inclusion and innovation (β = .87, se = .02, p < .01); inclusion and job satisfaction (β = .66, se = .06, p < .01); innovation and perceived quality of care (β = .21, se = .10, p < .05); and job satisfaction and perceived quality of care (β = .42, se = .08,  p < .01). Both indirect pathways from inclusion to perceived quality of care were found to be significant through increased innovation (β = .18, se = .08,  p < .05), and improved job satisfaction (β = .28, se = .07, p < .01).

 Discussion/implications: Part of ensuring the healthy development of pediatric clients, is focusing on creating a healthy work environment for the professionals providing care. Findings from this study are among the first to connect workplace inclusion with increased innovation, job satisfaction, and perceived quality of care in a diverse pediatric hospital, and can be informative for how organizational leaders can improve health care services through creating an inclusive workplace.