Why It Matters
In preparation for a new year of the Joy in Work Results-Oriented Learning Network — a collaborative focused on workforce well-being — the Institute for Healthcare Improvement (IHI) research team revisited the joy in work change package. The goal was to ensure that the change package reflects the latest evidence in the field and the data being rapidly generated by teams testing improvements in their organizations.
Given what we know health care teams are challenged by now, we concentrated our updates in the following focus areas: workforce shortages and adequate staffing; staff mental health and suicide prevention; psychological safety; physical safety; equity; and changes specific to COVID-19 and the ways in which it has affected how we all work. One theme in particular has broad applicability outside of the Network: equity.
Promoting workforce equity and an equitable work environment is pivotal to supporting staff members’ psychological safety. Prioritizing equity can help staff members feel comfortable bringing their full selves to work and support their sense of trust in their organization and their colleagues. While equity is often defined in the context of a macro-level system (e.g., city, county, state, or region), some of the same principles and considerations can be applied to a workplace.
Learn More about Joy and Well-Being at Work at the IHI Forum
The equity-related ideas in the updated joy in work change package can be organized into five guiding principles, or the ABCDEs of workplace equity:
- Assess — It is important to assess workplace equity at the organization at which you are leading change. Without understanding the gaps that exist for the people in the specific setting you are trying to improve, efforts run the risk of stalling or failing.
- Build — Once the gaps are understood and an aim is identified, the next step is to build: to make structural changes from the top down (with engagement at all levels) to prevent equity work from running into red tape and other barriers.
- Commit — Organizations need to make a concrete commitment to equity improvement initiatives through allocating financial and staffing resources to the work rather than expecting staff members to take it on in addition to their regular responsibilities. Again, this allocation of resources mitigates the risk of the work stalling or being relegated to the periphery.
- Defend — Health equity particularly intersects with principles of physical and psychological safety in the event of biased behavior from patients. While organizations cannot guarantee that there will be zero incidents of biased treatment from patients, they can enact systems and workflows to defend and protect staff members quickly and decisively. For example, a reliable policy and reporting system for incidents of bias will help to ensure that staff members’ concerns are heard and addressed.
- Evaluate — An organization’s progress on workplace equity and staff well-being should be continuously evaluated. A board-level committee devoted to organizational equity can help to hold hospital/health system leadership accountable to continuous improvement in support of staff well-being and joy in work.
See below how the guiding principles can be put into practice and sites that have tested these ideas.
It has become abundantly clear that equity work is joy work. The IHI research team will continue to learn from the Joy in Work Results-Oriented Learning Network participants and others. We anticipate more modifications to the change package as work in the field evolves.
Marina Renton, MPhil, is an IHI Project Manager. Jessica Perlo, MPH, is an IHI Senior Project Director.
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