To meet the needs of children from low-income and diverse racial/ethnic backgrounds, health care organizations continually strive to develop more ethnically diverse workforces to match their clientele.1-4 Achieving a diverse workforce, however, can result in new service delivery challenges such as increased staff conflict, distrust, and turnover,5-9 which can decrease staff engagement in quality improvement efforts10 and ultimately result in poorer service quality and effectiveness.10,11 One way to channel workforce diversity into positive outcomes is by creating an inclusive workplace.8,12,13 Although inclusion (i.e., an individual's sense of being valued as a unique and important part of an organization8,22) has been linked to several beneficial outcomes, such as increased job satisfaction, retention, and innovation,8 its role has yet to be examined with improving the quality and effectiveness of health care services, and little is known about how organizational leaders can promote workplace inclusion.14-16 Objective: The proposed study will use an innovative lens that considers the dynamic and increasingly diverse context of pediatric hospitals to examine how leadership and the work environment may influence the quality of health care services. Relevance to the Mission of AHRQ: The proposed project is relevant to critical issues in improving health care in the United States17, 18 and is responsive to the mission of the Agency for Healthcare Research and Quality (AHRQ), which strives to support research that enhances the quality of health care services for low-income children.
Aims :
The specific aims of the proposed research are to: (1) examine the extent to which inclusion influences the quality and effectiveness of health care services; (2) examine the extent to which leadership and inclusion influence innovation and ultimately the quality and effectiveness of health care services; and (3) explore the mechanisms underlying potential relationships among leadership, inclusion, innovation, and the quality of health care services. Method: Using a longitudinal mixed-method design, the proposed study will focus on a pathology and laboratory medicine department of one of the most diverse pediatric hospitals in the United States. The department plays a critical role in research, treatment, and diagnoses for the hospital, which serves low- income, inner-city children from Los Angeles, California. Initially, quantitative surveys of hospital staff members will be used to accomplish Aim 1 and Aim 2 (survey data will be collected at three time points at 6-month intervals), followed by qualitative interviews and observations with diverse samples of hospital staff members to accomplish Aim 3. The survey data will be used to test a conceptual model of leadership, inclusion, innovation, and health care service quality, whereas the interviews and observations will be used to help explain how the relationships in the conceptual model manifest themselves in day-to-day organizational processes. Implications: The information gained from the proposed research can be used to help inform workplace interventions designed to improve the quality and effectiveness of pediatric health care services.
Critical to issues of public health is improving the quality and effectiveness of child health care.17-19 The proposed study will use an innovative lens that considers the dynamic and increasingly diverse context of pediatric hospitals to examine how leadership and the work environment may influence the quality of health care services for children from low-income families. The proposed project is relevant and responsive to the mission of the Agency for Healthcare Research and Quality, which strives to support research that enhances the quality of health care services for low-income children.
| Serang, Sarfaraz; Jacobucci, Ross; Brimhall, Kim C et al. (2017) Exploratory Mediation Analysis via Regularization. Struct Equ Modeling 24:733-744 |
