Response from Feature Authors

DIFFERENT HEALTHCARE ORGANIZATIONS are at different stages in their diversity efforts, and they are approaching the challenges and opportunities that disparities in health and healthcare, changing populations, and demographics present in various ways. While we applaud the efforts that are in place, we also note that some organizations appear to work in silos. They use inconsistent processes to leverage data, knowledge, and information that may affect their ability to respond to changing internal and external customer needs and requirements. "Diversity" and "inclusion" are frequently used interchangeably. Diversity describes the spectrum of human similarities and differences. It encourages people to apply their unique differences, voices, and perspectives to problem solving, decision making, and creativity. Inclusion, on the other hand, describes the way an organization uses the potential of diversity. Inclusion creates a culture of collaboration, learning from differences, flexibility, fairness, and equal opportunity, where structures, policies, and practices enhance organizational effectiveness (Cornell University ILR School 2010). Regardless of the approaches used to address diversity and disparity, the ultimate goal is to establish equity in health and to improve care, health status, and health outcomes and inclusion in the workforce, workplace, and marketplace. One integrated approach that could combine the component parts addressed in these articles would be to apply a systems thinking framework to equity and inclusion. Systems thinking is based on the belief that the component parts of a system can be better understood in the context of how they relate to one another and to other systems than in isolation. The only way to fully understand why a problem or issue occurs and persists is to understand its relationship to the whole (Senge et al. 1994). Much of the early work addressing disparity and equity originated out of the quality discipline. Typically, diversity and inclusion have been housed within human resources. The Baldridge Quality Framework is a benchmark model that takes a comprehensive approach to leadership; strategic planning; patient, customer, and market requirements; measurement, analysis, and knowledge management; staff focus; process management; management analysis and knowledge management; and organizational performance results. The Baldridge National Quality Improvement Act of 1987 created the Baldridge Award to identify and recognize role model businesses and establish criteria for calculating improvement efforts and disseminating and sharing best practices, expanding to healthcare, education, and not-for-profit organizations. Adapting a systems thinking framework such as the Baldridge Framework could combine equity and inclusion efforts and ensure the integration of these concepts into healthcare organizational performance management systems. Consciously approaching equity and inclusion from the perspectives of various disciplines could provide additional awareness, insight, knowledge, and approaches. Implementation research, the scientific study of methods to promote the systematic uptake of clinical research findings and other evidenced-based practices into routine practice and hence improve the quality and effectiveness of healthcare, is one example. Implementation research addresses the challenge of translating findings from biomedical research into healthcare practice and considers influences on professional and organizational behavior in healthcare (Biomed Central 2010). "And, the discipline of Organizational Excellence addresses the overall way of working that balances stakeholders' concerns and increases the probability of long-term organizational success through operational, customer-related, financial, and marketplace performance excellence" (Edgeman, et al. 2000). The discipline of organizational development provides inputs for self-renewing, self-correcting systems in which people organize themselves according to the nature of their tasks and continue to expand the choices available to the organization as it copes with a changing environment. …