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Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings

Achieving optimal health for all requires confronting the complex legacies of colonialism and white supremacy embedded in all institutions, including health care institutions. As a result, health care organizations committed to health equity must build the capacity of their staff to recognize the co...

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Autores principales: Todic´, Jelena, Cook, Scott C., Spitzer-Shohat, Sivan, Williams, James S., Battle, Brenda A., Jackson, Joel, Chin, Marshall H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232289/
https://www.ncbi.nlm.nih.gov/pubmed/35353723
http://dx.doi.org/10.1097/ACM.0000000000004680
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author Todic´, Jelena
Cook, Scott C.
Spitzer-Shohat, Sivan
Williams, James S.
Battle, Brenda A.
Jackson, Joel
Chin, Marshall H.
author_facet Todic´, Jelena
Cook, Scott C.
Spitzer-Shohat, Sivan
Williams, James S.
Battle, Brenda A.
Jackson, Joel
Chin, Marshall H.
author_sort Todic´, Jelena
collection PubMed
description Achieving optimal health for all requires confronting the complex legacies of colonialism and white supremacy embedded in all institutions, including health care institutions. As a result, health care organizations committed to health equity must build the capacity of their staff to recognize the contemporary manifestations of these legacies within the organization and to act to eliminate them. In a culture of equity, all employees—individually and collectively—identify and reflect on the organizational dynamics that reproduce health inequities and engage in activities to transform them. The authors describe 5 interconnected change strategies that their medical center uses to build a culture of equity. First, the medical center deliberately grounds diversity, equity, and inclusion efforts (DEI) in critical theory, aiming to illuminate social structures through critical analysis of power relations. Second, its training goes beyond cultural competency and humility to include critical consciousness, which includes the ability to critically analyze conditions in the organizational and broader societal contexts that produce health inequities and act to transform them. Third, it works to strengthen relationships so they can be change vehicles. Fourth, it empowers an implementation team that models a culture of equity. Finally, it aligns equity-focused culture transformation with equity-focused operations transformation to support transformative praxis. These 5 strategies are not a panacea. However, emerging processes and outcomes at the medical center indicate that they may reduce the likelihood of ahistorical and power-blind approaches to equity initiatives and provide employees with some of the critical missing knowledge and skills they need to address the root causes of health inequity.
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spelling pubmed-92322892022-07-01 Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings Todic´, Jelena Cook, Scott C. Spitzer-Shohat, Sivan Williams, James S. Battle, Brenda A. Jackson, Joel Chin, Marshall H. Acad Med Articles Achieving optimal health for all requires confronting the complex legacies of colonialism and white supremacy embedded in all institutions, including health care institutions. As a result, health care organizations committed to health equity must build the capacity of their staff to recognize the contemporary manifestations of these legacies within the organization and to act to eliminate them. In a culture of equity, all employees—individually and collectively—identify and reflect on the organizational dynamics that reproduce health inequities and engage in activities to transform them. The authors describe 5 interconnected change strategies that their medical center uses to build a culture of equity. First, the medical center deliberately grounds diversity, equity, and inclusion efforts (DEI) in critical theory, aiming to illuminate social structures through critical analysis of power relations. Second, its training goes beyond cultural competency and humility to include critical consciousness, which includes the ability to critically analyze conditions in the organizational and broader societal contexts that produce health inequities and act to transform them. Third, it works to strengthen relationships so they can be change vehicles. Fourth, it empowers an implementation team that models a culture of equity. Finally, it aligns equity-focused culture transformation with equity-focused operations transformation to support transformative praxis. These 5 strategies are not a panacea. However, emerging processes and outcomes at the medical center indicate that they may reduce the likelihood of ahistorical and power-blind approaches to equity initiatives and provide employees with some of the critical missing knowledge and skills they need to address the root causes of health inequity. Lippincott Williams & Wilkins 2022-06-23 2022-07 /pmc/articles/PMC9232289/ /pubmed/35353723 http://dx.doi.org/10.1097/ACM.0000000000004680 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Articles
Todic´, Jelena
Cook, Scott C.
Spitzer-Shohat, Sivan
Williams, James S.
Battle, Brenda A.
Jackson, Joel
Chin, Marshall H.
Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
title Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
title_full Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
title_fullStr Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
title_full_unstemmed Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
title_short Critical Theory, Culture Change, and Achieving Health Equity in Health Care Settings
title_sort critical theory, culture change, and achieving health equity in health care settings
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232289/
https://www.ncbi.nlm.nih.gov/pubmed/35353723
http://dx.doi.org/10.1097/ACM.0000000000004680
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