Forward Momentum: Progressive Change through Diversity, Equity and Inclusion Initiatives in Academic Healthcare

Purpose: This study assesses the impact of Diversity, Equity, and Inclusion (DEI) initiatives in an Academic Radiation Oncology Department over 2 years. It explores multiple dimensions of DEI, including self-identified demographic variations, sex-based inequities, location-specific discrepancies, and temporal evolution, shedding light on the effectiveness of ongoing DEI efforts.

Methodology: DEI surveys were distributed to the department prior to implementation of DEI educational training and activities (January 2021) and again 30 months later (June 2023). The survey encompassed a range of questions related to workplace perceptions of DEI concerns. Survey questions were grouped into 4 broad categories (Inclusivity, Department Bias, DEI Training/Education and Career Development) and DEI indices were calculated. Chi-square tests and Mann-Whitney U test were used to explore associations and differences between the populations.

Results: Survey completion rates were 40% (135/332 responses) and 50% (201/406 responses) in 2021 and 2023, respectively. Compared to 2021, there were significant improvements in 3 out of 4 DEI indices: Inclusivity (mean score 3.72 vs. 3.91; p=0.042), DEI Training/Education (mean score 3.57 vs. 4.14; p< 0.001) and Career Development (mean score 3.39 vs. 3.61; p=0.019). There was no difference between 2021 and 2023 Department Bias mean scores (3.75 vs. 3.95; p=0.056). In 2021, black colleagues had significantly lower average DEI scores in all indices compared to their non-black counterparts (Inclusivity: 3.46 vs. 3.92; p=0.027; Bias: 3.46 vs. 3.92; p=0.028; DEI Training/Education: 3.19 vs. 3.67; p=0.032; Career development: 3.00 vs. 3.53; p=0.045). This became indistinguishable from their non-black colleagues in 2023 in all categories except Inclusivity (Bias: 3.89 vs. 3.91; p=0.542; DEI Training/Education: 4.01 vs. 4.12; p=0.110; Career development: 3.39 vs. 3.55; p=0.060). The Inclusivity index, though numerically improved, remained statistically different between the two racial groups (Inclusivity: 3.74 vs. 4.02; p=0.048). For women employees in 2023, the Inclusivity index became comparable to men (2021: Mean Score: 3.74 vs. 4.13; p=0.022; 2023: Mean Score: 3.86 vs. 4.07. p=0.084). Though numerically enhanced, there remains a significant difference between women and men with DEI Training/Education (2021: Mean Score: 3.49 vs. 3.85; p=0.030; 2023: Mean Score: 4.08 vs. 4.31. p=0.015) and Career Development indices (2021: Mean Score: 3.34 vs. 3.77; p=0.021; 2023: Mean Score: 3.51 vs. 3.86; p=0.018).

Conclusions: Our analysis suggests that targeted DEI initiatives within an academic healthcare setting can improve employee perception on workplace culture. However, gender inequities were highlighted in terms of DEI training and career development, emphasizing the critical role of ongoing assessments and focused efforts. These insights will guide future DEI strategies and reinforce the importance of continued vigilance in promoting an inclusive work environment in academic healthcare settings.

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