Institutional Viability and Capacity

Each nursing school has an organizational structure grounded in its mission, vision, values, goals, and priorities. A focus on Institutional Viability and Capacity is necessary to examine the nursing school’s infrastructure and allocation and utilization of resources to support alignment to build and support the capacity for diversity, equity, and inclusion. Leadership, accountability, strategic planning, and metrics are key drivers of sustainability, excellence, transformation, and success.

Create Clear Mission, Vision, and Values Statements

• Mission, vision, and value statements at the university level should clearly articulate DEI as an imperative. Ideally, the mission, vision, and values at the school level flow from the university’s mission, vision, and values. Nursing schools/programs needs to have clear statements about its expectations of and commitment to DEI efforts. These can include statements about how the school values diversity, how it promotes equity, and what inclusion means in terms of fostering a sense of belonging and community
• How diversity, equity and inclusion are recognized as core institutional values that drive decision-making, resource allocation, and development of policies and practices

The mission, vision, and values are critical for:

• Holding leaders and faculty accountable for developing and maintaining diversity and inclusion efforts within their schools
• Strategic planning in the areas of diversity, equity, and inclusion
• Guiding the teaching and learning environment

Developing a Diversity, Equity, and Inclusion Strategic Plan

The following excerpts regarding Diversity Strategic Planning were adapted from Diversity and Inclusion in Academic Medicine: A Strategic Planning Guide Second Edition (2016).

Task 1: Identify and gain support from key stakeholders

This initial task underpins many other tasks you will complete as you create and implement your plan. Given the nature of diversity, your strategic plan will touch every person at an institution; therefore, at every step, you will need to find allies and create partnerships to ensure the plan is carried out. The first step is essential because the task that follows it assesses where you are currently, which requires the permission and assistance of many across the organization.

Task 2: Assess the landscape

Conducting an environmental scan will help you determine the current state of DEI at your institution. Consider asking:

• How have commitment and action around diversity and inclusion evolved over time?
• Where was the focus on diversity 5 years ago? Where is it now?
• What policies are already in place to support DEI? The difference between policy and practice can sometimes be dramatic. Things are often done in a certain way because “that’s the way they have always been done.” The impact on processes such as hiring, recruitment, retention, professional development, lab space, support staff, promotion, and merit raises can be profound.

Consider policy versus practice in the following:

• Hiring practices
• Recruitment
• Equity (compensation, access, promotion, treatment, etc.)
• Mentoring

Task 3: Set diversity and inclusion goals that align with organization mission, vision, and values

Your goals for DEI reflect the desired outcomes of the strategic plan. To achieve them, they must align with the institution’s stated mission, vision, and values and be seen by all as strategic initiatives so they are not “siloed.” Alignment allows for collective ownership among the university, the school, as well as your community stakeholders. While schools may develop a strategic plan specifically for diversity, it is necessary for diversity to be integral to the school’s overall strategic planning and operations. Diversity must be central to the core business and operations of the school of nursing and not adjunctive or an add-on.

Task 4: Set clear and realistic objectives, supporting tasks, and action steps required to achieve goals

A strategic plan outlines actionable items - what a school of nursing would like to accomplish - whereas the action plan describes how the school of nursing will approach enacting the strategic plan.

Task 5: Develop accountability methods and metrics to measure achievement of objectives

Metrics allow you to monitor your performance. Baseline assessments of where you are, followed by targeted goals, are important.

Task 6: Establish roles, responsibilities, and decision-making channels

Having the right people on board with the necessary skills and dedication is essential. An advisory council can be appointed, composed of people who represent a cross-section of the organization and key stakeholders. Individuals who will be responsible for and assist in implementation will need to be assigned to implementation teams.

Task 7: Develop a realistic timeline for executing all action steps

Keeping momentum moving forward means that timelines must reflect reality. Those carrying out the action steps (i.e., the work) need to agree to your timeline and be held accountable. Achieving buy-in to the timeline is one of your biggest challenges. Other factors to consider to ensure that plans are implemented include establishing realistic time frames, identifying resources, and aligning plan objectives with annual operating plans and budgets.

Task 8: Prepare the written plan

Writing your strategic plan is a multifaceted job that will require coordination and various approvals. The details of the process should be reflected in your timeline.

Exemplar

University of Michigan Diversity Strategic Plan

Establish DEI as Core to the Schools Policies and Processes

• Diversity, Equity, and Inclusion should appear not only in strategic plans, but also in ongoing reports to the university administration and board, as well as accreditation documents.
• DEI must be central to the business and operations of the school as well as the core teaching, research, and service of the school.
• DEI initiatives should be tied to performance, evaluation, compensation, promotion, and rewards.
• There must be an ongoing review of current policies and procedures to identify barriers to advancing Diversity, Equity, and Inclusion.

Empower Leadership

• Leadership must establish the diversity initiative for the school of nursing.
• Leadership must articulate how DEI is linked to quality and safety within the organization.
• Leadership must participate in evidence-based trainings to gain the foundational knowledge and tools needed to effectively commit to prioritize and advance DEI within their schools.

Exemplars

Josiah Macy Jr. Foundation. (2020). Addressing harmful bias and eliminating discrimination in health professions learning environments.

AACN Gallery of Leadership: Strengthening Diversity, Equity, and Inclusion

Required Readings

View Required Readings [PDF]

Assign Accountability for DEI

• Everyone is accountable for DEI.
  • For a school of nursing to truly implement and uphold its stated commitment to diversity, equity, and inclusion, there must be a collective sense of accountability and dedication by all members.
• For some schools, it is the leadership team in collaboration with the whole that creates the structures, policies, and practices that can create equitable outcomes.
• Faculty from racially and ethnically diverse and historically marginalized groups should be included but should not be expected to take on a disproportionate share of diversity-related responsibilities.
• DEI titles, expectations, responsibilities, and reporting structures vary across institutions at both the school and university levels. The same is true for DEI committees/councils.
  • Consider providing examples of various titles and functioning within various types of nursing schools, and universities, and academic setting (e.g., an academic health system, state schools).
• The minority tax is defined as the burden of extra responsibilities placed on minority faculty in the name of diversity, equity, and inclusion.

Required Readings

View Required Readings [PDF]

Appoint DEI Leaders, Councils, Committees

Appoint DEI Leader

• The DEI leader may serve in the capacity of associate/assistant dean or other titles that are specific to the school structure. The DEI leader will:
  • Lead, coordinate, advise, and guide diversity and inclusion efforts
  • Serve as a partner and critical resource for directors and different committees of the school including but not limited to admissions, curriculum, academic affairs, student affairs, and fiscal operations
  • Chair or oversee the school’s DEI committee
  • Report to the associate dean for DEI to executive or leadership council in the school of nursing

Appoint a Council/Committee for DEI

• A DEI committee can be an effective way to enact diversity initiatives and move DEI efforts forward.
• DEI committees should be structured to meet the unique needs of the school of nursing.
• Consider DEI as a standing committee within the SON.
• Consider including members with expertise who can provide insight and advice on moving the DEI strategic and action plans forward.
• This committee can also play a role in reviewing disciplinary action related to bias, discrimination, and/or violations of a climate of inclusion.
• DEI committees in schools of nursing should include representation across the school, including department or program head, members from underrepresented groups, faculty, staff, students and community members.
• Activities of the council may include input into:
  • Developing a model/framework for DEI
  • Creating a diversity statement
  • Developing a strategic plan for diversity
  • Reviewing current policies and procedures for barriers to advancing DEI
  • Reviewing disciplinary action related to bias, discrimination, and/or violations of a climate of inclusion
  • Selecting and suggesting clinical sites to promote DEI values.
  • Build a bridge for students between education and workplaces that uphold diversity and support a diverse workforce.

Provide a DEI Budget and Resources

Schools of nursing must invest in DEI with an annual budget. Funding must be allocated for the associate dean for diversity and for building an office of diversity with adequate staffing. Items to include in the DEI budget:

• Salary and benefits for DEI leadership
• Salary and benefits for administrative support
• Funds for DEI recruiting; faculty development programming; and faculty, staff, and student retreats
• Retention programs for diverse students

Required Readings

View Required Readings [PDF]

Ongoing Programming and Professional Development

• Students, faculty, and staff must develop the knowledge, skills, and attitudes for advancing DEI
  • Diversity “Lunch and Learns” provide excellent DEI programing opportunities for all members of the SON

AACN's Diversity Leadership Institute

AACN Diversity Leadership Institute

Required Readings

View Required Readings [PDF]

Build Internal and External Support

• Institutional Partnerships
  • Connect with the University Multicultural Student Service Center
• Partnerships with Diversity Nursing Associations
  • American Association for Men in Nursing (AAMN)
  • Asian American/Pacific Islander Nurses Association, Inc. (AAPINA)
  • Black Nurses Rock (BNR)
  • National Alaska Native American Indian Nurses Association, Inc. (NANAINA)
  • National Association of Hispanic Nurses, Inc. (NAHN)
  • National Association of Indian Nurses of America (NAINA)
  • National Black Nurses Association (NBNA)
  • National Coalition of Ethnic Minority Nurse Associations (NCEMNA)
  • National Indian Nurse Practitioners Association of America (NINPAA)
  • Philippine Nurses Association of America, Inc. (PNAA)
• Community Partnerships

Exemplar

Schmidt, N. A., & Brown, J. M. (2016). Service learning in undergraduate nursing education: Strategies to facilitate meaningful reflection. Journal of Professional Nursing, 32(2), 100–106. https://doi.org/10.1016/j.profnurs.2015.06.006

Recognize Accomplishments in DEI

Diversity awards programs recognize individuals or organizations showcasing exemplary insight and fortitude in the area of workplace diversity

Award Programs

AACN Diversity Award

INSIGHT Into Diversity Higher Education Excellence in Diversity (HEED) Award

Track and Measure Success

• AACN Climate and Culture Survey (LAMP℠)
  • See page X
• Inclusive Excellence Equity Score Card
  • See appendix for sample measurement strategy
• Urban Universities for Health Metrics Toolkit
• The Health Workforce Diversity Tracker
• Equity Scorecard
  • Bensimon, E. M., & Lindsey, M. (2012). Confronting equity issues on campus: Implementing the equity scorecard in theory and practice. Retrieved from: https://eric.ed.gov/?id=ED530596
• Racial Equity Impact Assessment (REIA)
  ​A Racial Equity Impact Assessment (REIA) is a systematic examination of how different racial and ethnic groups will likely be affected by a proposed action or decision. REIAs are used to minimize unanticipated adverse consequences in a variety of contexts, including the analysis of proposed policies, institutional practices, programs, plans and budgetary decisions. The REIA can be a vital tool for preventing institutional racism and for identifying new options to remedy long-standing inequities. (Raceforward.org.)

Diverse Faculty Hiring

A lack of diverse nursing faculty has tremendous implications for the student body and academic nursing’s infrastructure. Increasing diversity of underrepresented nursing faculty helps to increase awareness and appreciation of cultural differences among racial and ethnic groups, promotes more effective healthcare delivery to an increasingly diverse patient population, improves the quality of nursing education and stimulates research that includes and reflects the needs of a more diverse population. Faculty who reflect the backgrounds of underrepresented students serve as role models and mentors that will support the academic advance and success of these groups of students.

Compounding the issue, a critical component of the progression of a successful academic career is being promoted in rank. According to the most recent AACN data, the greater percentage of minority faculty remain at the Assistant Professor rank. Faculty supports are needed to understand the promotion pathway for professional advancement and strategies are needed to address the barriers and challenges to this process.

• While significant strides have been made to increase diversity within the profession, current national demographics and projected changes clearly indicate that more efforts must be placed on attracting faculty from all backgrounds.
• Utilize best practices in faculty search and hiring.

Exemplar

Guide to Best Practices in Faculty Search and Hiring

Retrieved from: https://www.aacnnursing.org/portals/0/PDFs/DEI/diversity-spotlight.pdf

Required Readings

View Required Readings [PDF]

References

View References [PDF]

In this Section

This section provides tools and strategies for developing the human and institutional resources needed to fulfill the school of nursing’s broader institutional mission as well as the nursing profession’s mission related to DEI.

Click on the links below to navigate throughout the section.

Strategies

• Create Mission, Vision, Values Statement
• Develop a Strategic Plan
• Establish Policies and Processes
• Empower Leadership
• Assign Accountability
• Appoint Leaders, Councils, Committees
• Provide Budget and Resources
• Build Internal and External Report
• Recognize Accomplishments
• Track and Measure Success
• Hire Diverse Faculty

Tools and Exemplars

• University of Michigan's Diversity Strategic Plan
• Equity and Inclusion - Effective Practices and Responsive Stategies: A Guidebook for College University and Leaders
• AACN's Diversity Leadership Institute
• Award Programs
• Equity Score Cards
• Guide to Best Practices in Faculty Search and Hiring