Table 2.

Implementation strategies, examples, and relevant literature

DEIB implementation strategies	Examples identified by participants	Mapping to ERIC implementation strategies	Relevant literature
People
Talent recruitment, and retention:	- Tailor recruitment and retention policies and incorporate inclusive practices to these policies - Provide technical assistance and consultation to writing job advertisement and job descriptions to ensure language is inclusive - Change guidelines to include equitable search processes - Develop a formal implementation blueprint for how the organization will embody inclusive strategic human resource management	- Provide ongoing consultation, conduct educational meetings - Develop a formal implementation blueprint - Recruit, designate, and train for leadership	[33–35]
Employee learning:	- Develop and distribute corporate learning materials to support DEIB interventions to train and educate stakeholders - Integrate DEIB-related training into the existing corporate learning system - Develop incentives to encourage DEIB corporate learning within the organization	- Distribute educational materials - Alter incentive/allowance structures	[36–40]
Employee resource groups:	- Formalize ERGs within organization to support DEIB dissemination - Allocating budget to ERGs - Adopting ERG representation within corporate governance to serve as champions	- Use advisory workgroup - Utilize financial strategies - Identify and prepare champions	[41–43]
Formal workforce development and talent pipeline	- Develope resources that allow employees from minoritized populations to develop skills that will enhance their future job growth and enter leadership roles - Lead leadership training programs targeted at employees who are part of minoritized populations and/or traditionally under-represented within leadership - Adopt mentoring and coaching programs for employees from minoritized populations to identify	- Distribute educational materials - Conduct educational meetings - Recruit, designate, and train for leadership	[44–47]
Engaging top-level leaders:	- Promoting importance of the DEIB interventions to other health system leaders, such as the Board of Trustees and CEO through formal and informal channels - Developing one-on-one relationships with board members to share knowledge and expertise related to DEIB topics and gain support	- Facilitation - Obtain formal commitments - Involve executive board - Build a coalition	[48]
Health Equity
Reduce disparities in clinical outcomes, access, and patient experience	- Establish a committee of clinical leaders to identify barriers minoritized populations experience when equitable health care in their organizations - Inform clinical leaders of expectations regarding the incorporation of health equity into clinical care - Establish a regular operating routine for reviewing health disparities and health equity data from their organization - Identify and document what mid-level leaders and frontline staff are already doing to address disparities in clinical outcomes and access and establish future goals for these initiatives	- Build a coalition - Inform local opinion leaders - Identify early adopters - Capture and share local knowledge - Change records systems	[49–51]
Health equity research	- Creating a research center for Health Equity with a mission to support research focused on alleviating healthcare inequities - Creating systems and providing research support for clinicians engaging in health equity research - Identifying research agenda for the organization that advances the DEIB interventions	- Build a coalition - Capture and share local knowledge	[4,51
Language translation services	- Evaluating outcomes and experience utilizing existing translational services and identifying opportunities for growth - Incorporating translation services outcome metric into organization scorecard - Conduct a needs assessment to identify opportunities for creating patient-related materials (handouts, signage, patient portals) that are easily understood and use inclusive language - Ensuring that health system translation services are equitable and accessible to all patients - Managing translational services staff	- Audit and provide feedback - Change record systems - Facilitation - Conducting local needs assessment	[52, 53]
Community health outcomes evaluation	- Identifying metrics to monitor population health outcomes within underserved communities or communities with large minoritized populations - Incorporating community health metrics into the organizational performance evaluation - Reporting community health outcomes of under-served populations or minoritized populations	- Develop and implement tools for quality monitoring - Change record systems - Audit and provide feedback	[54]
Monitoring and Feedback
Board engagement	- Presenting at board meetings on key DEIB priorities and/or initiatives within the organization - Establishing relationships with board members and board sub-committees to support the engagement of boards of DEIB issues - Serving as DEIB subject matter expert to board	- Facilitation - Promote adaptability - Involve executive board - obtain formal commitments	[55]
DEIB scorecards	- Developing key metrics that provide evidence of DEIB implementation success in the organization - Establish sources of data and reporting routine to regularly obtain data on health equity outcomes on time - Mapping data within systems to support scorecards	- Purposefully reexamine the implementation - Develop and organize quality monitoring system	[56]
Listening sessions	- Events with organization leaders and employees present to support opportunities to voice thoughts about organizational culture and areas for improvement - Engage in listening sessions after critical events	- Conduct local needs assessments - Obtain and use patients/consumers/and family feedback	[57]
Operational Planning and Communicating
Negotiating the DEIB leader role	- Working with other organization leaders to demarcate specific responsibilities of DEIB position and determine workplan for areas of overlap between roles - Negotiate with other top-level leaders on how to partner on implementation strategies which require collaboration	- Facilitation - Inform local opinion leaders	[58]
Building collaboration to support sustainable change	- Meeting with employees across the organizational hierarchy to support buy-in - Developing buy-in with top-level leadership team	- Build a coalition - Conduct local consensus discussions	[59, 60]
Developing DEIB personnel infrastructure	- Hire and train DEIB leader direct reports - Establish staffing needs to support DEIB implementation strategies - Gain access to funding to hire DEIB staff through organization’s budget process	- Centralize technical assistance - Develop a formal implementation blueprint - Access new funding	[61]
Developing governance structure	- Building a framework for the implementation and maintenance of DEIB interventions - Establish DEIB leadership committee and document guidelines for committee - Building routines/processes and organizing meetings that support effective decision-making of DEIB issues	- Use Advisory boards and work groups - Provide interactive assistance	[41, 62, 63]
DEIB consultation to support DEIB strategies	- Meeting with organization leaders to support other leaders’ specific DEIB priorities or initiatives - Engage in tacit knowledge to support change management processes - Serve as a consultant and subject matter expert to support systematic integration of DEIB into all levels of organization - DEIB top-level leader establishes themselves as the DEIB resource and subject matter expert	- Provide local technical assistance - Facilitation - Inform local opinion leaders - Centralize technical assistance	[64, 65]
External Engagement
Community engagement	- Meeting with community leaders to assess social needs and creating a plan to alleviate them - Collaborate with the organization’s existing community engagement team to identify opportunities to improve engagement with communities with large populations of minoritized populations	- Build a coalition - Conduct local consensus discussion	[54]
Supplier diversity	- Sourcing hair and skin care that meets the needs of minorized populations - Collaborating with finance/purchasing team to diversify organization’s suppliers - Establishing sourcing targets related to engaging with a diverse group of 3rd party partners	- Mandate change - Change physical structure and equipment	[66, 67]