How do institutions assess progress on equity, diversity, inclusion, and anti-oppression? A scoping review protocol

Healthcare professions and institutions have been implored to re-examine how established practices across patient care, administration, and professional training contribute to health inequities among diverse patient populations (Canadian Public Health Association, 2018; Dryden & Nnorom, 2021; Olayiwola et al., 2020). Several institutions have publicly acknowledged racism and other systems of oppression are systemically embedded within the healthcare system, while committing to prioritizing equity, diversity, and inclusion (EDI) as well as instituting anti-oppression efforts (Canadian Public Health Association, 2018; College of Family Physicians of Canada, 2021; College of Physicians and Surgeons of Ontario, 2022; Government of British Columbia, 2020). Similarly, academic institutions (Dewidar et al., 2022; Mori, 2022) and businesses (Baum, 2021; Bohonos & Sisco, 2021) have been called to meaningfully address EDI issues within their own organizations. Recent literature in this landscape is replete with calls to action and recommended initiatives for different institutions. For example, a recent scoping review (Hassen et al. 2021) that examined anti-racism interventions in healthcare settings, recommended strategies such as (1) use a multi-level, long-term approach; (2) embed racial equity policies and procedures (e.g., hiring, retention, promotion); (3) relate mandatory training to broader systems of power, hierarchy, and dominance; and (4) integrate mechanisms for self-reflections. Whereas such recommendations are useful in strategizing future efforts, there is scant literature on how to assess progress or performance of EDI and anti-oppression (EDIAO) initiatives, including poor understanding about how to measure or monitor change mechanisms or identify performance indicators. Notwithstanding, to ensure progress and demonstrate public accountability, institutions (including healthcare, academia, and businesses) must cultivate better understanding of how to assess organizational functioning regarding EDIAO. Correspondingly, our research explores the various ways in which institutional progress on EDIAO may be monitored or assessed in healthcare and other institutions, including academia and businesses. Further, EDIAO research with healthcare institutions remain limited with regard to strategies to evaluate impact of EDIAO initiatives; thus, examining other types of institutions, such as academia and businesses, might provide some insights. We use a scoping review methodology (Arksey & O’Malley, 2005; Tricco et al., 2018) to examine pertinent literature for the variable approaches to tracking progress and outcomes for institutional-level EDIAO initiatives across healthcare, academia, and businesses. This will include and overview of the types of tools and frameworks that may be employed to facilitate outcome identification, monitoring, and measurement.

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