Research Article|Articles in Press

Leadership’s Role in Assimilating DEI to Improve Health Care

Published:January 21, 2023DOI:


      The Institute for Health Care Improvement (IHI) recently added health equity as the fifth aim to its framework of priorities. This article considers the importance of this aim for nurse leaders interested in transforming their organizations. It addresses a humbleness mindset necessary to begin understanding diversity, equity, and inclusion’s role, and the significant impact of one’s individual uniqueness to problem solve. It calls leaders to be self-reflective and understand the unconscious bias that may prevent inclusivity. Most important is the concept of acceptance of the multiverse that must be embraced to improve the collective health of all populations.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Nurse Leader
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Berwick D.M.
        • Nolan T.W.
        • Whittington J.
        The Triple Aim: care, health, and cost.
        Health Aff (Millwood). 2008; 27: 759-769
        • Bodenheimer T.
        • Sinsky C.
        From triple to quadruple aim: care of the patient requires care of the provider.
        Ann Fam Med. 2014; 12: 573-576
        • Batcheller J.
        • Zimmerman D.
        • Pappas S.
        • Adams J.
        Nursing’s leadership role in addressing the quadruple aim.
        Nurse Leader. 2017; 15: 203-206
        • Cheney C.
        Quintuple Aim: health equity added to healthcare improvement directive. HealthLeaders. 2022.
        (Available at:)
        • Prestia A.S.
        Sabotaging success: the role of unconscious bias.
        Nurse Leader. 2019; 17: 561-564
        • Corsino L.
        • Fuller A.T.
        Educating for diversity, equity, and inclusion: a review of commonly used educational approaches.
        J Clin Transl Sci. 2021; 5: e169
        • Habtemariam D.
        Glossary: Diversity, Equity and Inclusion Terms That Matter. Senior Executive.
        (February 25, 2022. Available at:) (Accessed October 2022)
        • Agrawal S.
        Tokenism VS Representation. The Unread Initiative. November 26, 2020.
        (Available at:) (Accessed September 2022)
        • Singh S.J.
        Boards Need Real Diversity, Not Tokenism. Harvard Business Review. August 31, 2021.
        (Available at:) (Accessed September 2022)
        • Baldwin J.
        The Blind Men and the Elephant.
        (Available at:) (Accessed October 2022)
        • Prestia A.S.
        The art of leadership diplomacy.
        Nurs Manage. 2017; 48: 52-55
        • McKinsey & Company
        Diversity Wins: How Inclusion Matters. May 2020.
        (Available at:)
        • AARP Press Room
        Exclusively From AARP The Magazine: Adam Sandler Gets Philosophical About Aging, Actor Harry Hamlin Talks Trusting Your Gut, and ‘70s Icon Linda Ronstadt Reflects on Her Family and Health.
        (Available at:) (Accessed October 2022)
        • Chang E.S.
        • Simon M.
        • Dong X.
        Integrating cultural humility into health care professional education and training.
        Adv Health Sci Educ. 2012; 17: 269-278
        • Covey S.
        The 7 Habits of Highly Effective People.
        Simon and Schuster, New York, NY1989
        • Stanford FC
        The importance of diversity and inclusion in the healthcare workforce.
        J Natl Med Assoc. 2020; 112: 247-249
      1. The Hospitals of Providence Provides Opportunity for Students With Disabilities to Help Secure Post-Graduate Employment. Tenet Healthcare.
        (Available at:)
        • Project SEARCH
        Preparing Young People With Significant Disabilities for Success in Competitive Integrated Employment.
        (Available at:)
        Date accessed: October 30, 2022
        • Ulrich B.
        • Cassidy L.
        • Barden C.
        • Varn-Davis N.
        • Delgado S.A.
        National nurse work–October 2021: a status report.
        Crit Care Nurse. 2022; 42: 58-70


      Angela S. Prestia, PhD, RN, NE-BC, is adjunct professor at Christine E. Lynn School of Nursing, Florida Atlantic University, in Boca Raton, Florida, and a consultant at Marian K. Shaughnessy Nurse Leadership Academy and adjunct professor at Frances Payne Bolton School of Nursing, Case Western Reserve University, in Cleveland, Ohio. Dr. Prestia also serves as the president of the Association for Leadership Science in Nursing (ALSN).