Hawai'i-Pacific Chapter
A quarterly e-newsletter for the Hawai'i Pacific Chapter of ACHE Vol. 3
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Messages from Chapter Leadership
Message from your ACHE Regent
Message from the Chapter President
Recent Events
2017 Hawai'i Cluster
ACHE 2017 Chapter Leaders Conference
Original Articles By ACHE Members
Postgraduate Fellowship Opportunities
Diversity and Inclusion: "An Adventure"
Calendar of Events
Calendar of Educational Events
News from the Education Committee
Membership Report: New Fellows, Members, and Recertified Fellows
News from the Guam Committee
ACHE National News
Career Corner
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How can we increase physician engagement in our chapter?
Create a Physician Board Position
Create a Physician Committtee
Offer Tailored Education Opportunities
Offer Networking with Local CMOs
No Need for Additional Physician Engagement

Jen Chahanovich, FACHE

Nick Hughey, FACHE

Micah Ewing

Chuck Tanner, FACHE

Suzie So-Miyahira

Nancy Hana


Josh Carpenter | Education

Emiline LaWall | Communications

Bobbie Ornellas, FACHE | Diversity

Tamara Pappas | Membership

Gidget Ruscetta, FACHE | Director

Angel Vargas, FACHE | Director

Denise Della

Art Gladstone, FACHE


Original Articles By ACHE Members
Diversity and Inclusion: "An Adventure"
Barbara Ornellas, RN, MSA, FACHE | Diversity Committee

What comes to mind when we hear the word “adventure”? Do the descriptors include: fun, expedition, outing, challenging, exploration, mission, safari, hunt or voyage? What is so intriguing about an adventure? One word: “unknown”. There are always some “unknown” twists and turns accompanying an adventure. This is true of the adventure and journey we embrace as “Diversity and Inclusion.” 



Diversity and inclusion have been defined in many ways. Although there are common threads in the characterization of these concepts, the professional background, workplace environment, cultural climate of an organization or delivery of services (e.g. health care) guide the definitions.



“Affirmative Action” and “Equal Employment Opportunity” are familiar concepts. Affirmative action focused on the number of women and minorities in the labor market. Title VII of the Civil Rights Act of 1964 and Section 501 of the Rehabilitation Act of 1973 mandated that “all federal personnel decisions be made free of discrimination on the basis of race, color, religion, sex, national origin, reprisal or disability.”[1] The Equal Employment Opportunity Act of 1972 covers “applicants to and employees of most private employers, state and local governments, educational institutions, employment agencies and labor organizations”.[2]


Organizational Engagement

The American Nurses Association (ANA) released a position statement on Cultural Diversity in Nursing Practice in 1991. In this statement, ANA defined Cultural diversity as “the differences between people based on a shared ideology and valued set of beliefs, norms, customs and meaning evidenced in a way of life.”[3] Nurses were encouraged to understand the interaction of multiple cultures in nurse-patient encounters including the setting in which these encounters take place.

In The American Medical Association (AMA) Code of Medical Ethics, several of the principles of medical ethics appear to parallel cultural diversity.[4]  In addressing disparities in health care, AMA encourages physicians to evaluate their practices regarding “race, gender identity, sexual orientation, sociodemographic factors, or other nonclinical factors do not affect clinical judgment”.[5]

The Agency for Healthcare Research and Quality (AHRQ) has identified priority populations and areas in the Healthcare Research and Quality Act of 1999.  These include “racial and ethnic minority groups, low-income groups, women, children, older adults, individuals with special health care needs (including individuals with disabilities, chronic care or end-of-life care), rural areas (including frontier areas) and inner-city areas”.[6] AHRQ notes that “cultural competence requires organizations and their personnel to value diversity, assess themselves, manage the dynamics of difference, acquire and institutionalize cultural knowledge and adapt to diversity and the cultural contexts of individuals and communities served.”[7]

The American College of Healthcare Executives (ACHE) “works to foster an inclusive environment that recognizes the contributions and supports the advancement of all, regardless of race, ethnicity, national origin, gender, religion, age, marital status, sexual orientation, gender identity or disability because an inclusive environment can enhance the quality of health, improve hospital / community relations, and positively affect the health status of society.”[8]

The Institute for Diversity in Health Management was created in 1994 through the unified efforts of the American College of Healthcare Executives, National Association of Health Services Executives and American Hospital Association (AHA). The Institute’s mission is to “increase the number of minorities in health services administration to better reflect the increasingly diverse communities they serve, and to improve opportunities for professionals already in the health care field”.[9]

The Joint Commission published “Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care – A Roadmap for Hospitals”[10] in 2010. The organization created Standards found in the accreditation requirements of the Hospital Manual.  Review shows that the majority of these standards are current requirements for accreditation.


The American Hospital Association launched “#123forEquity Pledge Campaign to Eliminate Health Care Disparities”[11] in 2015.


Diversity and Inclusion: An Ongoing Adventure

The journey of Diversity and Inclusion is an ongoing adventure. Concepts, definitions, methodology for incorporation into practice  and utilization of social media are forging new pathways. A diverse population of patients currently exists: those well-versed in disease processes and being involved in their care, those following culture especially with respect to interpersonal communication with healthcare providers which includes not asking questions and patients who are unable to formulate questions perhaps from fear. poor understanding of either disease processes or health care systems. Cultural and religious beliefs are a component of this complexity. Unique challenges for health care providers and delivery systems are continuously created. Another component is the  diversity in our health care providers including their own cultures, beliefs, interpersonal communication styles and backgrounds.


It is believed that in health care organizations, our focus should always be to first meet the biopsychosocial needs of our patients. Health care delivery systems are built for our patients and continue on an ever-changing, always challenging,  continuously evolving adventure we refer to as “Diversity and Inclusion”.



[1] U.S. Equal Employment Opportunity Commission https://www.eeoc.gov/federal/directives/md715.cfm

2  Equal Employment Opportunity is the Law.pdf https://www.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf

3  American Nurses Association Retired Position Statement: Cultural Diversity in Nursing Practice (1991)

4  AMA Code of Medical Ethics – AMA Principles of medical ethics https://www.ama-assn.org/delivering-care/ama-principles-medical-ethics

5  AMA:  Disparities in Health Care https://www.ama-assn.org/delivering-care/disparities-health-care

6 Agency for Healthcare Research:  Division of Priority Populations https://www.ahrq.gov/topics/priority-populations/index.html

7  Agency for Healthcare Research and Quality: What is Cultural and Linguistic Competence? https://www.ahrq.gov/professionals/systems/primary-care/cultural-competence-mco/cultcompdef.html

8  ACHE: Statement on Diversity http://www.ache.org/policy/diversity.cfm

9  Institute for Diversity in Health Management http://www.diversityconnection.org/diversityconnection/about-us/About-the-Institute.jsp

10The Joint Commission: Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010

11American Hospital Association:  #123for Equity Campaign to Eliminate Health Care Disparities http://www.equityofcare.org/


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