The impact of organizational inclusion for a diverse workforce on organizational climate assessments and hospital recommendations among nurse practitioners.

IF 2.6 3区 医学 Q3 HEALTH POLICY & SERVICES
Health Care Management Review Pub Date : 2026-10-01 Epub Date: 2026-08-24 DOI:10.1097/HMR.0000000000000505
Hyunmin Yu, Kathryn A Connell, Daniela Golinelli, Matthew D McHugh, Tari Hanneman, Jose A Bauermeister, Heather Brom
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Abstract

Background: While the nursing profession has advocated for workforce diversity, limited research has examined how institutional inclusion efforts are associated with the experiences of nurse practitioners (NPs), particularly in hospital settings.

Purpose: To examine whether institutional inclusion efforts were associated with NPs' strong recommendation of their hospital and whether this relationship was explained by NPs' assessments of organizational climate.

Methods: This cross-sectional study analyzed 2023 data from 742 NPs across 412 U.S. hospitals, drawing on the Penn Nurses4All Survey, the Healthcare Equality Index (HEI), and the American Hospital Association Annual Survey. The independent variable was employment in an HEI-participating hospital, and the dependent variable was NPs' strong recommendation of their hospital to family and friends. Mediating variables included NPs' assessments of organizational climate. Mediation analysis using weighting estimators was conducted to adjust for confounding and evaluate the extent to which organizational climate explained the relationship between HEI participation status and hospital recommendation.

Results: NPs in HEI-participating hospitals were 15% more likely to strongly recommend their hospital (95% CI: .07-.22). Significant indirect associations were observed and accounted for the total association through overall organizational climate (26.6%), professional visibility (26.6%), and NP-administration relations (20%), respectively.

Practice implications: Hospital participation in the HEI is associated with stronger hospital recommendations among NPs, partly through more favorable assessments of organizational climate. As health care systems work to improve work environments and job outcomes for a diverse workforce, cultivating a climate of inclusion through meaningful, everyday practices will be essential.

组织包容的不同劳动力对组织气候评估和医院建议护士执业的影响。
背景:虽然护理专业倡导劳动力多样性,但有限的研究已经调查了机构包容性努力如何与护士从业人员(NPs)的经验相关联,特别是在医院环境中。目的:研究机构包容努力是否与NPs对医院的强烈推荐有关,以及这种关系是否可以用NPs对组织氛围的评估来解释。方法:本横断面研究分析了来自美国412家医院的742名护士的2023项数据,参考了宾夕法尼亚大学护士调查、医疗保健平等指数(HEI)和美国医院协会年度调查。自变量为参与健康计划医院的就业情况,因变量为新生儿向家人和朋友强烈推荐医院的情况。中介变量包括NPs对组织氛围的评估。使用加权估计器进行中介分析以调整混淆因素,并评估组织氛围在多大程度上解释HEI参与状况与医院推荐之间的关系。结果:参与hei的医院的NPs强烈推荐所属医院的可能性高出15% (95% CI: 0.07 - 0.22)。观察到显著的间接关联,并分别通过整体组织氛围(26.6%)、专业知名度(26.6%)和np -行政关系(20%)占总关联。实践启示:医院参与HEI与NPs中更强的医院建议相关,部分原因是通过对组织氛围更有利的评估。随着卫生保健系统努力改善多样化劳动力的工作环境和工作成果,通过有意义的日常实践培养包容的氛围至关重要。
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来源期刊
Health Care Management Review
Health Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
期刊介绍: Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.
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