By Paige Mason BA MA(c), Jill Allan BSc BEd BA, Dara Bowie BA
Diversity and Inclusion – Not Just Buzzwords
Diversity is about every single person, each unique with different strengths borne from life experiences, education, personality type, socio-economic status and many other factors. Inclusion is about creating an environment where such strengths are celebrated and everyone can be their authentic self while feeling their views and work are valued. While we all tend to believe we are open-minded, unconsciously we favour people who are similar to us, and our personal histories heavily influence how we evaluate others, including coworkers and patients. To provide compassionate, effective patient care, it is important to possess a robust understanding of the influence that ethnic origins, belief systems, family structures, and a host of other culturally determined factors have on the way people experience the health care system. The potential of a diverse workforce can only be unleashed when a culture of inclusion is established, and the reduction of disparities in health can only be achieved with culturally competent health care providers. For these reasons, we will discuss the diversity and inclusion program at the Ottawa Paramedic Service, which aims to create an inclusive environment with an intersectional lens while improving care provided in the community through cultural competence.
Intersectionality aims to recognize and explore the impacts of the interconnectedness of characteristics such as race, sexual orientation, gender identity, age, class, disability, issues of immigration, and many more. It is the appreciation that someone, a woman for example, may not experience the same level of discrimination as another just because they are both women. Identity markers (e.g. race, gender identity, sexual orientation) do not exist independently of each other and instead have an effect on a person’s experience as a whole. By examining this topic through the lens of intersectionality, we aim to address issues of oppression while ensuring systems of inequalities towards other groups are not further perpetuated.
Whether moral, legal or as a business case – the argument for diverse and inclusive organizations is flourishing. As Tina Fey said in an interview with Oprah, “you wouldn’t make a soup with, like, one thing in it and expect it to be good”. An effective organization – like a tasty soup – is full of diverse ingredients, and the evidence supports this. Research in the private sector has shown that the more diverse the team members are (in age, race, gender, opinion), the more effective, productive, creative, and committed they are. Furthermore, studies have shown that a commitment to diversity and inclusion has a positive impact on an organization’s ability to attract and retain the best talent.[1,6] Higher cultural competency scores predicted higher quality of care for children with asthma and successful smoking cessation programs.[7,8] Even self-reported cultural competence by physicians correlated with higher levels of patient satisfaction and trust. This evidence supports the assertion that the positive outputs of a diverse, inclusive, and culturally competent workplace are both intrinsic and extrinsic.
Why Diversity Programs Fail
Years of social science and change management research points to one simple truth: you won’t get people to change by blaming and shaming them with rules and remediation. Organizations have long focused on diversity training and grievance procedures to limit bias in the workplace, but these tactics often invoke a backlash of negative opinions and the positive effects of the training rarely last beyond a day or two.[6,10] Once people see that a grievance system has little to no effect on problematic behaviour, they become less likely to report discrimination. This creates a false sense of comfort within the organization with the belief that there are no problematic behaviours at all. Unfortunately, “if you have a brain, you have bias” and while unconscious bias training is engaging and relevant, all too often people become aware of everyone else’s bias, but fail to recognize their own. This is not to say that diversity and inclusion training does not have a place – it certainly does – but the focus needs to shift from shame and blame, remedial training, and “controlling bias” to an awareness and acceptance that bias affects us all while engaging employees in helping to solve the problem. Exposing people to those different from them, encouraging social accountability for change, and empowering staff with a “voice and choice” to help solve the problem encourages people to think of themselves as a champion for diversity and inclusion.
The Diversity Champion Program at the Ottawa Paramedic Service
Founded in 2010, the Diversity Champion Program (DCP) is an encouraging example of a program that has empowered staff to become champions of diversity and inclusion within the Ottawa Paramedic Service (OPS). The program was formed with the support of senior leadership and in partnership with the City of Ottawa’s Diversity and Employment Equity Branch. The program’s success has been a factor in the City of Ottawa being named one of Canada’s Best Diversity Employers for the seventh year. Through collaboration with many organizations throughout the Ottawa area, the DCP strives to support the current diversity within the organization, build relationships with diverse communities across Ottawa, and improve diversity and inclusion through recruitment and retention strategies aimed toward developing an organization that is representative of the community we serve.
Since its inception, the DCP has been involved in many awareness and educational events focusing on the groups identified in the City of Ottawa’s Equity and Inclusion Lens Diversity Snapshot. Several of the DCP’s strategic direction and deliverables include those listed in Table 1. These are combined with several examples of events and initiatives the program has contributed to in the quest towards this vision:
While this is not an exhaustive list, Table 1 highlights the many collaborations and community connections involved with the program. The event with the greatest resource demand is the annual summer event for youth – the Paramedic Awareness Week Camp. The event is a completely free day camp targeted at youth aged 13-17 with the goal of reducing barriers to ensure youth feel welcomed and encouraged to learn and engage with the paramedic profession. Over the past eight years, campers have completed their Standard First Aid and CPR – C level certification, were introduced to the job of a paramedic and communications officer, learned patient assessment and triage skills, became proficient in the use of Automated External Defibrillators (AED), participated in leadership challenges, and learned about different cultures from other young people in their community. The youth communicated via six forms/languages: English, French, Mandarin, American Sign Language, Swahili, and Arabic and represented twelve ethnicities in our community: Ukrainian, Dutch, German, Irish, Chinese, Congolese, Canadian, Scottish, French, Italian, Ukrainian, and Libyan. The camp focuses on providing a unique experience for youth that may not have been aware of or considered a career as a Paramedic, Communications Officer or any role within the service as a whole. Camp participants have since entered careers as Paramedics and Communications Officers while other participants have joined the MedVent youth unit of volunteer first aid providers.
Position the OPS as an employer of choice developing targeted recruitment and outreach campaigns while hiring, retaining, and promoting a diverse workforce.
Orientation of all new paramedics, communications officers, and logistics staff includes cultural safety training & introduction to DCP
Discussions related to situational judgement testing
Develop ongoing topics related to diversity for paramedic professional development programs.
Inuit Cultural Awareness Session
Cultural Competence for Paramedics training session
DCP Human Rights Series
Daily information screens with rotating information about Black History Month, Chinese New Year, Lag Baomer Parade
Develop linkages with local colleges to promote awareness and interest in diversity and inclusion.
Invitations to paramedic students to attend DCP meetings
Young Women in Uniform event
Identify options for positive change in programs, policies, and services while liaising with senior management team.
Land Acknowledgement during professional development days
Hiring and internal recruitment processes updated
Accommodation policies and updates to uniform policies to recognize diversity
Host and participate in awareness events that support and recognize the diversity within OPS and the Ottawa community.
International Women’s Day Celebration banquet
International Day for Elimination of Racial Discrimination
National Aboriginal History
Hire Immigrants Ottawa coaching events
Ottawa Welcome Event for International Students
Ramadan community Iftar Dinner
International Day of Pink
Stigma Ends With Me Workshops and events
International Overdose Awareness Day
Develop information sessions and education campaigns for diverse community groups, community centers, organizations and schools.
Career fairs: Kitigan Zibi Anishinabeg, Mamidosewin Centre Indigenous Career Fair, AccessAbility Day Resource Fair
Connecting with new Canadians through the Catholic Immigration Centre
Support staff by organizing internal networks of support for designated groups.
Flag Raisings (Pride flag, Trans flag, Franco-Ontarian flag)
Positive Space signs
Paramedic Women’s Community
Female First Responder’s Day
Identify, document, and share best practices with others.
Internal newsletter with days of significance, training opportunities, community events, multicultural presentations
Continue to build relationships with city organizations and community groups.
Ethnocultural Seniors Forum
Ottawa Police Human Rights Forum
Rainbow Health Ontario (improve health and access to care for Ontario’s LGBTQ2S+ with training, consultation and informed public policy)
GLBT Police Liaison Committee
Hire Immigrants Ottawa Working Group
Thinking About Promoting Diversity and Inclusion?
It is important to start by taking a step back and truly understanding the current climate within your organization from a number of different angles. Ask yourself (i) what information is currently available (employee demographics, employee feedback, talent management data)? and (ii) what information do I need (cultural and community norms of the community, what change initiatives have worked in the past, what are the core values of my organization)? Moving forward, it is important to create a case for change and considering the “what’s in it for me (WIIFM)” principle. Presenting the WIIFM in stages can look something like this :
- Front line employee – knowledge they will be treated fairly, have the opportunity to share their views and receive transparent and bias free processes
- Junior leader – knowledge that engagement and motivation will be increased and there will be a wider talent pool to source best candidates
- Senior leader – knowledge they can attract and retain the best people because of the culture created, increased reputation, and better service delivery
- Furthermore, build and communicate a strategic plan that involves the answers to these questions :
- What are we striving to create?
- How will we know when we have gotten there?
- How does this link to the organization’s values?
- What will happen if we don’t do this?
Finally, challenge the status quo! We challenge each of you to :
- Examine your own values, beliefs, and assumptions to challenge the bias you hold
- Recognize conditions that exclude people
- Improve your cultural competence by educating yourself on varying world views
- Engage patients and families to share similarities and differences
- Develop a relationship of trust by interacting with openness, understanding, and a willingness to hear different perspectives
- Create a welcoming environment that reflects and respects the diverse communities that you work with and serve
Despite the progress the DCP has achieved, we can never rest in promoting diversity and inclusion for it is not a destination, nor a one-and-done initiative. It takes commitment on all levels to a frame of mind that helps people thrive, and it is everyone’s responsibility to monitor, promote and lead from every position. The DCP continues to develop awareness of the committee within the service through branding, PR strategies, and fundraising. Directing our attention to hiring/promotion processes, performing an assessment of the organizational climate, and introducing steps to reduce the effects of bias will be integral to the growth and adaptability of the OPS. The success of the DCP relies on the continued support of our senior leadership, our various partners, as well as the many unique and energetic volunteers who bring their varied talents, experiences, and enthusiasm to improve the organizations and communities they work in. We strive towards equity by questioning and addressing the systemic barriers that appear in our everyday world, and we encourage paramedics to use the DCP as a cultural informant to ask those tough questions. While we may all wear the same uniform, we must pause and truly see the individual wearing it to celebrate our uniqueness in a comfortable and safe environment.
“We would not accept substandard competence in other areas of clinical medicine, and cultural competence should not be an exception.”
– Dr. Joseph Betancourt 
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For more information related to the DCP program at the Ottawa Paramedic Service available via biannual reports, please contact firstname.lastname@example.org.