Diversity Ecosystem: Toward an Understanding of Its Role on Internal Marketing in Diversity Goals and Outcomes

Organizational leaders may announce diversity initiatives, yet often these goals are never fully realized. When organizational leaders establish diversity goals, they frequently rely on internal marketing teams to implement them. Internal Marketing’s ability to influence Diversity Outcomes and Self-Rated Employee Performance may differ due to the moderating effects of the organization’s Diversity Ecosystem. The Diversity Ecosystem is a novel construct that involves an employee’s interpretation of an organization’s openness, aspects of organizational justice, need for diversity and voice. Does the strength of an organization’s Diversity Ecosystem moderate the relationship between Organizational Commitment to Diversity and Internal Marketing? An employee’s level of Job Involvement may also mediate Internal Marketing’s effect on Diversity Outcomes and Self-Rated Employee Performance. In turn, how does an employee’s Job Involvement mediate the relationship between Internal Marketing and Diversity Outcomes and Self-Rated Employee Performance. This research began in the summer of 2020 as organizations faced pressure to diversify after the death of George Floyd. The researcher began the project with a series of qualitative interviews with governmental and corporate leaders to aid in hypothesis development. After initial x qualitative interviews, an initial quantitative survey was developed and sent to as a pretest to full-time employees. From those results and after a thorough literature review, an initial qualitative survey was sent to a pilot sample of full-time employees nationwide. After an analysis of the pilot sample, a quantitative survey was sent to 364 full-time employees across the United States. The survey was designed in Qualtrics and administered through Prolific. The survey data was analyzed through Partial Least Squares Structural Equation Modeling. The development and understanding of a Diversity Ecosystem offer a key academic research contribution and potential managerial implications for diversity efforts

Mind Your Meds: Safe Opioid Disposal Awareness

Driven by the effects of the opioid epidemic on friends, family members, students, and patients, members of the 2019 GEHLI Team “Mission Possible” are dedicated to bolstering educational awareness of safe leftover opioid disposal methods to decrease the supply of opioids in our community. On average, over 2/3 of opioid prescription medications are leftover and lead to later misuse or abuse (JAMA Survey). Despite a decrease in prescription writing for pain medication over the years, the mortality rate from overdose, and the rate of infants born to mothers with opioid abuse continues to steadily increase in Virginia (VDH). Team Mission Possible seeks to promote awareness of both the need and resources available for safe opioid disposal by educating prescribers in the VCU Health system and spreading knowledge to VCU patients, students, faculty, staff, and members of the surrounding community through: educational events on the Monroe Park and Medical campuses; teaming up with Miss Virginia’s “Mind your Meds campaign”; live Facebook interviews; and educational flyers

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research