ACC: A Statement on Respect, Civility, and Inclusion in the Cardiovascular Workplace

The American College of Cardiology (ACC) Solution Set Oversight Committee published a statement on building respect, civility, and inclusion in the cardiovascular (CV) workplace. The statement was published in the Journal of the American College of Cardiology.

Respect and civil behaviors are key to maintaining a high-quality CV workforce and to achieving the principal goal of the ACC of improving heart health and transforming CV care.

To achieve this, the clinical, educational, and research team members must ensure respect, civility, and inclusion.

The statement authors highlighted the fact that unintended consequences are becoming more frequent for organizations that do not take bias, discrimination, bullying, and harassment (BDBH) seriously. Some of these consequences include out-of-pocket expenses when a lawsuit is brought to the organization, adverse publicity, and disruption of ongoing daily activities. Altogether, implementing appropriate policies to promote civility and inclusion are more and more essential to maintaining CV quality of care.

The statement authors emphasized 5 main points for achieving respect, civility, and inclusion in the CV workplace:

·   Establishment of confidential and fair reporting mechanisms for investigating individuals or departments which are suspected or accused of BDBH.

·   Creating institutional resources, such as education and implicit bias training, to ensure hiring practices and performance evaluations are objective.

·   Adopt metrics to support the collection of data to track the department’s or institution’s performance on respect, civility, and inclusion and to make changes when necessary.

·   Embrace independent evaluation of inclusion and the effectiveness of BDBH-reducing measures.

·   Recognize champions and leaders who promote respect, civility, and inclusion.

In 2020, the ACC and AHA came to a consensus about the spectrum of civil (excellence, belonging, inclusion, equity, diversity, and respect) and uncivil (disrespect, microaggression, discrimination, bullying, harassment, and violence) behaviors. The authors emphasized that not all of these uncivil behaviors are recognized under the umbrella of BDBH behaviors. However, CV workplaces should clearly define which behaviors fall into the category of uncivil behaviors and acknowledge that there will be serious repercussions for engaging in these behaviors.

An organization must promote a range of components to make a tailor-made system to successfully address BDBH. These components include ongoing evaluation of effectiveness, dedicated resources and funds, strategic planning, and commitment from the leadership of the organization.

“The pervasiveness of BDBH throughout the CV workforce needs to be directly addressed with targeted and consistent efforts,” the statement authors wrote. “Effective enforcement requires deliberating and addressing toxic behaviors and actions with institutional transparency, independent scrutiny, and external accountability. Ultimately, we must instill a sense of belonging for all members of the CV workforce. Only then can we ensure freedom from BDBH.”

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Douglas PS, Mack MJ, Acosta DA, et al. 2022 ACC health policy statement on building respect, civility, and inclusion in the cardiovascular workplace. J Am Coll Cardiol. Published online March 17, 2022. doi:10.1016/j.jacc.2022.03.006