NSG 508 Week 5 Evidence-Based DEI Practices

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University of Phoenix

NSG/508 Theoretical Foundations of Advanced Nursing Practice

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Date

Evidence-Based Diversity, Equity, and Inclusion (DEI) Practices

Cancer care becomes more equitable and effective when healthcare organizations implement standardized screening for social determinants of health (SDOH) alongside culturally responsive oncology navigation. This evidence-based strategy helps identify barriers to treatment, improves access to supportive resources, reduces healthcare disparities, and promotes better patient outcomes. Guided by the Iowa Model of Evidence-Based Practice, this strategic plan outlines how oncology advanced practice nurses (APNs) can lead the implementation of sustainable DEI initiatives through leadership, collaboration, communication, and continuous evaluation.

Understanding the Importance of DEI in Oncology Care

Delivering high-quality oncology care requires more than clinical expertise. Patients with cancer often experience physical, emotional, financial, and social challenges that directly affect treatment adherence and outcomes. These challenges are frequently influenced by social determinants such as:

Race and ethnicity
Language barriers
Socioeconomic status
Geographic location
Health literacy
Transportation access
Food insecurity
Financial hardship

When these barriers remain unaddressed, they contribute to significant disparities in cancer diagnosis, treatment completion, survival, and overall quality of life.

Embedding diversity, equity, and inclusion (DEI) into oncology practice ensures that every patient receives individualized, culturally responsive care regardless of background or circumstances.

Evidence-Based Practice Change to Promote Health Equity

The proposed evidence-based practice (EBP) change involves implementing standardized SDOH screening for every oncology patient during routine clinical encounters and connecting identified patients with culturally responsive oncology navigation services.

Research demonstrates that unmet social needs—including transportation challenges, financial toxicity, language barriers, and limited access to community resources—can negatively influence cancer treatment adherence and survival. Standardized screening enables healthcare teams to identify these barriers early and provide appropriate referrals before they disrupt care.

Rather than relying on inconsistent referral practices or assumptions about patients’ needs, this approach creates a structured process that supports equitable, patient-centered oncology care.

Why the Iowa Model Is the Best Framework for Implementation

The Iowa Model of Evidence-Based Practice provides a structured yet flexible framework for implementing clinical improvements in complex healthcare settings.

The model supports implementation by:

Identifying priority clinical problems
Reviewing current evidence
Engaging interdisciplinary stakeholders
Testing interventions through pilot projects
Evaluating measurable outcomes
Integrating successful practices into routine care

Its continuous evaluation cycle makes it particularly effective for DEI initiatives because organizations can regularly assess outcomes, identify gaps, and refine interventions to improve equity.

Leadership Competencies Required for Successful Implementation

Oncology advanced practice nurses play a central leadership role in advancing equitable cancer care. Successful implementation requires several core leadership competencies.

Transformational Leadership

Transformational leaders inspire shared commitment, encourage innovation, and foster organizational cultures that prioritize inclusion and equity.

Cultural Humility

Healthcare leaders must continually recognize personal biases, respect diverse cultural perspectives, and encourage culturally responsive decision-making throughout the organization.

Change Management

Implementing new workflows often creates uncertainty. Effective change management helps staff adapt, reduces resistance, and encourages long-term adoption of new practices.

Data Literacy

Leaders must be able to interpret SDOH data, monitor equity-related outcomes, and use evidence to guide quality improvement initiatives.

Advocacy

Oncology APNs advocate for vulnerable populations by using clinical evidence to influence organizational policies, allocate resources, and improve access to equitable cancer care.

Resources Needed to Support Implementation

Successful implementation requires coordinated investments in technology, workforce development, education, and community partnerships.

Technology Resources

Technology supports standardized documentation and ongoing evaluation through:

Electronic health record (EHR) integration for SDOH screening
Automated referral systems
Clinical dashboards
Equity performance reporting

Human Resources

Effective implementation depends on interdisciplinary support from:

Oncology nurse navigators
Social workers
Community health workers
Medical interpreters
Financial counselors
Case managers

Educational Resources

Staff education should include:

Social determinants of health screening
Cultural competency and cultural humility
Implicit bias awareness
Trauma-informed communication
Patient-centered care

Financial Resources

Funding may be required for:

Oncology navigation programs
Workforce education
Technology enhancements
Community partnerships

Although implementation requires investment, addressing social determinants of health can reduce emergency department utilization, improve treatment adherence, and lower long-term healthcare costs.

The Role of Interprofessional Collaboration

Reducing cancer disparities requires collaboration across multiple healthcare disciplines.

Successful implementation involves coordinated efforts among:

Oncology physicians
Advanced practice nurses
Bedside nurses
Social workers
Pharmacists
Financial counselors
Case managers
Informatics specialists
Community organizations

Community partners—including transportation providers, food assistance programs, housing agencies, and patient advocacy organizations—extend support beyond the healthcare setting, ensuring identified social needs receive practical solutions rather than referrals alone.

Strong interdisciplinary collaboration improves care coordination while reinforcing organizational commitment to health equity.

Communication Strategies That Support DEI Implementation

Transparent communication strengthens staff engagement and patient trust throughout implementation.

Internal communication should explain:

The purpose of standardized SDOH screening
Expected patient benefits
Organizational DEI goals
Staff responsibilities
Progress toward implementation milestones

Regular communication through staff meetings, quality dashboards, and interdisciplinary huddles allows teams to share successes, identify challenges, and recommend improvements.

Patient communication should emphasize confidentiality, respect, and the purpose of screening to build trust, especially among historically underserved populations.

Strategies for Sustaining Evidence-Based DEI Practices

Long-term sustainability requires integrating DEI practices into routine oncology operations rather than treating them as temporary initiatives.

Key sustainability strategies include:

Embedding SDOH screening into standard clinical workflows
Including DEI education in employee orientation
Providing ongoing continuing education
Monitoring equity-focused performance indicators
Conducting regular quality improvement reviews
Aligning DEI initiatives with organizational strategic goals

Continuous leadership support and measurable improvements in patient outcomes help maintain organizational commitment over time.

Measuring Organizational and Cultural Change

Evaluation should combine quantitative performance indicators with qualitative feedback to determine the effectiveness of implementation.

Quantitative Measures

Key metrics include:

SDOH screening completion rates
Referral completion rates
Treatment adherence
Missed appointment frequency
Hospital readmissions
Emergency department utilization
Outcome disparities across demographic groups

Qualitative Measures

Qualitative evaluation provides insight into organizational culture and patient experience through:

Patient satisfaction surveys
Staff feedback
Employee engagement surveys
DEI climate assessments
Focus groups

Continuous analysis of these measures supports evidence-based improvements and helps organizations sustain equitable oncology care.

Benefits of Standardized SDOH Screening in Oncology

Implementing standardized SDOH screening and culturally responsive care navigation can produce measurable improvements across healthcare organizations.

Expected outcomes include:

Reduced cancer care disparities
Improved treatment adherence
Earlier identification of social barriers
Better patient satisfaction
Enhanced care coordination
Increased health equity
Stronger organizational commitment to DEI
Improved quality of life for patients with cancer

Standardized SDOH screening improves equity in oncology care.

Routine screening identifies transportation, financial, language, and social barriers that may interfere with cancer treatment. Early identification allows healthcare teams to connect patients with appropriate resources, improving treatment adherence and reducing disparities.

The Iowa Model supports successful implementation of DEI initiatives.

Its structured process encourages stakeholder engagement, evidence evaluation, pilot testing, continuous quality improvement, and sustainable integration into clinical practice.

Oncology advanced practice nurses are key leaders in advancing health equity.

Through transformational leadership, cultural humility, advocacy, interdisciplinary collaboration, and data-driven decision-making, APNs help create inclusive oncology environments that improve patient outcomes.

Frequently Asked Questions

What are social determinants of health (SDOH) in oncology?

Social determinants of health are non-medical factors that influence health outcomes, including income, education, transportation, housing, food access, language, and healthcare accessibility. These factors significantly affect cancer diagnosis, treatment, and survival.

Why is DEI important in oncology care?

DEI promotes equitable access to high-quality cancer care by addressing barriers that disproportionately affect underserved populations. It improves patient experiences, treatment adherence, and health outcomes while reducing disparities.

Why is the Iowa Model appropriate for oncology practice?

The Iowa Model provides a systematic approach for implementing evidence-based practice changes, involving multidisciplinary teams, evaluating outcomes, and sustaining improvements through continuous quality monitoring.

How do oncology nurse navigators improve patient care?

Oncology nurse navigators help patients overcome barriers related to transportation, finances, language, and healthcare navigation. Their support improves care coordination, treatment adherence, and patient satisfaction.

How can healthcare organizations measure the success of DEI initiatives?

Organizations can evaluate DEI initiatives using screening completion rates, referral outcomes, treatment adherence, patient satisfaction, employee engagement, health equity metrics, and organizational culture assessments.

Conclusion

Implementing standardized SDOH screening alongside culturally responsive oncology navigation is an evidence-based strategy for advancing diversity, equity, and inclusion in cancer care. Guided by the Iowa Model of Evidence-Based Practice, this approach enables oncology advanced practice nurses to lead meaningful organizational change through evidence-based leadership, interdisciplinary collaboration, continuous evaluation, and sustainable quality improvement. By addressing the social factors that influence health outcomes, healthcare organizations can reduce disparities, strengthen patient-centered care, and deliver more equitable oncology services.

References

Alcaraz, K. I., Wiedt, T. L., Daniels, E. C., Yabroff, K. R., Guerra, C. E., & Wender, R. C. (2020). Understanding and addressing social determinants to advance cancer health equity in the United States. Cancer Epidemiology, Biomarkers & Prevention, 29(11), 2141–2149. https://doi.org/10.1158/1055-9965.EPI-20-0674

American Nurses Association. (2023). Nursing: Scope and standards of practice (4th ed.). ANA Publishing.

Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., Rakel, B., Steelman, V., Tripp-Reimer, T., & Tucker, S. (2017). Iowa Model of Evidence-Based Practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doi.org/10.1111/wvn.12223