A quality improvement initiative to strengthen equity, diversity and inclusion and anti-racism considerations in the IDEA Framework

Trillium Health Partners' (THP's) Regional Ethics Program led a quality improvement project to explicitly address equity, diversity, and inclusion and anti-racism and anti-oppression in its IDEA: Ethical Decision-Making Framework. Various groups, encompassing diverse backgrounds and lived experiences, completed a short survey including demographic and open-ended questions. Survey responses revealed gaps within the IDEA Framework and recommendations for modifications (e.g., editing language to be more accessible and inclusive, placing a greater focus on lived experience). Several themes emerged including explicitness, simplification, and continued learning. This work is of particular interest to health leaders as it aims to expose where bias, power, and privilege exist when addressing ethical dilemmas within healthcare systems. It explicitly addresses implicit bias, discrimination and harassment, reflexivity in care, as well as re-defines and re-imagines ethical principles (e.g., accountability, diversity, inclusivity, justice, relationships, and trust).