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Culture Inclusion & Equity Action Collaborative

Advancing a culture of health equity and engagement that places the needs of people and communities at its core

As one of four action collaboratives under the National Academy of Medicine’s Leadership Consortium, the Culture Inclusion & Equity Action Collaborative (CIEAC) promotes equitable and evidence-based health care practices; implements strategies to ensure patient, family, and community engagement in health and health care decisions; and identifies the sociocultural conditions both inside and outside the health system that best meet individual needs.

A healthy life is influenced by a range of factors, and by some estimates health care only makes up for 10 to 20 percent of them. The other 80 percent or more include social and cultural factors such as education, race and gender, and the condition of the community a patient lives in. The CIEAC works to identify the cultural contexts that best facilitate a healthy life for individuals and the social structures that create highly engaged and resilient communities.

Strategic Framework  Winter 2020 Update  | Winter 2019 Update Summer 2018 Update

Mary Naylor (Co-Chair)

Mary D. Naylor (Co-Chair)

Sandra R. Hernández (Co-Chair)

Sandra R. Hernández (Co-Chair)

Action Collaborative Description

CIEAC catalyzes joint activities to drive health care culture in three main areas:

ܱٳܰ:Collaborative activities to ensure that the next generation of clinicians provides care that reflects patients’ preferences and values, care teams work collaboratively and in concert with patients, and health care leadership fosters the creation of a culture of care that is seamless, team-driven, and that continuously learns.

Evidence: The ability to make informed decisions requires targeted incentives and timely delivery of scientifically validated evidence at the point of decision in a format that best meets the needs of patients and family caregivers. To that end, learning health systems engage patients, families, and communities in the capture and use of information on their health and health care experiences to generate evidence and accelerate knowledge about the most effective and efficient care practices.

Բ𳾱Գ:The growth in awareness and opportunity for patients and families to be more engaged in their own care, as well as in the design and delivery of care at the organizational and policy levels, means it is critical to engage all health care stakeholders and accelerates the need to deepen the involvement of patients and family leadership in improving knowledge generation and value in health care, developing a culture of effective stakeholder collaboration, and the consistent, meaningful, and increasing engagement of patients, families, and communities in the design and delivery of health care in addition to personal engagement in their own health care decision-making.

This activity blends the expertise of professional organizations representing clinicians on the front lines of health care delivery, patient- and family-focused organizations, decision science practitioners, and government agencies actively involved in patient care or programs and policies centrally concerned with the identification and application of best clinical services. These professional and citizen leaders work collaboratively with individuals with relevant expertise from organizations with active, public, and patient-oriented health efforts. The aim is for an inclusive Collaborative – without walls – and participation in individual projects is structured according to interest, need, and practicality. As such, CIEAC seeks to include a wide variety of stakeholder voices to further cultural change and patient and family engagement, including but not limited to:


    • Aging organizations
    • Business and industry groups
    • Child and maternal health organizations
    • Clinician and other professional organizations
    • Community organizations
    • Decision science experts
    • Government agencies
    • Health and health care equity and disparities experts
    • Health IT organizations
    • Hospital and health system leaders
    • Patient and family organizations
    • Patient and family advisory council and thought leaders
    • Pediatric organizations
    • Payers and insurance organizations
    • Public health organizations
    • Purchaser and employer organizations
    • Researchers
    • Women’s health organizations
  • Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care. An NAM Perspective written under the auspices of CIAC that identifies the evidence-based elements to guide culture change in hospitals and health systems to drive patient and family engaged care for transformative health change.
  • Effective Care for High-Need Patients: Opportunities for Improving Outcomes, Value, and Health. Sponsored by the Peterson Center on Healthcare, this NAM Special Publication explores the successful spread and scale of models targeted to complex patients.
  • Optimizing Strategies for Clinical Decision Support: Summary of a Meeting Series. The result of a collaboration between the NAM and the Office of the National Coordinator for Health Information Technology, this NAM Special Publication summarizes and builds upon a meeting series in which a multi-stakeholder group of experts discussed the potential of clinical decision support (CDS) to transform care and includes highlights from discussions to address the barriers to realizing the full benefits of CDS-facilitated value improvement.
  • Patient and Family Health Care Leadership: A Resource Compendium. Development of this Resource Compendium was made possible through the generous support of the  and was conducted through the work of participants in the Patient & Family Leadership Network under the auspices of the CIAC.
  • . This paper provides insight into how to include patients as members of the health care team in order to effectively deliver team-based care, gleaned from semi-structured interviews with patients receiving such care. The discussion paper building upon previous work regarding the core principles of team-based care in order to help achieve the three-part aim of providing quality care and better health at lower cost.
  • . There is growing evidence that shared decision-making yields better outcomes and improves patients’ care experience. This discussion paper presents perspectives and progress in our understanding of what patients want in communication and decision support, and suggests catalysts to ensure that shared decision-making becomes a more routine aspect of care.
  • . An NAM survey indicates that nine in 10 American adults believe that their health-related data should be used to improve the care of other patients. This discussion paper explores how people value and understand health-related data sharing in a variety of contexts.
  • . An NAM Perspectives discussion paper in which authors identify key characteristics of effective teams from the literature and uses interviews with 11 teams located in various urban and rural settings to clarify how these factors shape effective team-based care. The review is intended to help guide clinicians, patients, administrators, and other stakeholders in the delivery of high-value, team-based care focused on the goals and priorities of patients and their families.

In-person attendance at meetings is by invitation only due to room capacity limitations. All meetings are available by webcast, and information on joining the webcast is available on the meeting event page as the meeting approaches.

Past Public Meetings:

Featured Activities

Guided by a committee of national and community leaders that reflect diverse backgrounds and perspectives, the Assessing Community Engagement project aims to provide community-engaged, effective, and evidence-based tools to those who want to measure engagement to ensure that it is meaningful and impactful, with a special emphasis on ensuring equity as a critical input and outcome. 

For more information, contact LeadershipConsortium@nas.edu

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