To foster a true sense of inclusion, equal ownership of process must be maintained. All participants must feel their voices are valued. True inclusion must entail empowerment and equitable ownership of goals, outcomes and the process between.
Best practices to foster inclusion and belonging in institutions may vary depending on population, environment or service factors. Below are a few guidelines that might be helpful:
An inviting attitude
Being disrespected or judged because of one’s difference is the biggest cause of exclusion, whether the exclusion is institutional, societal or self-imposed. Cultural Competence in healthcare could be enhanced greatly if staff and leadership maintain the right attitude. This includes awareness of entrenched institutional cultural biases, and openness to learning about their effects on diverse populations and the need for a sustainable change.
Having an inviting attitude must be a common practice, congruent in staff behavior across the institution. An inviting attitude begins with the understanding that there is no universal design, culture, tradition or way of doing anything. It is marked by respect and listening for possibilities and innovation. It involves staying engaged with diverse communities and keeping a balance between what we know and what is new.
Identifying and removing barriers
There are three kinds of barriers that impede meaningful participation and access: 1) Physical obstacles; 2) Institutional practices, processes and policies that over-reward members of certain populations while neglecting others and 3) Perceived barriers that are due to lack of trust from strained historic relationships between cultures.
Truly engaging communities requires the removal of all barriers. A proportionate involvement by leadership is required to support the involvement of front line and direct service providers. Physical structures and the general environment must be inviting. Practices must be inclusive in order to respond and reach out broadly. Finally, trust must be built in order to eliminate perceived barriers.
Formalizing partnership with traditionally excluded communities
Proactive and formalized engagement can allow community members to be acquainted with programs, jobs, services and processes of our health institutions. This knowledge is key to make informed choices and take steps towards self-inclusion. While working with communities, setting clear and transparent goals and objectives is important. It should be clear enough to show an intention to go beyond the mundane “inviting to participate”. Clear objectives may include, but not limited to: enhancing volunteerism in the institution, creating a system for partnership, communal fundraising, building capacity to increase communities’ understanding of the institution, building trust by increasing cultural interactions, seeking learning and teaching opportunities to increase mutual interest in each other.
In formalizing partnerships, it is crucial to understand the connection between institutional strategies created behind closed doors and the level of challenges faced by communities in their efforts to understand those strategies and the processes they involve. Generally, some communities will require more infrastructural support to build a partnership that holds a balance between their needs to be served and the institutions need to strategize. Clear and trusting communication can enhance understanding of this fact.
Enhancing integration of new members in the workforce
Enhancing integration may require revisiting institutional traditions and structures. It is of vital importance to name and replace obsolete long standing operational norms that no longer work, with emerging equitable opportunities. Active support of integration maximizes productivity and shortens the time it takes for in-coming people to feel a sense belonging. It may need creative approaches and, occasionally, more time and a little more cost, but always translates into better productivity, trust and inclusion. The results have far reaching positive implications for society.
A broad concept of ‘transition support’, a process to facilitate smooth and comfortable entrance and eventual sense of belonging for the new or challenged group member, could replace or compliment “orientation”.
 Adopted with changes from: Patricia Dyjur; Inclusive Practices in Instructional Design; http://www.usask.ca/education/coursework/802papers/dyjur/index.htm
 (McAllister, 2002), as cited by Patricia Dyjur; Inclusive Practices in Instructional Design; http://www.usask.ca/education/coursework/802papers/dyjur/index.htm