Diversity is strength of Dubai hospitals, study shows

A survey by 66 hospital wards in Dubai showed that a 'moderate degree' of diversity was good.

Left, Ahmad Sabbah, a nurse manager, and Jose Salmon, a critical care specialist, in Rashid Hospital in Dubai. The study found that diversity is a positive in the workplace. Alex Atack for The National.
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DUBAI // The staffing in Dubai hospitals is typical of many workplaces in the country, with many nationalities, faiths and languages spoken.

Now the secret to that diversity – and the strengths and challenges that it brings – is set out in a study.

Focused on healthcare, the study used data about the proportion of medical personnel in hospital teams in Dubai that were Muslim or non-Muslim, Emirati or non-Emirati.

The conclusion? Diversity is undoubtedly good, but at high levels it can raise challenges that need to be managed.

To understand how these ­potential influences played out, surveys were completed by 66 hospital wards, 49 of them medical wards and the other 17 surgical wards, at Dubai Hospital, Latifa Hospital and Rashid Hospital, home to one of the country’s largest trauma wards.

One of the researchers, Dr Carmela Di Mauro, an associate professor in business engineering at the University of Catania in Italy, said that a “moderate degree” of diversity was found to be good, but that the data indicated that “things become more difficult” as it continues to increase, up to the maximum diversity of 50 per cent of one group and 50 per cent of another.

“The reason why intuitively this high degree of diversity doesn’t work, is because these two groups might become confrontational if two equal size sub-groups form within the team. It’s not beneficial to performance or decision-making,” Dr Di Mauro said.

That said, Dr Di Mauro explained that it is equally beneficial to have a team made up of one group – say group A – constituting 25 per cent, with the other – group B – constituting fully 75 per cent, or vice versa.

“In both cases, the addition of new cultural values, mindsets and points of view contributes to more effective decision-making.”

The authors of the study said an individual’s religion or nationality could affect their attitude to work-related issues such as the role that gender plays, in that it can influence how individuals behave or what they wear, especially in relation to religious festivals.

It can also underpin important values, such as the extent to which they hold a work ethic. In medicine it may also correlate with differences in training and clinical practice.

The aim of the surveys was to discover the relationship ­between religious and cultural diversity and efficiency.

A ward’s efficiency was calculated using three inputs (the number of beds, doctors and nurses) and three outputs (the number of inpatient surgery discharges, inpatient non-surgery discharges and outpatients). From these a mathematical model produced a numeric value for efficiency.

Also from the surveys, a numeric value for religious diversity and for diversity in nationality was computed, before a regression analysis – a statistical method for determining the relationship between two variables – was carried out.

The relationship between the hospital teams’ religious diversity and their efficiency, when plotted on a graph, produced an inverted U-shape. This means that team efficiency was relatively low when diversity was low, but grew as diversity increased, peaking at a medium level of religious ­diversity, before falling as diversity continued to rise.

This finding tied in, Dr Di Mauro said, with work carried out in other employment sectors.

The effect tended to be stronger for surgical than for non-surgical teams, probably because the surgical teams carry out more complex tasks.

“The recommendation we give in the article is if you can avoid having that kind of diversity of creating two sub-groups who may become confrontational inside the team, avoid it. It’s a recommendation for hospital managers or medical speciality managers,” she said.

“Sometimes it cannot be avoided. In that case the way is conflict management; you have to be a very good conflict manager to mitigate the negative ­effects of that.”

Entitled, Does Religious Diversity in Health Team Composition Affect Efficiency? Evidence from Dubai, the study was published in the British Journal of Management.

Another of the authors was Dr Ali Ayach, a research fellow at the University of Rome Tor Vergata in Italy, who until 2014 worked for Dubai Health Authority as a consulting manager.

The other authors were Dr Alessandro Ancarani, Dr ­Simone Gitto and Dr Paolo Mancuso, all affiliated to the University of Catania or the University of Rome Tor Vergata.

Dr Ayach, who has since left DHA and now works in the private sector, said the message from the research was that healthcare managers should not look only to technology to improve efficiency, but should adopt a “people-centred” ­approach.

“Furthermore, a proper standardisation of the medical practice is crucial in this case; such a standardisation may be reached through the introduction of new policies,” he said.

Although the research found challenges associated with high diversity levels, Dr Di Mauro said that the study was not ­arguing against having a diverse workplace.

“What we try to argue is that multiculturalism is good, but you have to manage it; you cannot let it go freely because you might run into problems. But, in principle, it’s a great thing,” she said.