Clinical Scorecard: Advancing Equity, Diversity, and Inclusion in Intensive Care: A Position Statement from the European Society of Intensive Care Medicine

At a Glance

Key Highlights

• Diversity includes gender, ethnicity, language, culture, age, educational attainment, religious belief, socioeconomic status, disability, and sexual orientation and gender identity.
• The statement distinguishes equity from equality: equity accounts for differing needs and barriers to support fair access and opportunity.
• Social determinants, including ethnicity, gender, language barriers, and socioeconomic status, continue to influence access to and quality of care.
• Inclusive teams require psychological safety, active listening, equitable participation, transparent selection processes, and leadership commitment.
• Implicit bias, resistance to change, limited resources, and inconsistent data collection are identified as barriers to EDI implementation.

Guideline-Based Recommendations

Diagnosis

• Collect data to identify disparities and support evaluation of EDI initiatives.
• Use measurable indicators to assess team diversity and climate.

Management

• Provide equitable access to training, professional development, support, and career opportunities, addressing structural barriers.
• Use structured mentorship, transparent recruitment and selection procedures, and equitable committee participation.
• Promote inclusive leadership training, open discussion, psychological safety, and active listening to underrepresented groups.
• Support inclusive clinical research with minority-group representation.

Monitoring & Follow-up

• Use measurable indicators to assess team diversity and climate.
• Systematically evaluate EDI initiatives; the statement notes that comprehensive data collection is necessary and that inconsistent data collection makes evaluation challenging.

Risks

• Disparities may persist in workforce representation, access to opportunities, patient access to care, and patient outcomes.
• Cultural resistance, enduring stereotypes, constrained resources, and insufficient tracking tools can impede EDI implementation.
• Underrepresentation in clinical research can restrict the applicability and generalizability of findings.

Patient & Prescribing Data

Patients receiving intensive care, including people with differing ethnic, gender, age, socioeconomic, language, and disability-related characteristics.

The statement calls for access to appropriate, high-quality care based on individual clinical needs, without restriction based on personal characteristics, while maintaining a focus on comparable outcomes. It provides no medication-specific prescribing data.

Clinical Best Practices

• Consider individual patient needs and barriers when supporting fair access to intensive care.
• Respect cultural differences and support communication with patients and families to promote patient-centred care.
• Embed inclusion in everyday practice so team members feel valued, respected, and empowered to participate.
• Ensure events are accessible and broaden representation among speakers and leadership.
• Support initiatives for ICU professionals’ psychological health and work-life balance; the statement reports these have shown promise for job satisfaction and well-being.

Related Resources & Content