VAC: A Statement on Respect, Civility and Inclusion in the Cardiovascular Workplace

The American College of Cardiology (ACC) Solutions Set Oversight Committee has released a statement on strengthening respect, civility, and inclusion in the cardiovascular (CV) workplace. The statement was published in the Journal of the American College of Cardiology.

Respect and civil behaviors are essential to maintaining a high quality CV workforce and to achieving ACC’s primary goal of improving heart health and transforming CV care.

To achieve this, members of the clinical, educational and research team must ensure respect, civility and inclusion.

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The authors of the statement highlighted the fact that unintended consequences are increasingly common for organizations that do not take bias, discrimination, bullying and harassment (BDBH) seriously. Some of these consequences include out-of-pocket costs when a lawsuit is filed against the organization, negative publicity, and disruption to ongoing day-to-day operations. Overall, implementing appropriate policies to promote civility and inclusion is increasingly critical to maintaining quality CV care.

The authors of the statement highlighted 5 main points for achieving respect, civility and inclusion in the CV workplace:

· Establishment of confidential and fair reporting mechanisms to investigate individuals or departments suspected or accused of BDBH.

· Create institutional resources, such as implicit bias education and training, to ensure that hiring practices and performance reviews are objective.

Adopt metrics to support data collection to track department or institution performance on respect, civility and inclusion and make changes as needed.

· Adopt an independent evaluation of the inclusion and effectiveness of BDBH reduction measures.

· Recognize champions and leaders who promote respect, civility and inclusion.

In 2020, the ACC and AHA reached consensus on the range of civil (excellence, belonging, inclusion, equity, diversity, and respect) and uncivil (disrespect, microaggression, discrimination, bullying, harassment, and violence) behaviors . The authors pointed out that not all of these uncivil behaviors are recognized under the umbrella of BDBH behaviors. However, CV workplaces should clearly define what behaviors fall into the category of uncivil behavior and recognize that there will be serious repercussions for engaging in these behaviors.

An organization must promote a range of components to create a tailored system to successfully address BDBH. These components include ongoing evaluation of effectiveness, dedicated resources and funds, strategic planning, and organizational leadership commitment.

“The pervasiveness of BDBH throughout the CV workforce must be directly addressed with focused and consistent efforts,” the authors of the statement wrote. “Effective enforcement requires deliberating and addressing toxic behaviors and actions with institutional transparency, independent review and external accountability. Ultimately, we must instill a sense of belonging in all members of the CV workforce. Only then can we guarantee the absence of BDBH.

Disclosure: Several authors have declared industry affiliations. Please refer to the original article for a full list of disclosures.


Douglas PS, Mack MJ, Acosta DA, et al. 2022 ACC Health Policy Statement on Strengthening Respect, Civility and Inclusion in the Cardiovascular Workplace. J Am Coll Cardiol. Published online March 17, 2022. doi:10.1016/j.jacc.2022.03.006