There is a business imperative for providing equitable care. The motivating factors are relatively straightforward: the changing demographics of the United States, ever greater attention to high-quality care and regulations, to name a few. Hospitals and care systems that fail to recognize the importance of equity in health care may be left behind.
In 2001, the Institute of Medicine published Crossing the Quality Chasm and listed six aims for improvement. Providing equitable care was included in the aims but listed last. Too often, equitable care has been an afterthought or something separate from the overall work of a hospital. The reality is that providing good care requires strong consideration for eliminating health care disparities and meeting the needs of a hospital's community and patient population.
The National Call to Action to Eliminate Health Care Disparities is a partnership between America's Essential Hospitals (formerly the National Association of Public Hospitals and Health Systems), American College of Healthcare Executives, American Hospital Association, Association of American Medical Colleges and Catholic Health Association of the United States. It was developed on the premise that addressing disparities is no longer just about morality, ethics and social justice; it is vital to performance excellence and improved community health. My role as chair of the AHA's Equity of Care Committee is to make sure hospitals understand that.
A hospital's "business" is treating and healing those in need and caring for the community. We know the following:
• Racial and ethnic minorities currently make up one-third of the U.S. population and will become the majority of the population around 2050, according to U.S. Census Bureau estimates.
• Members of racial and ethnic minorities are more likely to experience medical errors, adverse outcomes, longer lengths of stay and avoidable readmissions. Preventing these poor outcomes will assist with overall quality improvement.
• As payment becomes more dependent on outcomes, it is not financially viable to ignore persistent poor health outcomes in certain patient populations. Providing, and being paid for, the highest quality care can only come about with an elimination of health care disparities.
• All patients deserve not just equal care but care that is individualized to their needs.
The business imperative for equitable care is clear, and the Call to Action partnership is helping to ensure hospitals understand this, too. Although change will not happen overnight, we are working to move the issue along and promote best practices, while raising awareness along the way.
We are beginning to see organizations make the linkage between eliminating disparities in care and providing high-quality care, and we know hospitals will respond. Tools, guides and other resources are available at the Equity of Care website at www.equityofcare.org. The steps are in place to follow, and the Call to Action partners are eager to provide assistance.
Equity of care is the business of all hospitals. To provide the highest quality care, ensure the health of all patient populations and navigate future changes in health care delivery, hospitals and care systems must address the issue of equity — by reducing health care disparities, promoting diversity and focusing on community health.
Richard de Filippi is chair of the AHA Equity of Care Committee, former chair of the AHA Board of Trustees and a trustee at Cambridge (Mass.) Health Alliance Foundation. You can contact him at rdef@ariano.com.
Web Resources
Eliminating care disparities
The Equity of Care guide "Reducing Health Care Disparities: Collection and Use of Race, Ethnicity and Language Data" describes a four-step approach to obtaining an accurate REAL data set. It also discusses how hospitals and care systems can use this data to reduce disparities in health care. This guide is part of a continuing series of resources offered by the partners in the National Call to Action to Eliminate Health Care Disparities to support hospitals and care systems working to provide equitable care. Access the guide at www.equityofcare.org or www.hpoe.org.
Quality webinar series
Two Hospitals in Pursuit of Excellence webinars spotlight the 2013 AHA–McKesson Quest for Quality Prize recipients, honored for achieving the Institute of Medicine's six quality aims: safety, patient-centeredness, effectiveness, efficiency, timeliness and equity. An October "Profiles in Excellence" webinar featured presentations by Franklin Woods Community Hospital, Johnson City, Tenn., and St. Mary's Hospital, Centralia, Ill. The November webinar features Beth Israel Deaconess Medical Center, Boston, and Vidant Medical Center, Greenville, NC. For more information and to download presentations, visit the HPOE website at www.hpoe.org and click on "HPOE Webinars."
Patient and family engagement
Engaging patients and families is critically important to improving care. "A Leadership Resource for Patient and Family Engagement Strategies" provides concrete, practical steps grounded on evidence-based research to improve patient and family engagement in health care organizations. These steps include assessing how well the organization is doing, identifying processes and systems to support patient engagement, ensuring adequate staff training, intervening to overcome specific obstacles and monitoring progress toward achieving patient and family engagement goals. The guide is available at www.hpoe.org/patient-family-engagement.
