In a focused effort to collect accurate, reliable data on race, ethnicity and language preference, or REaL data, for patients across its regional service area, Cone Health created an e-learning tool for its registration staff that emphasizes asking rather than assuming the answers to those questions.
Designed by the system’s Physician Council for Health Equity and its Office of Inclusion and Health Equity, the scenario and role-playing e-learning tool was disseminated in 2015 to staff in inpatient, outpatient, emergency, ambulatory care and phone-registration areas, with the dual goals of improving care quality and reducing health disparities among patients in the Greensboro, N.C.-based system. Those goals have been reached — and exceeded. As a result, Cone Health garners honorable mention in the American Hospital Association's 2017 Equity of Care Award for its work in reducing health disparities among its patients.
The updated REaL data, in which a significant percentage of patients registered as more than one race, helped the system to determine that it had a 52 percent minority patient base, and that 41 percent of those minorities were African-American. The Cone Health Cancer Center then launched an initiative to reduce treatment completion disparities for African-American patients diagnosed with early stage breast or lung cancer.
Four interventions have since erased those disparities: creating a real-time registry that issues automated alerts for missed appointments and unmet care milestones; tracking race-specific data on treatment adherence; employing a nurse navigator trained in culturally appropriate communication; and holding quarterly staff education sessions on unconscious health bias, gatekeeping and other contributors to treatment inequities. As a result, the share of patients who completed cancer treatment went from 64 to 96 percent among African-American patients, and from 76 to 96 percent among white patients.
“We are proud of our cancer center’s results in reducing, and in one case eliminating, racial disparity that existed between African-American and white lung-cancer patients — and to bring all patients to the same level of treatment completion,” says Laura Vail, director of the Office of Inclusion and Health Equity. “We’ve worked on other specific disparities over the past year and are seeing significant health equity gains.”
That continued dedication is embodied in Cone Health’s five employee network groups, which meet regularly to devise internal strategies to improve cultural competence for staff and create strategies to partner with the community at large. The groups include the Black and African-American Health Network Group, which offers internal services ranging from health screenings to spiritual support and community services such as health fairs at churches; Women Inspiring Women, which addresses professional development, heart disease, nutrition and gender bias for employees and community members; VetNet, which provides fellowship opportunities for military veterans and raises staff awareness about health disparities among veterans; the Caregivers Group, which offers support to employees who care for parents, spouses or children with special needs; and the LGBT Employee Network Group, which has led Cone Health to Leader status on the Human Rights Campaign’s Health Equity Index for the last four years.
“These groups make the community connection,” Vail says. “They help us think differently and build bridges.” She recounts a meeting of the LGBT employee group to which members of the transgender community were invited to participate in a panel discussion. When they said they didn’t believe they could access local primary care, several physicians in attendance stepped forward and offered their services, “and we closed that gap,” Vail says.
Vail says a particularly memorable moment occurred at a Cone Health event last September, where CEO Terry Akin apologized on behalf of Cone Health and honored Alvin Blount, M.D., the last living physician involved in the landmark 1962 case Simkins v. Moses H. Cone Memorial Hospital, which led to national desegregation of all hospitals that accepted Hill-Burton Act funds. “For our leaders to do that, to stand up and say, ‘We want to make this right,’ it created a new level of trust in our community,” Vail says.
The American Hospital Association's Equity of Care Award is presented annually to hospitals or care systems that are noteworthy leaders and examples to the field in the area of equitable care. Honorees demonstrate a high level of success in reducing health care disparities and promote diversity in leadership and staff within their organizations.
The goals of this award are:
- Recognize outstanding efforts among hospitals and care systems to advance equity of care to all patients.
- Accelerate progress of the National Call to Action to Eliminate Health Care Disparities and its stated goals and milestones.
- Spread lessons learned and progress toward health care equity and the promotion of diversity.