Accelerating Results: A Framework for Implementing Equity

Pt. 1  

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WE AREWe are an integrated cultural & diversity consulting, language and training company.

We are a team of experts serving healthcare providers and health-related companies across the United States.

We are a woman and minority owned business. We are passionately dedicated to helping you create a deliberate and effective infrastructure for understanding in your organization.

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Learning Objectives: • Understand the resources needed to operationalize equity• How to develop an action plan to implement equitable care

within their organizations. • Learn to develop a Framework for implementing equity

• Identifying the Framework • Purpose of the Framework• Guiding Principles• Framework Domains and Subdomains

• Preferred Practices for Measuring and Reporting Equity

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Agenda PT. 1 

Discussion of health equity and health disparity and your goals for improvement 

The framework for planning 

#123 for Equity 

Developing an Action Plan and sharing best practices

Wrap up Part 1

15 minute break.

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What is Health Equity? Equity means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives. To achieve health equity, we must treat everyone equally and eliminate health status inequities and avoidable health care disparities.

Health inequities are differences in health outcomes that are avoidable, unfair, and unjust.

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What is Health Disparity? Health disparities are differences application of health care treatment among groups of people.

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WHAT ARE THE TOP 3 FACTORS AFFECTING HEALTH EQUITY 

ACHEIVEMENT?

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WHAT ARE THE TOP 3 BARRIERS PREVENTING HEALTH EQUITY?

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What is the Value of a Framework?

Training:Imparting Facts, Knowledge, and Empowerment

Action Plan

Governance:Diversity and Opportunity from Board Room to Mail Room

Training:Imparting Facts, Knowledge and Empowerment

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PURPOSE OF THE PLEDGE

Take the Pledge to Act to Eliminate Health Care Disparities. Universal and rapid progress in ensuring that every patient receives the highest quality of care is essential to our efforts to meet the changing needs of our communities. As our nation makes the demographic shift toward aminority‐majority ratio, the need to identify and address disparities in care is increasing. The need to increase diversity in hospital leadership and governance is a viable tactic. However, our consensus about the need to address these issues is not currently matched by a level and 

pace of action that will ensure success.

#123forEquity Pledge to Act 

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#123forEquity Pledge to Act 

By the end of month six, provide cultural competency training for all staff or develop a plan to ensure your staff receives cultural competency training.

By the end of month nine, have a dialogue with your board and leadership team on how you reflect the community you serve, and what actions can be taken to address any gaps if the board and leadership do not reflect the community you serve.

By the end of month one (from the date of your start), choose a quality measure to stratify by race, ethnicity or language preference or other socio demographic variables (such as income, disability status, veteran status, sexual orientation and gender, or other) that are important to your community’s health. Quality measures to stratify could include readmissions or other core measures.

By the end of month three, determine if a health care disparity exists in this quality measure. If yes, design a plan to address this gap.

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The collection and use of patient demographic data is an important buildingblock to identify areas of strength and opportunities for improvement in providing thehighest quality of care for all patients.

■Overall, hospitals are actively collecting patient demographic data,including race (97%); ethnicity (94%); and primary language (95%).

■22% of hospitals have utilized data to identifydisparities in treatment and/or outcomes betweenracial or ethnic groups to analyze (one or more ofthe following): clinical quality indicators,readmissions or CMS core measures. This is anincrease from 20% in 2011.

Summary Finding on Collection and Use of Data

Source: Institute for Diversity in Health Management, Health Research Education Trust

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More than 100 million people in the United States are considered minorities.

Hispanics and Latinos comprise the largest ethnic minority group with 14.8% of the entire population

African Americans comprise the largest racial minority group with 12% of the entire population

47 Million people in the United States speak a language other than English as their primary language

Sources: U.S. Census Bureau, 2012; Selig Center for Economic Growth, 2009.

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Developing Your Action Plan:  Collection and Use of Data 

Do you systematically collect race, ethnicity and language preference from all your patients? How?

Do you use REAL data to look for variations in clinical outcomes, resource utilization, length of stay and frequency of readmissions within your hospital? How?

Do you compare patient satisfaction ratings among diverse groups and act on the information? How?

Do you actively use REAL data for strategic and outreach planning? How?

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WHY IS THIS EFFECTIVE? 

HOW COULD IT BE IMPROVED?

WHAT ARE BEST PRACTICES YOU CAN RECOMMEND?

Group Discussion

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WHAT IS YOU’RE AH HA SO FAR?

WHAT HAS BEEN ADDED TO YOUR TO DO LIST? 

Break 

Accelerating Results: A Framework for Implementing Equity

Pt. 2  

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Agenda PT. 2 

Welcome Back

Review of AHA goals

Key principles in putting together an action plan

Action planning and sharing best practices

Discover key resources found in handbook

Wrap Up

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VIDEO

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PUTTING TOGETHER AN ACTION PLAN 

WHAT ARE PRINCIPLES GUIDING YOUR PLANS?

WHO IS INVOLVED IN YOUR PLANNING?

WHAT RESOURCES ARE YOU USING? WHAT RESOURCES ARE YOU LACKING?

WHAT AND HOW ARE YOU MEASURING RESULTS?

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Goals and Milestones (2013‐2020)   Goal 1 – Increasing collection and use of race,   ethnicity and language (REAL) preference data:

• 2011 – 20 percent (baseline)

• 2015 – 25 percent

• 2017 – 50 percent

• 2020 – 75 percent

Source: American Hospital Association

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Best Practice: Race, Ethnicity and Language Preference Data•Develop consistent processes to collect REAL data

oAsk patients to self‐report their informationoTrain staff (using scripts) to have appropriate discussions 

regarding patients’ cultural and language preferences during the registration process

•Use quality measures to generate data reports stratified by REAL  group to examine disparities. Use REAL data to: 

oDevelop targeted interventions to improve quality of care (scorecards, equity dashboards)

oHelp create the case for building access to services in underserved communities

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Goals and Milestones (2013‐2020)   

Goal 2 – Increasing cultural competency training:

• 2011 – 81 percent (baseline)

• 2015 – 90 percent

• 2017 – 95 percent

• 2020 – 100 percent

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ractice: Cultural Competency Training for ved Patient Care

Educate all clinical staff during orientation about how to address the unique cultural and linguistic factors affecting the care of diverse patients and communitiesRequire all employees to attend diversity trainingProvide culturally and linguistically appropriate services such as:oQualified Interpreters and TranslatorsoBilingual staffoCommunity health educatorsoMultilingual signage

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als and Milestones (2013‐2020)   oal 3 ‐ Increasing diversity in governance and leadership:

• 2011 ‐ Governance 14 percent / Leadership 11 percent (baseline)

• 2015 ‐ Governance 16 percent / Leadership 13 percent (or reflective of community)

• 2017 ‐ Governance 18 percent / Leadership 15 percent (or reflective of community) 

• 2020 ‐ Governance 20 percent / Leadership 17 percent (or reflective of community)

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Practice: Increased Diversity in Governance

Actively work to diversify your board to include voices and perspectives that reflect your communityIncorporate specific goals into the board work plan with accountability for goalsEngage the broader public through community‐based activities and programsConsider creating a community‐based diversity advisory committee

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Practice: Increased Diversity in Leadership

Regularly report on the ethnic and racial makeup of senior leadersSupport and assist the development of mentoring programs within health care organizationsAt every opportunity, advocate the goal of achieving full representation of diverse individuals at entry, middle and senior levelsAdvocate diversity in appointing job search committee members and promote a diverse slate of candidates for senior management positions.

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ACTION PLAN: CULTURAL COMPETENCY

Have your clinicians, patient representatives, social workers, discharge planners, financial counselors and other key patient and family caregivers received special training in diversity issues?  How?

Has your hospital developed a “language resource” to identify qualified people, inside and outside your organization, who could help your staff communicate with patients and families from a wide variety of nationalities and ethnic backgrounds? How?

Are written communications with patients and families available in a variety of languages that reflect the diversity of your community?  How?

Do you educate all clinical staff during orientation and at least annually about how to address unique cultural and linguistic factors affecting the care of diverse patients and communities?  How?

Do you have policies in place that are communicated and enforced requiring qualified interpreters be made available to all patients?  How?

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WHY IS THIS EFFECTIVE? 

HOW COULD IT BE IMPROVED?

WHAT ARE BEST PRACTICES YOU CAN RECOMMEND?

Group Discussion

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Q1: Does your organization have a plan to diversify your Board that is reflective of your community? How?

Q2: Do you incorporate specific goals into the Board work plan with accountability for goals? How?

Q3: Do you engage the broader public through community-based activities and programs? How?

Q4: Do you utilize a community-based diversity advisory committee? How?

eloping Your Action Plan: ernance and Leadership

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REVIEW WITH STAKEHOLDERS

COMPLETE YOUR PLAN

REVIEW OTHER RESOURCES FOR BEST PRACTICES 

NEXT STEP

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WHAT ACTIONS WILL YOU TAKE WHEN YOU RETURN TO YOUR OFFICE? 

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THANK YOU