To reduce health care disparities, hospitals should stratify quality measures and care experience by various patient characteristics and address language barriers, thought leaders say in a report on their work as part of an equity group convened by America’s Essential Hospitals.
The association’s Equity Leadership Forum included association staff; experts from member hospitals; and other key stakeholders, including hospital, quality improvement, academic, and government-sponsored organizations. America’s Essential Hospitals has shared the Forum’s findings and recommendations with The Joint Commission.
Using REAL Data
A Forum subcommittee on data use recommended stratifying data by race, ethnicity, and language (REAL), and other patient characteristics, to help health care organizations better identify disparities and improve care quality for diverse populations. The panel made two recommendations:
- Hospitals should stratify clinical quality and patient experience data by race, ethnicity, language, gender, disability status, and socioeconomic status to determine disparities.
- Hospitals should create action plans to reduce disparities found through data stratification.
The subcommittee advised that data should be culled through self-identification, adding that infrastructure for such data collection should be supported in all health care settings. In addition, the panel suggested that hospitals develop locally relevant, culturally appropriate category sets, as well as adopting the Office of Management and Budget’s recommended race, ethnicity, and preferred language categories.
Tackling Language Barriers
Meanwhile, the Forum’s subcommittee on language access recommended aligning with a U.S. Department of Health and Human Services (HHS) plan to shift the legal standard for the type of interpreters a health care organization must provide from “competent” to “qualified” to reduce the risk of medical errors.
In addition, the subcommittee proposed several metrics organizations can follow to improve their language access programs and services:
- identification of participants’ need for language services
- leadership training and/or orientation programs for administrative and clinical leaders
- patient engagement in language access services and translated documents
- stratification of performance data by language to determine disparities
- use of the most appropriate individuals for interpretation