VITAL2019, America’s Essential Hospitals’ annual conference, covered a wide variety of topics important to essential hospital leaders. In this blog series, we’ll highlight key takeaways from popular sessions at the conference.
“What policy levers are in place to advance equity and reduce disparities?”
Essential hospital leaders from the California Association of Public Hospitals and Health Systems (CAPH) posed this important question during an interactive discussion at VITAL2019. Joined by leaders from Contra Costa Health Services, in Martinez, Calif., and UC San Diego Health, in San Diego, they shared how 12 of 17 CAPH hospitals met annual targets for disparities reductions. During this effort, they also collected REAL (race, ethnicity, and language) and SOGI (sexual orientation and gender identity) data to compare quality and provide more culturally competent care.
Here are three key takeaways from “Reducing Disparities: A California Statewide Effort.”
- If you don’t capture it, you can’t measure it. California’s Section 1115 waiver, the Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program, requires the collection of REAL and SOGI data to reduce disparities. The presenters described the standardized structure used across all health systems to capture REAL and SOGI data. The hospitals also stratify the data by PRIME metrics to launch disparities interventions, such as reducing disparities in smoking cessation and blood pressure control among African Americans. Today, more than 3,000 health care staff and providers have completed sexual orientation and gender identity training, and CAPH hospitals have collected SOGI data on 61 percent of patients.
- Make data available to front-line staff to effect change. The ability to monitor and stratify data helped front-line staff identify problems and standardize efforts across hospitals. For example, CAPH leaders observed that providers who spoke Mandarin with their Mandarin-speaking patients had better quality reports. Additionally, CAPH leaders found that providers were screening African American patients for tobacco use but were not referring patients for cessation.
- To move upstream, our efforts must focus on more than the health system. Health systems alone cannot effect change. Implicit bias training, workforce diversity among providers and front-line staff, and collaboration with community organizations also are key to driving change.
Read more VITAL2019 takeaways and stay tuned for the fifth and final post in our blog series, highlighting the Finance and Payment Policy education track.