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AHA-IFD Equity of Care Slide Deck
- 1. © 2015 American Hospital Association M. Tomás León, MBA President and CEO, Institute for Diversity in Health Management Email: tleon@aha.org / Phone: 312-422-2697 February 1, 2016 National Call to Action to Eliminate Health Care Disparities
- 2. Diversity is a Reality in the U.S.
- 3. The U.S. is rapidly becoming more diverse. However, racial and ethnic minorities bear a disproportionate burden of chronic illnesses (including mental health disorders), are more likely to be uninsured, face unequal access to quality health care services, and suffer the worst health care outcomes than the general population. The Challenge & Opportunity
- 4. National Call to Action Partners
- 5. - Increase collection and use of race, ethnicity and language preference data - Increase cultural competency training - Increase diversity in leadership and governance National Call to Action Goals
- 6. Diversity and Disparities A Benchmark Study of U.S. Hospitals in 2013 6
- 7. Benchmark Results and Projections Milestones by Year Collection and Use of REaL Data Cultural Competency Training Increasing Diversity 2011 (Baseline) 18% 81% Governance 14% Leadership 11% 2013 (Progress Data) 19.4% 86.4% Governance 14% Leadership 12% 2015 Goal 25% 90% Governance 16% Leadership 13% 2017 Goal 50% 95% Governance 18% Leadership 15% 2020 Goal 75% 100% Governance 20% Leadership 17%
- 8. Summary Findings Collection and use of data: • Hospitals actively collecting patient demographic data including race (97%); ethnicity (94%); and primary language (95%) • 22% of hospitals use data to identify disparities in treatment or outcome Cultural competency training: • 86% of all hospitals educate all clinical staff during orientation; an increase from 81% in 2011 • 65% of hospitals require all employees to attend diversity training Leadership: • Minorities represent 31% of patients nationally • Minorities comprise: – 14% of hospital board members, unchanged from 2011 – 12% of executive leadership positions, unchanged from 2011 – 17% of first- and mid-level management positions; up from 15% in 2011
- 9. Past. Present. Future. Do To Do For Do With Shift from Sick Care to Well Care>> Shift from Volume to Value>>
- 10. Experience of Care Population Health Per Capita Cost The Goal: The Triple Aim Health equity is the target.
- 11. The WHY: Population Health
- 13. #123forEquity Pledge to Act 1. SIGN THE PLEDGE - Pledge to achieve the three areas of the National Call to Action within the next 12 months. 2. TAKE ACTION – Implement strategies that are reflected in your strategic plan and supported by your board and leadership. Provide updates on progress to the AHA and your board in order to track progress nationally. 3. TELL OTHERS – Achieve the goals and be recognized. Tell your story and share your learnings with others in conference calls and other educational venues, including social media to accelerate progress collectively.
- 14. Our Pledge to Act Request Address the following areas in the next 12 months. Below is a suggested timeline for addressing each area, but it can be modified based on your needs: • 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 sociodemographic 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 • 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.
- 16. • Nearly 1,000 hospitals and health systems pledged • 37 state and metropolitan hospital associations pledged. • 24 local and national organizations endorsements #123forEquity Pledge to Act Progress
- 17. Equity of Care Toolkit This toolkit is a user- friendly “how-to” guide to help accelerate the elimination of health care disparities and ensure our leadership teams and board members reflect the communities we serve. www.equityofcare.org
Editor's Notes
- The National Call to Action to Eliminate Health Care Disparities was launched in 2011 along with four other national health care associations – America’s Essential Hospitals, American College of Healthcare Executives, Association of American Medical Colleges, and Catholic Hospital Association of the United States – with a focus on three core areas: Increasing the collection and use of race, ethnicity and language preference data, Increasing cultural competency training, and Increasing diversity at the leadership and governance level. Founded on the commitment that equitable care for all patients is not just the right thing to do but central to our ongoing quality improvement work and part of a business imperative moving forward.
- Through the National Call to Action we challenged the field to begin addressing these issues. Within the three core areas, the Call to Action partners have agreed to goals and milestones within each focus. To gauge our baseline and progress we have engaged in a biennial national survey of hospitals. Based on the most recent survey our progress has been limited. Overall, hospitals are actively collecting patient demographic data. But, only 22 percent of hospitals utilized data to identify gaps in care in clinical quality indicators, readmissions or CMS core measures. Cultural competency training provides clinicians and caregivers with educational opportunities to help them better understand and respect differences between patients and positively impact the care patients receive. In 2013, 86 percent of hospitals educated all clinical staff during orientation about how to address the unique cultural and linguistic factors affecting the care of diverse patients and communities, up from 81 percent in 2011. Minority representation in hospital leadership and governance lagged with only 14 percent of hospital board members and an average of 12 percent of executive leadership positions comprising minorities, largely unchanged since 2011.
- To accelerate progress, given the date we are seeing, the AHA through the Equity of Care effort and the Institute for Diversity have refocused our efforts with a national campaign to ask hospitals, health systems, state hospital associations and those with an interest in promoting this topic to pledge their commitment to take action with a focus on the three core areas. The AHA intends to challenge every hospital leader to commit to the following: TAKE THE PLEDGE - Pledge to achieve the three areas of the Call to Action within the next 12 months. TAKE ACTION – Implement strategies that are reflected in your strategic plan and supported by your board and leadership. Provide quarterly updates on progress to the AHA and your board in order to track progress nationally. TELL OTHERS – Achieve the goals and be recognized. Tell your story and share your learnings with others in conference calls and other educational venues, including social media to accelerate progress collectively.
- To build support and capture a commitment hospitals, state hospital associations, and individuals and organizations who would like to endorse the campaign can take the pledge online at equityofcare.org, or by paper. The AHA piloted this project with the AHA board and saw immediate and significant progress. We are asking the same of our internal groups such as the equity of care committee and the IFD board. We know it can be done and with accelerated adoption we can move the dial forward. As you can anticipate, we are asking to support and sign the pledge. The AHA can take it from there with your CEO or board’s acknowledgement. As one of those AHA board members, I can tell you (share personal experience with the project – example could be how you looked at data to determine a disparity existed and any action taken). In support the AHA through EOC will expand our national recognition system to honor hospitals and health systems making progress in these areas and will feature their commitments and achievements on our website and through ongoing promotional materials.
- This map shows the number of hospitals that have signed the pledge so far, by state. The states in green represent those where the State Hospital Association has also signed to the pledge. At the top, is the total number of hospitals who have pledged, to date, as well as the total number of State Hospital Associations who have joined the campaign. Do you know if you are on there? You should be…
- As before the AHA, along with our partners, will continue to release tools and guides, educational opportunities (webinars, speaking engagements, and educational tracks at member conferences), communications via internal and external publications, and ongoing marketing to ensure high visibility of the issue, along with needed resources to encourage sustainability. Available publicly to all via www.equityofcare.org, these resources are intended to provide the resources, expertise and steps required to positively impact disparities. To help you in your journey we created the Equity of Care Toolkit for Eliminating Health Care Disparities. This is a user-friendly “how-to” guide to help accelerate the elimination of health care disparities and ensure our leadership teams and board members reflect the communities we serve. For a free copy of the Equity of Care toolkit, please visit equityofcare.org. You are also receiving flash drives with the material on it for your use and dissemination.