thequalitypostGreetings from Cat, Saj, Ari and Jenica Welcome to the 111th edition of The Quality Post! In this issue, we express solidarity with victims of structural racism and shine a light on health care equity. We showcase a piece on Addressing Disparities in Care; feature the CIWA Caring Wisely Initiative led by Anne Ritchie, Maggie Jones, and Jonathan Duong; and update you on our performance on our FY20 DHM True North Quality Metrics. inthisissue Addressing Disparities in Care
HBR Tip: Take Meaning Action Against Racism
Expanding Evidence-Based Care for Alcohol Withdrawal to the Stepdown Unit
FY20 DHM True North Quality Metrics
Addressing Disparities in Care IHI White Paper - Achieving Health Equity In 2016, the Institute for Healthcare Improvement released a framework for healthcare systems to improve health equity in the communities they serve, especially at the point of care, and to impact many of the determinants that create these disparities. They outline 5 recommendations: 1. Make health equity a strategic priority, including demonstrating leadership commitment to improving equity 2. Develop structure and processes to support health equity work, including establishing a committee to oversee and manage equity work and dedicating financial resources 3. Deploy specific strategies to address the multiple determinants of health on which health care organizations can have a direct impact – this includes access to health care services, and addressing socioeconomic status, physical environment, and health behaviors 4. Decrease institutional racism within the organization, including addressing and reducing implicit bias of employees and organizational policies, structures, norms and patient care; making the physical spaces accessible and welcoming to all patients; accepting all insurance plans, especially Medicaid and Medical, and improving patients’ health insurance literacy 5. Develop partnerships with community organizations to improve health and equity - leverage community assets to work together on community issues related to improving health equity
Take Meaningful Action Against Racism If you’re a business leader in the U.S., no matter your ethnic or political identity, you have an opportunity to speak up and take meaningful action against racism right now. Of course, no one leader’s language can fix the deep-seated, systemic racial injustice in America. But the right words can be a salve for the widespread pain that so many are experiencing — and it can set the conditions for an action-oriented culture. If you are a leader who is not Black, don’t approach statements or conversations about racism with a defensive mindset, don’t make sweeping generalizations about people’s feelings, words, or actions, and, crucially, don’t rely on your Black and brown colleagues to educate you on the news or social justice initiatives. Acknowledge what you don’t know, commit to listening and learning, and pledge to use your position of power to effect change. Do the research to understand current events, using data from reliable sources. Give your Black and brown employees the space to be angry, afraid, disenchanted, or even disengaged from work. Seek support and reading materials from your HR team or office of diversity and inclusion. Create space for continued reflection, discussion, and vulnerability by making it clear that you care and are available. Finally, take meaningful action: Make a strong public statement, donate to Black-owned businesses and social justice causes in your community, form a committee on racial justice and reform — there are countless ways to help build a better future. Find a few that align with your organization, and make a commitment to them. Racism isn’t just Black people’s problem, and inaction is a tacit endorsement of the status quo. This tip is adapted from “U.S. Businesses Must Take Meaningful Action Against Racism,” by Laura Morgan Roberts and Ella F. Washington Expanding Evidence-Based Care for Alcohol Withdrawal to the Stepdown UnitProviding high quality, evidence-based patient care at a lower cost is the cornerstone of healthcare value improvement. Over the past year, an inter-disciplinary team that included Anne Ritchie, Maggie Jones, and Jonathan Duong spearheaded a Caring Wisely initiative to expand the use of the CIWA tool for the treatment of mild to moderate alcohol withdrawal syndrome from the ICU to the stepdown unit (TCU). This was a wide-ranging project that included the training of all TCU nurses in CIWA assessments, the creation of symptom-driven treatment protocols, and close partnership with our ED and ICU colleagues. The team has consistently reached their goal of having < 20% of mild-moderate alcohol withdrawal patients admitted to the ICU since the rollout of this new protocol in September 2019. This has led to at least $292,000 of direct cost savings through April 2020. The team would like to thank all hospitalists for their support of the work, and greatly appreciate your continued feedback. For more information about their work, click below. |