Experts urge hospitals to spot healthcare disparities
Joint Commission report finds link to patient demographics
A report released by The Joint Commission calls on hospitals to improve patient care by eliminating racial and ethnic disparities. In April, One Size Does Not Fit All: Meeting the Needs of a Diverse Population, found “racial and ethnic disparities are linked to poorer health outcomes and lower quality care.” The report aims to inform healthcare providers of the importance of cultural and geographical awareness and its connection to patient safety. It is structured around four themes:
- Building a foundation
- Collecting and using data
- Accommodating the specific needs of patient populations
- Creating collaboration internally and externally
- As hospitals become more aware of the relationship between patient safety and patient
- demographics, experts say there is urgency for policies to be put in place so all patients are
- getting the care they deserve.
“[Patient demographics] should be part of patient safety. It shouldn’t happen on the side,” says Romana Hasnain-Wynia, PhD, director of healthcare equity and associate professor at Northwestern University’s Feinberg School of Medicine in Chicago.
Hasnain-Wynia also served as a project advisor and reviewer for the Joint Commission (formerly JCAHO) report. Part of providing the best quality of care is to understand patient backgrounds, she says. The Joint Commission report discusses the importance of doing this without resorting to stereotypes.
“You can’t simply fix disparities; then everyone gets poor quality care,” says Jonathan Skinner, PhD, professor of community and family medicine at Dartmouth Institute for Health Policy and Clinical Practice in Hanover, NH. “Instead, set quality care at 100% for all races, and then you’ve automatically gotten rid of poor-quality care.”
Skinner and the Dartmouth Institute were involved in the early stages of research for the Robert Wood Johnson Foundation initiative “Aligning Forces for Quality,” which in June announced a $300 million grant designed to reduce significant regional and ethnic care disparities by targeting 14 communities across the United States. The researchers behind this grant examined Medicare claims for evidence of racial and geographic disparities and found that both were prevalent.
The best way to begin to reduce regional and ethnic disparities in healthcare is to treat patients like customers, Skinner says. Facilities can do this by getting feedback from patients and setting standards to fix these problems.
Resources to help lower disparities in care
For hospitals that want to improve patient safety by addressing the needs of diverse populations, there are resources available to get them started.
The Health Research and Educational Trust Toolkit team has released a free Web-based toolkit that provides hospitals with information and resources for collecting race, ethnicity, and language data from patients that is available at www.hretdisparities.org.
The toolkit contains tips about how to collect data, how to ask patients questions, methods for staff training, ways to garner community involvement, and other features.
The Joint Commission’s report also showcases a self- assessment tool that facilities can use to incorporate cultural issues into patient care. This tool provides the questions to facilities that are starting to create policies. Visit www.jointcommission.org to read the Joint Commission report.
Briefings on Patient Safety, August 2008, HCPro, Inc.