NEW YORK, NY—November 19, 2024—A new report from United Hospital Fund, Practical Approaches to Centering Equity in Health Care Quality: Shared Lessons from New York City’s Hospital Systems, provides a series of lessons and insights from a task force of health care and health equity leaders from nine local hospital systems on ways to help coordinate efforts to improve health equity and health care quality—and reduce persistent health disparities that exist across New York City.
In establishing the 22-member task force, United Hospital Fund’s goals were to develop a framework to help organizations better understand the drivers of inequities—and to identify and share promising practices from task force members to help advance health equity throughout the city.
“Over the past two decades, there’ve been some great advancement in the health care quality improvement field in areas like patient safety, efficiency, and patient-centered care, but these improvements in quality aren’t benefitting everyone equally,” said Oxiris Barbot, MD, president and CEO of United Hospital Fund. “Our task force brought together experts in both the health equity and the health care quality fields to collaborate and share practices that are very purposefully bridging these two fields and demonstrating progress.”
As explained in the report, the task force focused its discussions and information exchange on three drivers of health equity: equity-centered care, equity-centered whole system quality, and equity-centered patient and community engagement. In each of these areas, the report includes spotlights and examples of ways the participants are connecting quality and equity in their health systems.
A few (of many) examples include:
Redesigning Nursing Care to Integrate Patients’ Social Needs. Nursing staff at New York City Health + Hospitals/Harlem began to ask patients about social circumstances—such as income, food insecurity, environment, and experiences of oppression—as part of their daily interactions and then shared that information in their regular interdisciplinary huddles with the whole patient care team. While the intervention’s impact on patients is in the process of being measured, participating nurses are reporting increased job satisfaction. In particular, nurses reported that looking at their patients holistically and caring for them as whole people took them back to the reasons they went into nursing in the first place and helped find meaning in their work.
Making Maternal Care More Equitable through Remote Hypertension Monitoring. Mount Sinai Health System tested a remote pre- and post-natal blood pressure monitoring program for pregnant Medicaid patients at home to help reduce disparities in maternal care and mortality. In New York City, the risk of maternal death for non-Hispanic Black women is nine times higher than it is for non-Hispanic white women. The program provides free, easy-to-use technology that transmits blood pressure information in real time and does not rely on an in-home Wi-Fi network—and includes weekly phone calls with pharmacists regarding medication levels and compliance. Result: the average post-partum blood pressure of participants decreased from above to within recommended levels.
Investing in Community Health Workers. One health care organization, Montefiore Health System, hired, trained, and coached community health workers to serve as liaisons between and among their organization, patients and families, and social service providers, ensuring constant communication with families about their social needs and whether those needs are being met.
“The taskforce has provided a unique opportunity for leaders in both equity and quality to listen and learn from both the successes and challenges that our neighbor hospitals and neighbor communities are facing,” said task force member Komal Bajaj, MD, MS-HPEd, Chief Quality Officer, NYC Health + Hospitals/Jacobi/North Central Bronx and Medical Director of Sustainability for NYC Health + Hospitals.
The Bridging Quality and Equity Task Force was supported by a grant from the Donald A. Pels Charitable Trust.
About United Hospital Fund
United Hospital Fund works to build an effective and equitable health care system for every New Yorker. An independent, nonprofit organization, we are a force for improvement, analyzing public policy to inform decision-makers, finding common ground among diverse stakeholders, and developing and supporting innovative programs that improve health and health care. We work to dismantle barriers in health policy and health care delivery that prevent equitable opportunities for health. For more on our initiatives and programs please visit our website at www.uhfnyc.org and follow us on LinkedIn, X., Instagram, and Facebook.