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American Hospital Association Launches Health Equity Initiative

Analysis  |  By Christopher Cheney  
   April 04, 2022

The American Hospital Association's new Health Equity Roadmap provides a model for transformation and resources to make progress.

The American Hospital Association (AHA) has released a Health Equity Roadmap to help the organization's members make advancements in equity and inclusion.

Health equity has emerged as a pressing issue in U.S. healthcare during the coronavirus pandemic. In particular, there have been COVID-19 health disparities for many racial and ethnic groups that have been at higher risk of getting sick and experiencing relatively high mortality rates.

"The Health Equity Roadmap is a framework to support our member hospitals and health systems in their efforts to become more inclusive and more equitable organizations as we work toward dismantling the structural barriers that exist for some of our patient populations," says Joy Lewis, MPH, MSW, senior vice president of health equity strategies at AHA.

The AHA's Health Equity Roadmap has five components and resources, she says.

1. Transformation model: "There are six levers of transformation in the model. If our members focus on these six areas, they will be well-positioned to mobilize and make positive change toward becoming more equitable. The six levers of transformation are community collaboration for solutions, equitable and inclusive organizational policies, culturally appropriate patient care, collection and use of data to drive action, diverse representation in leadership and governance, and systemic and shared accountability," Lewis says.

2. Transformation assessment: "The transformation assessment serves as both a diagnostic of a hospital's current state and a baseline of where they are to help create a structure and process for continuous improvement toward transforming to more equitable and inclusive environments for both their workforce and the patients and communities they serve. The assessment calls out key performance indicators across each of the six levers of transformation," she says.

3. Transformation profile: "When a hospital conducts the assessment, they get the results in the form of a transformation profile. The profile says, 'Here is where you are. Here is your placement on the equity continuum.' There are five placements on the equity continuum—exploring, which is an embryonic stage of development; committing; affirming; immersing; and transforming, which is the most advanced stage. The profile provides data around where you are in each of the six levers of transformation. For example, a hospital could be transforming in their data collection and how they use data to improve care, but they could be exploring when it comes to addressing the issue of diverse representation in leadership and governance," Lewis says.

4. Action planners: "Once a member has the profile, they are then able to access the action planners, which are like a workbook. You gather a team of leaders from across the hospital who would be making contributions in each of the levers of transformation. This team thinks through and crafts actions that need to be taken to move from exploring to committing, for example," she says.

There 30 different action planners in total given the six levers in the transformation model and five placement levels of the equity continuum. Each action planner includes reflective questions that hospitals should ask of themselves and best practices.

For example, there is an action planner for the affirming placement level of the equity continuum for community collaboration for solutions. Reflective questions that hospitals should ask of themselves for this action planner include: What are the obstacles related to community collaboration for solutions at your organization? What are the impacts of these obstacles? Who is most impacted by these obstacles? Best practices for this action planner include: Conduct an audit to determine what barriers exist for individuals and marginalized communities in their ability to achieve good health and access healthcare services. Assess how well your existing services are reaching marginalized communities. Gather information on patient experience and disaggregate by race to determine common barriers for communities.

5. Health Equity Action Library: "When our members get their profile and they receive their placements on the equity continuum, they are also given a link to the resources in the Health Equity Action Library that can help them to mobilize and take actions to move from one placement to another on the equity continuum," Lewis says.

The Health Equity Action Library is accessible to all hospitals and health systems. Access to the rest of the Health Equity Roadmap is limited to AHA members.

Benefits of addressing health inequities

Addressing health inequities benefits patients, she says. "Given that the goal of the healthcare system is promoting health, it is clear that eliminating disparities is the right thing to do for patients. We want each patient to have the opportunity to achieve their optimal health status, and the same goes for communities. For example, if you look at racial health inequities, studies have shown that racial health inequities can cost billions of dollars in lost productivity and can result in premature death."

Addressing health inequities also improve the performance of hospitals and health systems, Lewis says. "For hospitals and health systems, eliminating inequities improves patient engagement, decreases readmissions, and improves health outcomes. Eliminating inequities also improves performance and reduces healthcare costs. Addressing health disparities allows hospitals and health systems to perform better in value-based payment arrangements. So, there is a business case for addressing health inequities."

Related: Health Equity Top Priority for Leader of Institute for Healthcare Improvement

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

The Health Equity Roadmap's transformation model features six levers of transformation such as community collaboration for solutions and culturally appropriate patient care.

The Health Equity Roadmap's transformation assessment generates a profile that tells hospitals where they are on an equity continuum for each of the transformation model's levers.

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