Health care inequities are so deeply entrenched that working to advance equitable care represents an enormous task. But adopting the tools and methods used to improve health care quality and safety is one strategy that has shown to be a successful way to get started on this journey.
The “Advancing Equity through Quality and Safety Peer Network Series,” an AMA Ed Hub™ Health Equity Education Center resource, explores in detail how this can be accomplished. The set of free, online CME activities—offered in collaboration with the Brigham and Women’s Hospital and The Joint Commission—builds on the work started in 2019 by the Brigham and the Institute for Healthcare Improvement (IHI), which led to the design, testing and implementation of a framework for the work done by the AMA Peer Network for Advancing Equity and Quality.
This first-of-its-kind online curriculum provides comprehensive instruction for integrating equity into quality and safety practices to identify inequities as undesired variations in a system and remove them.
Data shows the dramatic contrast in experience and outcomes within health care for patients from marginalized racial and ethnic groups. For example, at the Brigham, these examples of inequitable care were identified and studied:
- Emergency department admissions to cardiology for heart-failure care.
- COVID-19 mortality risk among Latino patients who spoke little or no English.
- Security emergency responses.
“We aspire to have uniform excellent quality and safety for our patients,” said AMA Executive Vice President and CEO James L. Madara, MD. “Yet, in the absence of equity—if you think about it—this is impossible to accomplish. That lack of equity is a glass ceiling for our efforts in quality and safety.
“The infrastructure and processes already widely established for quality and safety, mirror the infrastructure and processes needed to establish health equity,” Dr. Madara added. “So, these two take-homes—providing a burning platform and providing leverage for this work—are what make me really excited for the Peer Network. That burning platform creates the shared commitment to this work and that leverage of existing infrastructure allows us a vision that feels within reach.”
5 transformation focus areas
“The focus of this series of modules is to support the transformation of health care systems to advance equity,” says the series’ video introduction, adding that these systems would then “provide quality, equitable care for each and every patient.”
Through modules, recordings of excerpts taken from webinars, and other resources, the series will examine these five focus areas for embedding equity into an organization’s quality and safety infrastructure.
Integrating equity into all harm-event reporting. Health care organizations can start by systematically collecting and tracking harm events where discrimination or bias may have been a contributing factor and applying an equity lens to reviewing all harm-event data in quality, safety, risk and patient experience.
Equipping staff with the knowledge, skills and tools to create safe spaces. Doing so enables conversations about inequities in the quality and safety of care. This is needed when reviewing cases where bias or discrimination may have contributed to the harm.
Collecting and using harm event data, segmented by sociodemographic characteristics. Gathering and stratifying harm-event data by race, ethnicity, age, language preference, sexual orientation and gender identity, disability, and socioeconomic status—as identified by insurance type—makes inequities visible.
Building the will for urgent action by senior leaders. Leadership commitment is crucial in the adoption of new practices and behaviors. Data by itself can sometimes be desensitizing and ineffective in moving people to action. The individual stories of people who have been harmed while providing or receiving care, however, can effectively move leaders to action.
Ensuring accountability to historically marginalized communities. Acknowledging and addressing past and present harms is critical, as is sharing power to design and evaluate solutions.
“I have really appreciated being involved in the Peer Network,” said Cristina Cordero, PhD, MPH, a standards development project director for The Joint Commission. “As we think about the standards we want to move forward at the national level, it so helpful to hear about the resources you are developing.”
The CME activities within the “Advancing Equity through Quality and Safety Peer Network Series” are enduring material and designated by the AMA for a maximum of either 0.25 or 0.5 AMA PRA Category 1 Credit™️. Additional activities detailing collecting and using harm-event data, building will, and ensuring accountability will be available in the coming months.
The activities are part of the AMA Ed Hub™️, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources all in one place—with automated credit tracking and reporting for some states and specialty boards.
Learn about AMA CME accreditation.
