The AMA has launched an initiative to improve health outcomes among historically marginalized populations by leveraging quality- and patient safety-reporting infrastructures that health systems have built and then systematically embedding health equity into that work.
The AMA Advancing Equity through Quality and Safety Peer Network is a year-long mentorship and networking program that will equip participating health systems with the foundational knowledge and concrete tools to embed equity throughout their institutions’ health care delivery practices and advance racial justice and equity for their patients, staff and communities.
The AMA collaborated with the Brigham and Women’s Hospital and The Joint Commission to create the program, which merges patient-centered approaches to quality and safety with robust structural analyses of racism and equity to support an overall mission of delivering equitable, high-quality care to every single patient.
“For the past two years, the COVID-19 pandemic has further exposed systemic inequities in the quality and safety of the patient care experience—including gaps in interpretation services, telemedicine access, and crisis standards of care,” said AMA Immediate Past President Gerald E. Harmon, MD.
“Through collaborations like the Peer Network, the AMA continues its work to remove the social and structural factors that interfere with patient-centered care—providing health systems with guidance to inform equitable solutions, dismantle inequities, and improve health outcomes for our patients from historically marginalized communities,” added Dr. Harmon, a family physician in South Carolina, whose tenure as AMA president ended earlier this month.
Eight organizations leading the way
Some 20,000 physicians are represented by the first eight organizations participating in the program. They are:
- Atlantic Medical Group/Atlantic Health System.
- Children’s Hospital of Philadelphia.
- Dana-Farber Cancer Institute.
- Ochsner Health.
- University of Iowa Hospitals & Clinics.
- The University of Texas MD Anderson Cancer Center.
- University of Wisconsin Hospitals & Clinics.
- Vanderbilt University Medical Center.
Atlantic Medical Group/Atlantic Health, Ochsner Health and University of Iowa Hospitals & Clinics are members of the AMA Health System Program, which equips leadership, physicians and care teams with resources to advance their programs and help drive the future of medicine.
These health systems also participate in the AMA Insight Network, which helps AMA Health System Program members gain early access to innovative ideas, get feedback from their peers, network, and learn about pilot opportunities. Learn more.
One AMA Insight Network event featured a presentation by Karthik Sivashanker, MD, MPH, the AMA’s vice president of equitable health systems and innovation. Dr. Sivashanker explained how Brigham and Women’s used its existing quality- and safety-improvement infrastructure to promote equity.
The idea behind designing resilient and reliable health systems is to capture and prevent errors before they reach the patient, regardless of whether the individual physician or health professional is tired, distracted, biased or having a bad day, Dr. Sivashanker explained in his presentation. The same can be done for health inequities that are widespread, pervasive, preventable and unjust.
Read more from Dr. Sivashanker about five ways to use quality improvement tools to tackle health inequities.
To bring equity lens, probe further
Dr. Sivashanker said in an interview that the approach he and his colleagues take at Brigham and Women's hospital, where he is a medical director of quality, safety and equity, is to ask whether there was an associated inequity every time there is an incident of patient harm identified.
“Then, like we would with any other contributing factor to a preventable harm, ask: What actions do we want to take to address those contributing factors? And then actually taking those actions,” he said. “It's just doing quality and safety work—but doing it with equity as an explicit focus where it's built into all the processes and ways we do the work.”
Examples include finding inequities at Brigham and Women’s in:
- 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.
The Peer Network initiative is part of the AMA’s strategic plan to embed racial justice and advance health equity. Learn more about the AMA Center for Health Equity.