Effective July 1, 2023, Improving Health Care Equity became a new Joint Commission National Patient Safety Goal (NPSG). NPSGs are established standards determined by Joint Commission to ensure patients receive safe healthcare in all health care settings. You may know these as Universal Protocol, Safe Medication Storage, Correct Patient Identification (2 identifiers), and others. Just like all the other NPSGs, Improving Health Equity is going to take a well-structured approach to make organizational change. The first step in making meaningful changes is understanding what health equity is.
Health equity and racial/ethnic healthcare disparities are sometimes used interchangeably, but the distinction is important. Racial/ethnic healthcare disparities are measurable differences in healthcare outcomes for patients of different races and ethnicities. Racial and ethnic healthcare disparities have been measured for decades and continue to plague healthcare and communities of color. Black and Hispanic populations experience disparities for a number of health issues and outcomes, including cardiovascular disease, maternal mortality, infant mortality, among others. Disparities in morbidity and mortality related to the COVID-19 pandemic reignited passionate discussion about how to tackle these disparities, though a clear path for improvement is not well-defined. The contributing factors related to healthcare disparities are complex and interwoven. Access to healthcare, insurance, food insecurity, housing, education, and other factors known as social determinants of health have a tremendous impact on disparities and it is difficult for healthcare providers to impact change on most of these factors. However, this is where health equity is important.
Health equity is the state in which everyone has a fair and just opportunity to achieve their personal highest level of health. Healthcare’s responsibility to health equity is the delivery of fair, equitable care, and on that, we can have a tremendous impact. Some activities stipulated by the Joint Commission are a good start:
- Identify an individual to lead activities to improve health care equity
- Assess the patient’s health-related social needs
- Analyze quality and safety data to identify disparities
- Develop an action plan to improve health care equity
- Take action when the organization does not meet the goals in its action plan
- Inform key stakeholders about progress to improve health care equity
The Robert Wood Johnson Foundation’s Culture of Health model and the CDC offer more recommendations about activities that can improve health equity:
- Make sure you understand Social Determinants of Health and how they impact individuals.
- Review policies and practices that may contribute to systemic racism and poor care for individuals of color. Check out this article in the New England Journal of Medicine about the use of race in clinical algorithms which contribute to disparate care.
- Engage with community partners to address specific needs of populations.
- Be intentional about increasing the diversity of the healthcare workforce.
- Reflect on implicit biases and how they contribute to disparate care practices. Read more about implicit bias and how it impacts nursing care.
The National Institute of Nursing Research notes that public trust, proximity to patients, families, and communities, and the sheer size of the nursing workforce, enables nurses to be the perfect partners to engage in work that addresses the challenges in healthcare. Be on the lookout for more communication about how UAMS will address the Health Equity NPSG and how you can be involved.
