Advancing Health Care Equity

By Ana Pujols McKee, MD, Chief Medical Officer and Chief Diversity, Equity and Inclusion Officer

When it comes to health disparities in minority populations, the real research-to-practice gap is real.

Scholars have known for decades that Black, Latinx and Asian American patients are at a significantly higher risk of contracting – and in many cases, dying from – preventable hospital-acquired infections (HAIs) such as MRSA, C. diff or catheter-associated urinary tract infections (CAUTIs) than non-Latinx white patients.

It’s time to build a bridge between what PhDs have studied for years and the actual healthcare experience. I am so thrilled to introduce the Advancing Equity Through Quality and Safety Peer Network, developed in conjunction with the American Medical Association and Brigham & Women’s Hospital (BWH). 

The icing on the cake is that one of the leaders of the network is Haytham Kaafarani, MD, MPH, FACS, Director of the Massachusetts General Hospital (MGH) Center for Outcomes & Patient Safety in Surgery (COMPASS). Dr. Kaafarani also is Director of the MGH Wound Center and Director of Trauma & Emergency Surgery Research at MGH. Dr. Kaafarani will be joining The Joint Commission as our new Chief Patient Safety Officer and Medical Director in September. 

This year-long mentorship and networking pilot program will equip eight 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.  

Through individual consultations and group learning opportunities with the Peer Network’s panel of subject matter experts, participating health systems will learn strategies for systematically identifying and addressing root causes of inequities via an integrated approach to quality, safety, equity and operations. 

Additionally, utilizing a framework designed at BWH and the Institute for Healthcare Improvement to reduce health inequities within clinical operations by leveraging an infrastructure of quality and safety, this patient-centered approach will include a robust structural analyses of racism and equity to support an overall mission of delivering equitable, high-quality care to all patients.  

Early Adopter Institutions
The first phase of the AMA Peer Network’s approach will begin with a national group of early adopter institutions as participants, including: 

• Atlantic Medical Group/Atlantic Health*
• Ochsner Health*
• University of Iowa Hospitals & Clinics*
• Children's Hospital of Philadelphia
• Dana-Farber Cancer Institute
• University of Texas MD Anderson Cancer Center
• University of Wisconsin Hospitals & Clinic
• Vanderbilt University Medical Center

*Denotes AMA Health System Program member

1. Cross-sectional employee teams from executive leaders to community health leads will participate in:
   Monthly all team calls for foundational learning in racial justice and equity, integrated approaches to quality, safety and equity and social/structural drivers in health.
2. . Peer-to-peer calls to facilitate sharing of barriers, opportunities and strategies.
3. Case review calls with subject matter experts to apply an equity-informed high reliability approach to analyzing individual harm events and driving systems-level change. (A video highlighting parts of an AMA Peer Network case review call is available here).
4. Individual coaching calls with subject matter experts.
5. Asynchronous learning.
6. Action periods, where teams are actively applying the tools, strategies and best practices in their home institutions.

Participating institutions are early adopters, but the goal is not new. We all seek to:

• Highlight strong practices and implementation strategies.
• Provide expert consultation on public and social health models to “connect the dots” between operational equity efforts and strategy.
• Develop a leadership pipeline capable of redesigning equitable health systems.
• Facilitate peer-to-peer learning.
• Create networking opportunities.

The problems regarding health disparities are deeply rooted in our health systems. Yet, I am energized by this collaboration and convinced we have the best minds at the table to make a difference.

 Ana Pujols McKee, MD, is the Executive Vice President, Chief Medical Officer, and Chief Diversity, Equity and Inclusion Officer of The Joint Commission. In this role, Dr. McKee focuses on and develops policies and strategies for promoting patient safety and quality improvement in health care and leads The Joint Commission enterprise in meeting its goals of improving diversity and inclusion.