Toward Health Equity and Patient-Centeredness Integrating Health Literacy, Disparities Reduction, and Quality Improvement: Workshop Summary (2009) / Chapter Skim
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6 Policy Issues of Integration
6 Policy Issues of Integration
Pages 63-70
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From page 63... ...
Second, health care organizations do not collect data about patients' race, ethnicity, and primary language in patientreported processes. Such data would allow for the assessment of whether implemented initiatives indeed made changes for the better.
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From page 64... ...
Little incentive exists to stratify data, which would allow data to be used to support changes. Development of equity measures would be greatly helped by creating a uniform method for collecting race, ethnicity, and primary language data at the health care organization level, coupled with providing incentives for organizations to do so.
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From page 65... ...
Addressing cultural differences in communication is critical to providing high-quality care, as the frequency and magnitude of adverse events increase with poor communication. Figure 6-1 shows the relationship between providing highquality safe care to the patient at the "sharp end" and the organizational culture and infrastructure at the "blunt end." While patient Patient "Sharp End" Patient centered care Clinicians Supportive infrastructure "Blunt End" Organizational culture FIGURE 6-1 Providing high-quality safe care.
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From page 66... ...
While recognizing that disparities in processes of care will always exist because each patient and his or her preferences are different, part of health care is managing these differences. Disparities in outcomes can be influenced by appropriate responses to differing patient preferences, as well as unnecessary variability in care processes.
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From page 67... ...
• Diverse workforce: The workforce should be diverse to help health care organizations become more innovative in com municating with patients and in making the system better at many levels. To complement cultural expectations, expectations of the infrastructure must also be addressed, including the following: • Supportive infrastructure: Resource staff, interpretation and translation equipment, and information technology should all be used as necessary enablers of communication, data col lection, and analysis.
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From page 68... ...
A secondary incentive for producing better care is reducing the waste of health care resources that result from adverse events and system failures. The reimbursement policy and infrastructure must be transformed to support delivery of better care by reducing disincentives to providing high-quality, safe care and providing incentives to do so.
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From page 69... ...
Schyve emphasized that it is very common in health care to jump directly from recognizing a problem to choosing a solution, sometimes because that solution was successful in another institution that faced the same problem. This is often inappropriate,
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From page 70... ...
70 TOWARD HEALTH EQUITY AND PATIENT-CENTEREDNESS though; only data can reveal the specific causes of the problem, which may differ among institutions. Applying the same "solution" to a different cause is likely to waste resources, lead to disappointing results, and leave the problem unresolved.
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