Issue link: https://beckershealthcare.uberflip.com/i/1293502
34 QUALITY IMPROVEMENT & MEASUREMENT to strengthen community partnerships and community-engaged research to improve health equity. Mayo has campuses in Florida, Arizona and in the Midwest, and we are putting a particular focus in the Southern states because of the diverse population in these areas and the disproportionate impact of COVID-19 on populations in these areas. Fritz Francois, MD, chief medical officer and patient safety officer at NYU Langone Health (New York City): Recognizing the importance of providing access to patients in order to address health disparities and achieve better equity, we advanced care in Brooklyn, an area with the highest percentage of Medicaid patients. Our goal was to ensure that the same quality of care delivered in our Man- hattan hospital was provided in our Brooklyn hospital as well. To do so, we introduced services that did not exist at NYU Langone Hospital-Brooklyn, such as advanced endoscopy and robotic surgery. Additionally, we introduced what is fundamental to addressing disparities and achieving equity: We measured what we were doing. We looked at our metrics and asked, "Are we seeing same results as it relates to key indicators, including mortality, hospital-acquired conditions systemwide?" We were able to slowly bend that curve. And our strategy goes beyond what we did in Brooklyn. Our ratio of number of observed deaths to number of expected deaths for the en- tire system is well below 1.0. at achievement is also because we've established the same standards across the entire system. Hospital-acquired conditions were another important set of metrics. We have similarly measured that and focused on strategies that resulted in significant improvements. As it stands now, we have been able to look at all these things across various measures — surgical site infections, 30-day admissions, etc. — to ensure we were achieving the same outcomes systemwide for all our patient populations. Julia Iyasere, MD, vice president, NewYork-Presbyterian Center for Health Justice (New York City): At NewYork-Presbyterian, we are committed to eliminating health disparities for our patients and our communities. As a part of this commitment, we conduct a comprehensive community needs assessment every three years to identify how we can help better serve our communities. e most recent assessment revealed that access to healthy food and food in- security are core issues for our patients and their families across our system and diverse communities in New York City and Westchester County. Chronic diseases, such as obesity, diabetes and heart disease are among the leading causes of death and disability in the state, and improving nutrition and food access is a key element in preventing these conditions. To build on these efforts, we expanded our health screening of patients to include questions around social determinants of health so that we could further understand the needs and disparities in our communities. At our Washington Heights Family Health Center, part of NewYork-Presbyterian's Ambulatory Care Network, staff found that nearly 30 percent of families with young children who came to the clinic said they could not always afford food. To address this disparity, NewYork-Presbyterian launched a number of healthy food access initiatives, including Food FARMacia, a pilot program that began in June 2019. is mobile food market is open on Tuesdays, Wednesdays, and Fridays, alternating between NewYo- rk-Presbyterian and community sites and provides a wide variety of dry goods and fresh fruits and vegetables. e program is a collabo- ration between NewYork-Presbyterian's Ambulatory Care Network, CHALK (NewYork-Presbyterian's childhood obesity prevention program) and the West Side Campaign Against Hunger. To date, 1,255 families have been registered. Families take home between 30 to 40 pounds of free food at each visit. e program has given away around 164,000 pounds of food so far. rough contin- ued use of data accumulated from health screenings, this program is currently expanding in Brooklyn, Queens and Westchester. Redonda Miller, MD, president of Johns Hopkins Hospital (Bal- timore): Across the Johns Hopkins Health System, we are working to address disparities in the identification and care of patients with COVID-19 in our local Latino community. At the Johns Hopkins Hospital and our sister hospital, Johns Hopkins Bayview Medical Center, a disproportionate share of patients admit- ted for COVID-19 has come from this community. ese patients live in densely populated neighborhoods, tend to be essential work- ers and oen lack access to COVID-19 testing. In addition to these risk factors, they face challenges that include language barriers and a hesitancy to seek out necessary care due to undocumented status. In an effort to reduce this inequity, we decided to bring testing and follow-up care directly to the community through a collabo- ration between Johns Hopkins, the city of Baltimore, the nonprofit Baltimoreans United in Leadership Development and faith-based organizations. Since late June, our Johns Hopkins testing "go team" has erected a tent at a church in one of the hardest-hit Baltimore City ZIP codes for appointment-based and walk-up testing. e response has been robust and has amplified the need for this work. To date, the team has conducted more than 1,000 tests. Among the Latino residents tested, about 35 percent tested positive for COVID-19, compared with less than 5 percent of non-Latino residents. Plans are underway to expand this successful model to other Latino communities in central Maryland. Adam Myers, MD, chief of population health and director, Cleve- land Clinic Community Care: It is undeniable that the structure and fabric of our society has — by design — placed Black Americans and people of color at a disadvantage for hundreds of years. Recent events have again highlighted the reality of structural racism and its profound effect in producing economic, political, educational, social and health inequities. is is not new information. is reality has played out since slavery. ose disadvantages result in higher death rates of Black babies and Black mothers, a dramatically higher prevalence of chronic diseases and profoundly shorter life expectancies for Black Americans. ese are just a few of the historical and enduring effects of these structural disadvantages. "It is undeniable that the structure and fabric of our society has – by design – placed Black Americans and people of color at a disadvantage for hundreds of years." - Adam Myers, MD, chief of population health and director, Cleveland Clinic Community Care