Becker's Hospital Review

38 38 CEO / STRATEGY How health disparity initiatives at US News' top hospitals have fared over the last year By Kelly Gooch and Hannah Mitchell L ast year, Becker's spoke to the top 10 hos- pitals named to U.S. News and World Re- port's 2020-21 Best Hospitals Honor Roll to look at what they are doing to address health disparities. A year later, Becker's checked in with those systems to look at how their health equity initiatives have evolved, what has been the most successful and if there are any results to report from those initiatives. Mayo Clinic In 2020, Rochester, Minn.-based Mayo Clin- ic announced an investment of $100 million over 10 years to combat health disparities. is was a "big, bold move" for health system leaders, who have spent time over the last year identifying strategic priorities related to the investment, said John Knudsen, MD, medical director for Mayo Clinic's Office of Health Equity and Inclusion. Dr. Knudsen said Mayo has specifically con- sidered how it will allocate this money across the organization from a multisite perspec- tive, as well as how it will distribute the funds within research and education. One part of the investment is developing an advanced diversity, equity and inclusion platform to identify and track progress in ad- dressing disparities. It is intended to use both qualitative and quantitative metrics. "is was one thing we thought was import- ant, sort of a high-level dashboard, analytic platform to look at all aspects [of diversity, equity and inclusion]," said Dr. Knudsen. "And, obviously, it's not just something that's a single page. It's intended to say, 'What are we doing with workforce? What about re- search?' All of these things would have a place or a home in this platform." rough pilot projects, he said Mayo has also identified and is now targeting health dispari- ties in diabetes between white and Black patient populations and between the non-Hispanic or Latino and the Hispanic or Latino patient populations. Additionally, it is targeting similar health disparities in colon cancer screenings. "A whole series of tactics will be deployed in the coming month to dig down and understand not only what's causing the disparities but what we can do to address them. We're looking at success as eliminating those," Dr. Knudsen said. Mayo is not only focusing on patients, but also the workforce. For instance, part of the $100 million investment to combat health dispar- ities has gone toward a pilot education and training program using virtual reality technol- ogy. Dr. Knudsen said the idea behind the pro- gram is to enhance the nursing team's empath- ic understanding of people's lived experiences and to create more realistic role-playing to bet- ter navigate difficult interactions with patients, patients' families or co-workers. He said Mayo also used a technology platform last year to collect stories from employees who experienced or witnessed racism, bias or dis- crimination at work. Now, human resources and leadership are using the stories to inform policy and other workplace initiatives. In August, Mayo launched the second phase of that platform allowing for sharing and learning for experiences of allyship among employees. "ere's a real yearning and interest in our workforce to do what they can to address some of these issues we know some of our workers are experiencing and facing," ex- plained Dr. Knudsen. "So allyship has be- come something a lot of people have been looking for opportunities to get behind. is has been another way to get the workforce be- hind some of these efforts to not only recruit and retain a more diverse workforce but also to improve the work environment." With research and community engagement, he said Mayo has worked hard to build strong relationships with community partners to get information out there from trusted sources but also create bidirectional communication frameworks, so the organization hears from communities about issues they're facing or information they're missing. "In an organization with so many competing priorities and many activities going on, we're always looking at what's being supported by top leaders. at $100 million was an import- ant message to all of us that this is something Mayo Clinic really cares about. It has reawak- ened and really activated a lot of people in the organization to begin to think of ways of how they or their practice or their domain could advance some of these goals around equity, inclusion and diversity," Dr. Knudsen said. Massachusetts General Hospital In November, Boston-based Mass General Brigham launched United Against Racism to address structural racism. e comprehensive, systemwide plan "in- vests in leadership teams and leverages a multimillion-dollar commitment with goals, timelines, accountability and metrics of suc- cess," said Joseph Betancourt, MD, senior vice president of equity and community health at Massachusetts General Hospital, part of Mass General Brigham. "e plan focuses on diversity of leadership and governance, training, and creating an anti-racist culture; equity in patient care via data collection, performance measurement, digital access, clinical interventions and the removal of race from clinical guidelines; and a broad new strategy on community health focused on addressing the social determi- nants of health, the deployment of communi- ty health workers, a mobile health initiative, advocacy and anchor investments," he said. Massachusetts General Hospital has also launched its Structural Equity 10-Point Plan to support, complement and build on United Against Racism at the hospital. Dr. Betancourt said the initiatives involve all four pillars of the hospital's mission — care, training, research and community health — and will significantly affect the organization's people, culture and care. "While we are early in our implementation, we are making steady progress and are al- ready seeing gains and achievements, with many more expected in the short and long- term," he said. UCSF Health At San Francisco-based UCSF Health, the health system has expanded its work on health equity since 2020, said Joshua Adler, MD, ex- ecutive vice president and chief clinical officer. It deployed a comprehensive system for col- lecting race, ethnicity, sexual orientation and gender identity data from its patients. is has allowed the system to identify and address dis- parities in a number of important measures of health and health outcomes. Over the past year, UCSF focused on hyper- tension control, in which its Black patients were not achieving the same level of blood pressure control as its patients overall. e health system engaged with its patients to de- termine how best to help them achieve con- trol, including direct outreach to patients to provide video or in-person visits to evaluate blood pressure control; use of medications; any challenges they faced; provision of home blood pressure measuring devices; input from pharmacists on medication choices,

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