Becker's Hospital Review

39 WOMEN'S LEADERSHIP 39 CEO / STRATEGY side effects and mitigation efforts; and a focus on non-medication-based interventions that can lower blood pressure. is also included straightforward approaches by nurse managers to standardize workflows during video visits, to make sure clinicians captured blood pressure during those visits and outreach to patients to make sure they attended their scheduled physician visits. "By June 2021, the disparity had been completely eliminated in our primary care population," Dr. Adler said. In another intervention, the system found that its Latino patients have a lower rate of completed advance care directives. With in- terventions that included improved language concordant documents, use of interpreters and timing the discussions so that family members could participate, UCSF was able to eliminate this disparity as well. Since UCSF's data infrastructure was in place, it was able to recognize an emerging disparity in real time. Patients with limited English pro- ficiency were using video visits at a lower rate than patients overall. is was particularly rel- evant during the early months of the pandemic when video visits were the preferred method of care. e health system implemented an on-de- mand interpreter program for video visits and hope that this intervention will help patients uti- lize this technology when desired. NYU Langone Health New York City-based NYU Langone Health launched the Institute of Excellence in Health Equity in 2020. e goal of the institute is to make sure patient outcomes are comparable, regardless of whether a patient is in Brooklyn or Manhattan, said Fritz Francois, MD, chief medical officer and patient safety officer at NYU Langone Health. e fuel behind NYU Langone's strategy is its key pillars such as research, clinical care and education. Community engagement, by far, has been the most successful initiative. By go- ing into communities, the health system can get a pulse on what is going on with social de- terminants of health. For example, to address food insecurities, the health system uses food pantries to support the community's needs. Community engagement is the most success- ful initiative because it also allows the health system to engage with communities about COVID-19 vaccine hesitancy. e health system is going to start focusing on how it develops the next generation of physi- cians to address health equity. It is looking at opportunities to embed this type of training in medical school, residency and beyond. NYU Langone measures the results of its ini- tiatives by comparing mortality rates between Manhattan and Brooklyn residents, and has seen that patients from both locations have similar outcomes. e system also compares rates of hospital-acquired conditions, which are also the same between populations. e institute was successful in securing fund- ing from the National Institutes of Health to look at efforts related to hypertension. It's an example of where the center will position itself in the future. It's not just clinical work or just education, Dr. Francois said. It is also asking questions that can be answered with research and applying collective funding to it, he said. Johns Hopkins Medicine Baltimore-based Johns Hopkins Medicine's health equity initiatives have continued to evolve during the COVID-19 pandemic. Last year, the health system discussed using a mo- bile COVID-19 testing site in the parking lot of one of the hardest-hit Baltimore ZIP codes with a large number of Latino residents, said Sherita Golden, MD, vice president and chief diversity officer at Johns Hopkins Medicine and professor of medicine at the Johns Hop- kins University School of Medicine. Since Feb. 26, more than 4,180 individuals have been vaccinated in 40 clinics held at this location. Johns Hopkins partnered with public health agencies in Washington, D.C., and Maryland to deliver vaccines to community members unable to access mass vaccination and clinical sites be- cause of transportation barriers, disabilities im- pairing mobility, limited computer usage, lack of healthcare access and lack of broadband. Ap- proximately 90 percent of residents vaccinated through these efforts have been Black. During February and March, more than 2,000 people were vaccinated in senior housing communities in Washington, D.C. — a col- laboration between Johns Hopkins Medicine, the D.C. Department of Health and the D.C. Housing Authority. e initiative was ex- panded to Baltimore in collaboration with the Baltimore City Health Department. Between the initiative's launch in late February and this interview in August, more than 4,000 people were vaccinated in senior housing, places of worship and other community-based sites. Johns Hopkins also operates a mobile van to facilitate pop-up vaccine sites throughout Bal- timore to reach those having difficulty access- ing vaccines. Johns Hopkins' Office of Diversity, Inclu- sion and Health Equity partnered with local and community organizations to host vir- tual Facebook Live town halls. Each of these events reached thousands of community members across Maryland and Washington, D.C. It is key to address community concerns and restore trust, particularly in the Black and Latino communities, Dr. Golden said. Johns Hopkins continues to monitor the de- mographics of those vaccinated through its mobile community efforts. It is also monitor- ing the reach of its education collaborations with diverse media outlets and collecting viewership statistics aer each event. Johns Hopkins Medicine's patient demographic data is missing less than 10 percent of entries. is will enable the system to look at vaccination rates among patients by race and ethnicity to guide its future efforts, Dr. Golden said. NewYork-Presbyterian In October 2020, New York City-based NewYork-Presbyterian launched the Dalio Center for Health Justice, dedicated to un- derstanding and improving health equity, ad- dressing health justice, and driving action that results in measurable improvements in health outcomes for its patients, employees and communities it serves. Because 80 percent of health outcomes are driven by social, be- havioral and environmental factors, the Dalio Center focuses on supporting community initiatives, understanding and championing economic empowerment, social engagement, workforce development, neighborhood revi- talization, and education, said Julia Iyasere, MD, executive director of the center. In collaboration with New York City-based Weill Cornell Medicine and New York City- based Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyte- rian announced a health equity research grant program to support innovative research that will directly advance efforts to reduce health inequities and disparities. A grants commit- tee with tripartite membership will evaluate and oversee the awards, with preference to funding research that provides solutions and takes action. e system is also developing educational and outreach programs about health disparities for its staff and communities. In collaboration with the Division of Community and Popula- tion Health and the Office of Government and Community Affairs, the trio hosted a series of interactive vaccine education presentations to staff, patients and the community, engaging with about 15,000 people to date. It will start hosting an annual health equity symposium to bring together leading healthcare profes- sionals, researchers and advocates in the field. e system is working with its medical school partners and hospital operations team to de- velop and expand several institutional proj- ects to bolster its clinical programs that focus on improving access to and quality of health- care, such as the Black Transplant Health Ini- tiative. e goal is to address both new and historic barriers to care through enhanced engagement with the Black community — lis- tening, building awareness, providing educa- tion, increasing access and advancing trans- formational transplant care. n

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