Fran A. Ganz-Lord MD, FACP (is Senior Director, Performance Improvement, Network Performance Group, Montefiore Medical Center, Bronx, New York, and Associate Professor, Division of General Internal Medicine, Albert Einstein College of Medicine.), Paul Beechner MS (is Manager, Performance Improvement, Network Performance Group, Montefiore Medical Center.), Mark Wnorowksi MS (is Senior Manager, Performance Improvement, Network Performance Group, Montefiore Medical Center.), Dennis Asante MS (is Performance Improvement Specialist, Network Performance Group, Montefiore Medical Center.), Kenay Johnson MA, CPHQ (is Senior Manager, Performance Improvement, Network Performance Group, Montefiore Medical Center.), John Bianco MPH (is Performance Improvement and Data Specialist, Network Performance Group, Montefiore Medical Center.), Susan Gazivoda (is Project Associate, Network Performance Group, Montefiore Medical Center.), Stefanie K. Forest MD, PhD (is Clinical Performance Improvement Specialist and Laboratory Director, Network Performance Group, Montefiore Medical Center, and Assistant Professor, Department of Pathology, Albert Einstein College of Medicine. Please address correspondence to Fran A. Ganz-Lord)
{"title":"Equity and Performance Improvement: A Novel Toolkit That Makes Using an Equity Lens the Default","authors":"Fran A. Ganz-Lord MD, FACP (is Senior Director, Performance Improvement, Network Performance Group, Montefiore Medical Center, Bronx, New York, and Associate Professor, Division of General Internal Medicine, Albert Einstein College of Medicine.), Paul Beechner MS (is Manager, Performance Improvement, Network Performance Group, Montefiore Medical Center.), Mark Wnorowksi MS (is Senior Manager, Performance Improvement, Network Performance Group, Montefiore Medical Center.), Dennis Asante MS (is Performance Improvement Specialist, Network Performance Group, Montefiore Medical Center.), Kenay Johnson MA, CPHQ (is Senior Manager, Performance Improvement, Network Performance Group, Montefiore Medical Center.), John Bianco MPH (is Performance Improvement and Data Specialist, Network Performance Group, Montefiore Medical Center.), Susan Gazivoda (is Project Associate, Network Performance Group, Montefiore Medical Center.), Stefanie K. Forest MD, PhD (is Clinical Performance Improvement Specialist and Laboratory Director, Network Performance Group, Montefiore Medical Center, and Assistant Professor, Department of Pathology, Albert Einstein College of Medicine. Please address correspondence to Fran A. Ganz-Lord)","doi":"10.1016/j.jcjq.2023.11.003","DOIUrl":null,"url":null,"abstract":"<div><p>Performance improvement methodologies do not currently include any structures that encourage analysis of how bias, inequity, or social determinants of health (SDOH) contribute to outcomes. The Montefiore Center for Performance Improvement developed a novel quality improvement (QI) toolkit that ingrains issues of diversity, equity, and inclusion (DEI) and SDOH into the Institute for Healthcare Improvement's tools. The toolkit prompts QI teams to evaluate DEI and SDOH at each step of the journey, including an updated charter and stratified baseline tool, a new fishbone diagram for the discovery phase with a tail to include DEI and SDOH, and additions in the Study and Act sessions of the Plan-Do-Study-Act worksheet to address these issues. After development and dissemination of this toolkit, the authors conducted a pre-post analysis of projects conducted by QI fellows in their institution. Prior to introducing the new toolkit, 22.9% of projects from 2016 to 2021 incorporated DEI/SDOH into any stage of the QI process. After implementing the amended tools, this increased to 88.9% in the 2022 fellowship. These results show that this simple approach can hardwire consideration of DEI and SDOH into improvement projects.</p></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1553725023002714/pdfft?md5=75b99e4aa56655cc315750db6206b085&pid=1-s2.0-S1553725023002714-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725023002714","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Performance improvement methodologies do not currently include any structures that encourage analysis of how bias, inequity, or social determinants of health (SDOH) contribute to outcomes. The Montefiore Center for Performance Improvement developed a novel quality improvement (QI) toolkit that ingrains issues of diversity, equity, and inclusion (DEI) and SDOH into the Institute for Healthcare Improvement's tools. The toolkit prompts QI teams to evaluate DEI and SDOH at each step of the journey, including an updated charter and stratified baseline tool, a new fishbone diagram for the discovery phase with a tail to include DEI and SDOH, and additions in the Study and Act sessions of the Plan-Do-Study-Act worksheet to address these issues. After development and dissemination of this toolkit, the authors conducted a pre-post analysis of projects conducted by QI fellows in their institution. Prior to introducing the new toolkit, 22.9% of projects from 2016 to 2021 incorporated DEI/SDOH into any stage of the QI process. After implementing the amended tools, this increased to 88.9% in the 2022 fellowship. These results show that this simple approach can hardwire consideration of DEI and SDOH into improvement projects.
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