Addressing Veteran Health-Related Social Needs: How Joint Commission Standards Accelerated Integration and Expansion of Tools and Services in the Veterans Health Administration
Justin M. List MD, MAR, MSc, FACP (Director, Health Care Outcomes, Office of Health Equity, US Department of Veterans Affairs (VA), Washington, DC.) , Lauren E. Russell MPH, MPP (is Health System Specialist and ACORN Co-Lead, Office of Health Equity, US Department of Veterans Affairs.) , Leslie R.M. Hausmann PhD (is Associate Director, VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and Associate Professor of Medicine and Clinical Translational Science, University of Pittsburgh School of Medicine.), Kristine Groves RN, BSN, MBA-HCM, CPHQ (is Executive Director, Office of Quality Management, US Department of Veterans Affairs.), Benjamin Kligler MD, MPH (is Executive Director, Office of Patient Centered Care and Cultural Transformation, US Department of Veterans Affairs, and Professor, Department of Family and Community Medicine, Icahn School of Medicine at Mount Sinai, New York.), Jennifer Koget MS, LCSW, BCD (is National Director of Social Work, Fisher House and Family Hospitality and Intimate Partner Violence Assistance Programs, Care Management and Social Work Services, US Department of Veterans Affairs.), Ernest Moy MD, MPH (is Executive Director, Office of Health Equity, US Department of Veterans Affairs.), Carolyn Clancy MD, MACP (is Assistant Under Secretary for Health for Discovery, Education and Affiliate Networks, US Department of Veterans Affairs. Please address correspondence to Justin M. List)
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Abstract
Background
The Joint Commission recently named reduction of health care disparities and improvement of health care equity as quality and safety priorities (Leadership [LD] Standard LD.04.03.08 and National Patient Safety Goal [NPSG] Standard NPSG.16.01.01). As the largest integrated health system, the Veterans Health Administration (VHA) sought to leverage these new accreditation standards to further integrate and expand existing tools and initiatives to reduce health care disparities and address health-related social needs (HRSNs).
Initiatives and Tools
A combination of existing data tools (for example, Primary Care Equity Dashboard), resource tools (for example, Assessing Circumstances and Offering Resources for Needs tool), and a care delivery approach (for example, Whole Health) are discussed as quality improvement opportunities to further integrate and expand how VHA addresses health care disparities and HRSNs. The authors detail the development timeline, building, limitations, and future plans for these tools and initiatives.
Coordination of Initiatives
Responding to new health care equity Joint Commission standards led to new implementation strategies and deeper partnerships across VHA that facilitated expanded dissemination, technical assistance activities, and additional resources for VHA facilities to meet new standards and improve health care equity for veterans. Health care systems may learn from VHA's experiences, which include building actionable data platforms, employing user-centered design for initiative development and iteration, designing wide-reaching dissemination strategies for tools, and recognizing the importance of providing technical assistance for stakeholders.
Future Directions
VHA continues to expand implementation of a diverse set of tools and resources to reduce health care disparities and identify and address unmet individual veteran HRSNs more widely and effectively.
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