Why Safety and Quality Depend on Equity–and Vice Versa
How can safety and quality care in our healthcare institutions depend upon equity?
It has long been true that every patient deserves safe and high-quality care, but today’s diverse population demands that we focus now on eliminating healthcare disparities in our institutions, according to Jack Lynch, FACHE, president and CEO of Main Line Health (MLH), Bryn Mawr, PA, in a recent article in the Journal of Healthcare Management (J Healthc Manag. 2017 Sep/Oct;62(5):298-301).
What is the connection between equity and the delivery of safe and quality care? Past research has demonstrated a simple fact accepted by healthcare leaders today: patients identifying as racial minorities or LGBQT face increased risk for adverse safety events in our healthcare system. With our population rapidly diversifying—according to the US Census Bureau (2017), minorities will make up 54% of the American population by 2050—we must commit now to an unequivocal pledge of safety and quality care for every patient. Falling short of this, we will risk providing suboptimal care for fully one of every two patients who seek our assistance.
According to Lynch, the pledge to achieve equity at MLH is built on three mandates:
- Commitment to the STEEEP principles (to deliver care that is Safe, Timely, Efficient, Effective, Equitable and Patient centered)
- Education for cultural competence
- Organizational culture that rewards employees who take a stand for safety
“As healthcare leaders, we must address disparities in care with the same intensity and passion with which we have unequivocally embraced patient safety and quality,” Lynch says.
One patient at a time—that’s how they meet the challenge at MLH, according to Lynch. While inequities in the country’s healthcare system lead to disparities in patient care, healthcare leaders cannot and should not consider this problem insurmountable, in Lynch’s view. By adopting the National Academy of Medicine’s STEEEP principles and holding all employees accountable for ensuring that each patient receives care that is safe, timely, efficient, effective, equitable and patient centered, MLH is committing to achieve their vision of equitable care for all by 2020.
When ethnic disparities in patient safety occur, often they can be traced to a lack of cultural competence—a blend of cultural knowledge, attitudes, skills and resources—on the part of the healthcare providers (Suurmond, Uiters, de Bruijne, Stronks, & Essink-Bot, 2010, p.S116). Healthcare leaders today have a moral and financial imperative to invest in cultural competence education for their staff.
AT MLH, managers participate in a Diversity, Respect and Inclusion workshop over 2 days; the hospital intends to roll out similar training to all staff in 2019. In his article, Lynch mentions several national organizations that can help healthcare organizations improve their teams’ cultural competency. One such resource is the ACHE’s Leading a Culture of Safety: A Blueprint for Success, which helps leaders build a safety culture grounded in trust, respect and inclusion.
Speaking up for safety
“At MLH, we have worked diligently to create a culture in which everyone feels empowered and encouraged to speak up for safety and ‘have each other’s back,’” says Lynch, though he shares that the organization, like others, has much work to do. Such an environment is an essential precondition for patient safety. Human error is unavoidable in healthcare, as everywhere. For this reason, healthcare leaders must cultivate a culture of respect and trust, where staff members feel empowered and emboldened to admit to, to report, and to stand up to impending error.
“If we can establish trust and respect in our organizations, we can then be sure every healthcare worker will be that much more committed and sensitive to providing compassion, respect, and an equitable experience to every individual who gives us the privilege to serve and care for them,” promises Lynch.