English, eLearning
Description
Vocal Characteristics
Language
EnglishVoice Age
Middle Aged (35-54)Accents
North American (General) North American (US General American - GenAM)Transcript
Note: Transcripts are generated using speech recognition software and may contain errors.
module four Slide 4.10. In other modules in this series, we talked about how health care and community partners need to address the social drivers of health inequities from individual needs like food security and housing stability to deeper root causes such as racism and economic inequities. We called this change in mindset, moving upstream as we are trying to improve people's health by addressing the factors that make people sick In the first place. In this module, we will talk about some practical measures that we, as healthcare providers can take to address these upstream issues and improve outcomes for our patients and communities. Slide 6.10. Specifically, we will explore an approach we called upstream Quality improvement, which adapts the same quality improvement framework and metrics that we already use for addressing challenges with traditional healthcare delivery and apply them to address the upstream social drivers of health and inequity at all levels. Slide 7.10 with me. As always, our Armando Diane and Christina. Armando is a nurse care manager. Diane is a primary care physician who recently took a leadership role for population health management in her system. And Christina is a social worker who moved from a community based organization to the community benefits department of a major health system in her area. Slide 8.10. By the end of this module, you should be able to define quality improvement concepts as they relate to upstream issues like social needs, social determinants of health and health equity, identify the elements of an upstream quality improvement campaign and describe how to develop a Q. I. Project charter to help improve health equity by addressing social needs, social determinants and structural determinants of health inequity Slide 10.10. Have you been involved in any major quality improvement Q. I. Projects at your workplace? Yes. So many. I'm getting a bit tired of them. That's understandable. Hopefully the guidance in this module will help expand the scope of what Q. I can accomplish. Yes, I've been involved in one or more. Good to hear this module should help you seek UI in a new light and give you a set of tools for addressing social and health equity issues that may affect your patients, your practice and your community personally. No, but we have had several Q. I. Projects in recent years. Good. You'll likely find a lot of the guidance in this module new but not to worry. We will provide step by step guidance for how to apply Q. I. Principles to address various social drivers of health and equity. No, we really haven't had many Q. I projects. That's alright. We'll review standard Q. I briefly and provide step by step guidance for addressing the social needs of patients and social determinants of health within communities. We will also highlight resources and tools to help you and your team develop campaigns to address social and structural drivers of health equity. No, I've heard the term Q. I but I don't really know what it means not to worry in this module. We'll discuss the basics of quality improvement and how you can use similar methodologies to make impactful upstream interventions. Slide 12.10 whether you work in a hospital clinic or another practice setting, you're no doubt heard the term quality improvement or Q. I. Before most health systems were on quality improvement initiatives year round. Typical goals for Q. I. Projects might include increasing uptake and adherence, the best practice guidelines, reducing readmissions, hospital acquired infections or no show rates increasing uptake of a particular procedure or intervention like breast cancer screenings. Slide 13.10. But these initiatives tend to focus on what goes on within the walls of a facility and often look narrowly at improving biomedical processes and outcomes rather than taking a broader bio psycho social perspective. Typically healthcare Q. I. Projects tend not to address social needs, health equity or other upstream factors. But what if we were to account for upstream social drivers of health equity and reimagine how we apply quality improvement? What could a hospital or clinic realistically do to measurably improve outcomes related to things like food insecurity, housing instability or structural racism? Slide 14 10 share your thoughts. Can you imagine ways you could use a Q. I approach to improve or track performance related to social drivers of health and equity in your setting. Not really. That seems like the job of the government and the social sector. Maybe for a few specific easily measured things like screening for social needs Perhaps as a secondary goal in a more conventional Q. I. Project. It's possible, but I'm not sure it would be practical where I work. Yes, I believe we could be doing this. We're already doing this. Thanks for your thoughts. Let's take a look at what upstream quality improvement looks like in action. Slide 15 10. Before we talk about upstream quality improvement, let's really quickly think through what goes into conventional quality improvement. What's the first thing we do for a typical Q. I. Initiative? That's right. We'd start by defining a problem which for a conventional Q. I. Project might be improving vaccination rates during flu season. But now, what would be the next step? Exactly. So we have a specific problem and a specific measurable goal. Say improving flu vaccination rates by 10% during flu season. What next? Right. So we have a problem. Low flu vaccination rates, a goal, improve it by 10%. And an intervention extended hours. So how might we apply the same basic idea but with an equity lens to address upstream issues. Well, yes and no racism is a social problem that affects the health of the community. But to address it, we need to focus on specific social drivers that disproportionately impact a specific group of patients Slide 17.10. And we can do this by following many of the same general principles of Q. I. As we said before, we need to define a problem. We need to have a specific and measurable goal. We need to identify and implement a specific set of interventions and we need to identify opportunities to test our ideas including exactly where the interventions should happen and who is responsible for making them. Slide 18 10. So for example when looking at our data, we might recognize that men are ending up in the emergency room with serious injuries including gunshots are data might show that young, black and latin X men suffer disproportionately higher rates of these injuries. Through conversation with patients and community partners and through data analysis we might find that this is connected to unemployment and at a deeper level structural racism. Slide 19.10 taking a cue I approach, we might set a goal of successfully connecting at least 90% of the unemployed men who come to the E. D. With injuries to a jobs and support program run by a community partner organization. Our theory of change being that this upstream intervention for unemployment will lead to better health and social outcomes for our priority population. Slide 20.10 to that end we might have nurses screen every young man who comes to our E. D. With injuries for unemployment and other unmet social needs. As soon as they're stabilized. Going beyond the E. D. We might also decide to attend or even host a meeting with local community partners, the public health department, law enforcement and public officials to discuss policies that can address this problem. And from there, we'd identify key metrics to track our performance and monitor results among our priority population, just as we would for conventional Q. I. Initiative.