In modern health care, hospitals stand as beacons of healing, embodying the convergence of medical science and human empathy. These centers of health are not just facilities; they symbolize a commitment to providing equitable care to all. Yet, beneath the surface of this noble endeavor, disparities persist, reflecting broader societal challenges. Health equity in hospitals goes beyond policy; it represents a moral imperative to ensure that every individual receives the care they need regardless of background or economic status. This complex and ever-evolving pursuit is at the heart of transforming healthcare into a truly inclusive system.

Why Does Inequity Exist in Hospitals

The persistence of inequity within the walls of hospitals is a complex issue with multifaceted roots. Several key factors contribute to the existence of inequity in health care settings.

1. Socioeconomic Disparities: Patients from lower-income backgrounds often face barriers to accessing health care services, including limited financial resources, lack of insurance, and transportation challenges. These barriers can result in delayed or forgone medical care, ultimately impacting health outcomes.
2. Racial and Ethnic Disparities: Systemic racism and bias within health care systems can lead to differential treatment and healthcare access based on a patient’s race or ethnicity. This can result in disparities in the diagnosis and management of diseases, as well as variations in treatment recommendations.
3. Geographical Disparities: Rural or underserved areas often have fewer health care facilities and providers, reducing access to care. Patients in remote areas may need to travel long distances to reach a hospital or specialist, creating disparities in health care utilization.
4. Cultural and Linguistic Barriers: Cultural and linguistic differences between patients and health care providers can hinder effective communication and understanding. This can lead to misdiagnoses, inappropriate treatments, and reduced patient engagement, all of which contribute to health care inequity.
5. Lack of Diversity in the Health Care Workforce: Patients may feel more comfortable and receive more culturally competent care when treated by health care professionals who share their background. Increasing diversity among health care providers is essential to addressing this aspect of health care inequity.
6. Systemic and Policy Factors: These may include underfunding of health care programs, lack of investment in underserved communities, and policies limiting access to care for certain populations. Addressing these systemic and policy factors is crucial to reducing health care inequities.

The Role of Medicare in Health Equity

Medicare supports health equity through its comprehensive coverage, which includes hospitalization, outpatient medical services, and prescription drugs. This coverage helps reduce the disparities in health care access and outcomes for the elderly and disabled populations. Moreover, Medicare’s preventive care services and chronic disease management programs are instrumental in mitigating health inequities, as these initiatives are designed to provide early detection and consistent management of health conditions that disproportionately affect underserved populations.

Despite its significant role, Medicare faces challenges in fully addressing health equity. Issues such as coverage gaps, high out-of-pocket costs for certain services, and limitations in long-term care coverage can still leave some beneficiaries vulnerable. Additionally, disparities in health care access and quality persist among different groups within the Medicare population, influenced by factors such as race, ethnicity, and socioeconomic status.

One aspect of Medicare that impacts health equity is its portability, especially when beneficiaries move to another state. Understanding how to transfer Medicare to another state is crucial for maintaining continuity of care. While Medicare coverage is generally nationwide, there are nuances, particularly with Medicare Advantage plans and Part D prescription drug plans, which may have specific service areas or networks.

Beneficiaries must be aware of these details to ensure seamless access to health care services when relocating, thus contributing to the overall goal of health equity in the Medicare program.

Strategies for Advancing Health Equity in Hospitals

This section delves into the strategies hospitals are adopting to advance health equity, ensuring that every individual receives equitable care.

• Policies and Practices to Enhance Health Equity in Hospitals: Hospitals must adopt policies and practices that explicitly address disparities to advance health equity. This includes implementing anti-discrimination policies, promoting diversity and inclusion in the workplace, and adopting equitable hiring and promotion practices. Hospitals can also establish clear guidelines for addressing patients’ cultural and linguistic needs, ensuring that all individuals receive respectful and equitable care.
• Role of Healthcare Professionals in Promoting Equity: Health care professionals play a pivotal role in advancing health equity. Training programs should focus on cultural competency and sensitivity, enabling healthcare providers to understand and address the unique needs of patients from diverse backgrounds. Encouraging diversity in the health care workforce is essential, as a diverse health care team can better relate to and serve a diverse patient population.
• Importance of Community Involvement and Patient Advocacy: Engaging with the community is essential for hospitals to address health disparities effectively. This involves partnerships with local organizations, conducting community needs assessments, and involving community members in decision-making processes. Additionally, hospitals can establish patient advocacy programs to empower individuals to navigate the health care system and advocate for their health. Also, many minority-owned business enterprises are taking a more proactive role, establishing business models that can effectively address inequity within health care settings.
• Utilizing Technology and Data to Address Inequities: Advancements in health care technology and data analytics can be harnessed to identify and address health inequities. Hospitals can use data to track disparities in care outcomes and tailor interventions accordingly. Telehealth and remote monitoring can increase access to care for underserved populations, bridging geographic barriers. Moreover, electronic health records can include cultural and social determinants of health data to provide a more comprehensive view of patients’ needs.

Wrapping Up

The challenges are evident in the journey toward health equity, but so is the unwavering commitment to change. Health equity is not an abstract goal. It’s a fundamental right. Hospitals, as beacons of hope, are pivotal in this pursuit. Policies, practices, and innovation are shaping a healthcare landscape where every individual receives the care they deserve. This journey is not finite; it’s a continuous path toward a world where health disparities are a thing of the past.

In a 2019 study by the Department of Population Health at the New York University’s School of Medicine, Washington, D.C. ranked second among the 500 largest U.S. cities for highest life expectancy gaps between racially and ethnically segregated neighborhoods.

Residents of the nation’s capital face a life expectancy gap of 27.5 years between the city’s most affluent neighborhoods and its most underserved communities, which house a large percentage of the city’s Black residents.

“[It’s an] unacceptable reality in one of the most powerful cities in the world,” says Michael Crawford, MBA, MHL, associate dean for strategy, outreach, and innovation at Howard University College of Medicine, affiliated with association member Howard University Hospital, in Washington, D.C., and founder and executive director of Howard University’s 1867 Health Innovations Project.

Having worked in health care for more than two decades, Crawford has long been familiar with the intersections of public health, finance, strategy, policy, innovation, and strategic partnerships in the space. In his previous role of chief of staff at Unity Healthcare, Crawford took an interest in the unique role digital health technology could play to eradicate gaps in care and offer patients within medically underserved communities greater medical autonomy.

Patient Safety & Quality Poster Competition Winners

The District of Columbia Hospital Association awarded its 2023 Patient Safety & Quality Awards for its poster competition at its Patient Safety & Quality Summit on November 14.

“Congratulations to the poster competition winners. Their expertise and tireless efforts are instrumental in paving the way for an improved health care system to better serve patients and provide quality patient care,” said DCHA President & CEO Jacqueline D. Bowens.

• Gold: Children’s National, Improving the Utilization of Palliative Care Consultation in the Neonatal Intensive Care Unit
  • Emily Rosenstein, Sofia Perazzo, and Jan Wilson
• Silver: MedStar National Rehabilitation Hospital, Improving Patient Outcomes Through High Intensity Gait Training
  • Maria Stidham, Katherine Brundage, and Alyssa Herzog
• Silver: Howard University Hospital, Midline Or Middle Ages! Catheter Associated Bloodstream Infection Reduction and Patient Satisfaction Improvement Strategy
  • Mpey Tabot Tabot, Renee Skific, John Prempeh, Mailen Fernandez, Rohan Kuruvilla, Mesay Asfaw, Daniel Larbi, Angella P. Browne, Terrance Jacobs; Shelly McDonald-Pinkett, Angesom Kibreab, and Alem Mehari
• Bronze: The George Washington University Hospital, Education & Call Backs for Patients with Hypertensive Disorders of Pregnancy Increases Adherence to Postpartum Care
  • Sheetal Sheth, Emily Nuss, Erika Sasaki, Phyllis Harris-White, Lauren Wohl, Kathryn Marko, and Lisa Cook
• Bronze: Howard University Hospital, Taking Wound Care Outcomes to the Next Level
  • Linda Miller, India Medley, Gina Wilson, and Musu Komeyan
• Bronze: MedStar Georgetown University Hospital, Impact of Supply Chain Disruption on CLABSIs in a Pediatric Transplant Unit
  • Megan Rayes

The Gold Winner was awarded a $3,000 prize, the Silver Winners received $2,000, and the Bronze Winners received $1,000. The award winners were chosen by a panel of independent judges from the health care industry. Congratulations to all winners.

Patient Safety & Quality Individual Award Winners

DCHA awarded its 2023 Patient Safety & Quality Awards for a non-clinical and clinical individual who exhibit excellence in their field, strengthening their hospital’s mission and goals. Award winners also manage change in an environment of competing priorities, and support resiliency and engagement from patients, caregivers, and the care team. The awards were presented during DCHA’s 45th Anniversary Gala Celebration on November 16.

Paul Quigley, Executive Director of Security, Parking & Transportation at Children’s National won the award in the non-clinical category.

Paul has implemented several initiatives to improve the safety for the patients, families, and staff at Children’s National Hospital. He’s instituted comprehensive training programs and processes including active shooter training, de-escalation techniques, electronic security screening, and security townhall meetings. Paul is a person that brings knowledge and experience and communicates his passion for safety and security in a way that makes you feel comfortable, not fearful. Even though he’s a leader, he will routinely be on the frontlines making rounds to ensure he’s meeting the safety expectations of staff, patients, and families.

Rosie Dunkle, Critical Care Clinical Specialist at MedStar Washington Hospital Center won the award in the clinical category.

Rosie’s leadership on the Catheter-Associated Urinary Tract Infections (CAUTI) Prevention Committee at MedStar Washington Hospital Center has led to a diagnostic stewardship protocol, nurse champion empowerment program, interdisciplinary CAUTI event reviews, and meaningful improvements to the pathology, provider, and nursing Electronic Medical Record resulting in a sustained CAUTI Standard Infection Ratio far exceeding system expectations. Rosie is an exceptional nurse who consistently exemplifies the highest level of safe, quality patient care for the most vulnerable patients. Rosie’s open communication skills enable her to be a great team player who demonstrates a caring and compassionate attitude towards her patients, co-workers, and family members.

“Congratulations to our winners – Paul & Rosie! Your dedication to creating a safe patient care environment is a true embodiment of what hospitals stand for,” said DCHA President & CEO Jacqueline D. Bowens.

Distinguished Service Award

DCHA presented its Distinguished Service Award to Dr. Sharon Lewis, former interim director of DC Health. The Distinguished Service Award is presented to individuals who demonstrate exceptional leadership, exemplary professional skills, and noteworthy achievements in the health care sector. Dr. Sharon Lewis stands as a shining example of a dedicated professional who devoted 36 years of her career to serving the DC Health hospital and health care community. Dr. Lewis excels in fostering collaboration between private, public, federal, and municipal stakeholders, driving innovation in health care management, and spearheading advancements in health care careers.

“The Distinguished Service Award recognizes and celebrates Dr. Sharon Lewis’s extraordinary contributions to the health care sector. Her dedication and exceptional skills have left an indelible mark on the industry,” said DCHA President & CEO Jacqueline D. Bowens.

DCHA extends its congratulations to Dr. Lewis and looks forward to continuing the exceptional work together and delivering outstanding leadership to the DC community.