Centering Equity in Digital Health Solutions

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.

DCHA Presented Leadership & Service Awards to Local Advocates at 45th Anniversary Gala

DCHA Presented Chairman Vincent C. Gray with Inaugural Health Equity Award

DCHA proudly commemorated our 45th Anniversary on November 16, with a grand celebration at the Ronald Reagan Building & International Trade Center. This significant milestone provided an opportunity for DCHA to recognize and honor an individual whose unwavering dedication has significantly impacted the health care landscape in the District of Columbia.

The DCHA Board of Directors announced The Honorable Vincent C. Gray as the inaugural recipient of the DCHA Health Equity Award. This esteemed accolade was presented to Chairman Gray in recognition of his decades-long, dedicated service to the District of Columbia and his steadfast commitment to ensuring that all residents have equal access to high-quality health care services.

“This much deserved recognition is in honor of his decades of service to the District and his perseverance in ensuring that all residents have access to quality health care. Councilmember Gray has a history of dedication to eradicating health disparities and was an instrumental force in making the Cedar Hill Regional Medical Center a reality,” said DCHA Board Chairman and President of Sibley Memorial Hospital Dr. Hasan Zia.

DCHA extends its heartfelt congratulations to The Honorable Vincent C. Gray and expresses its deep appreciation for his outstanding contributions to the health care community. This momentous occasion reaffirms DCHA’s commitment to working collaboratively to build a health care system that truly serves all residents.

“We are thrilled to honor and recognize individuals who tirelessly champion the rights and well-being of patients and families,” remarked DCHA President & CEO Jacqueline D. Bowens. “In honor of his exceptional contributions, we are excited to announce that this award will be known as the Vincent C. Gray Health Equity Award, reflecting Chairman Gray’s enduring legacy and commitment to the cause of health equity.

The Vincent C. Gray Heath Equity Award will honor and recognize individuals who are making health equity a reality in their community and leveraging engagement to improve health outcomes for those most impacted by health disparities. The award will go to an individual or organization that can demonstrate they have contributed to reducing disparities in health care quality.

DCHA Presented Doreen Gentzler with Haynes Rice Community Service Award

DCHA presented its Haynes Rice Community Service Award to Doreen Gentzler, former anchor with NBC4 at its 45th Anniversary Gala on November 16 at the Ronald Reagan Building & International Trade Center. This prestigious award acknowledges Doreen’s exceptional commitment and meritorious service in enhancing the health and well-being of the community served by DCHA members. It is a testament to her unwavering personal integrity and outstanding professional skills in problem-solving and surmounting obstacles to foster cooperative actions.

“Doreen has been a dedicated advocate for the DC community for over four decades, championing the cause of health care in both the hospital and health care sectors,” said DCHA President & CEO Jacqueline D. Bowens. “Her unwavering commitment to the DC Health & Fitness Expo and her role as a trusted source of health information for the greater Washington metropolitan area have left an indelible mark. She has tirelessly advocated for the betterment of both physical and mental health in the region.”

DCHA extends its congratulations to Doreen Gentzler and looks forward to continuing to work together and delivering outstanding efforts and leadership to our DC community.

Gentzler, a native of Arlington, Virginia, returned home to the Washington area in 1989 to join Jim Vance, Bob Ryan and George Michael on the WRC anchor desk. On her first newscast, Gentzler’s longtime co-anchor and close friend Jim Vance welcomed her by saying, “This is Doreen, folks. Doreen Gentzler. She’s going to be with us for quite a while.” Thirty-three years later, it’s safe to say Vance was right.

Gentzler played a key role in the station’s ratings success, anchoring News4 at 6 and News4 at 11 through her entire tenure and reporting throughout the world, including in Bosnia and Ecuador and aboard the USNS Comfort hospital ship. But she’s best known for her reporting in the D.C. area, where she has served as the station’s medical reporter for more than 30 years. Her clear, intelligent approach to telling these stories has provided important information, which some have called lifesaving.

DCHA Presented Dr. Kurt Newman with Robert Sloan Leadership Award

DCHA is thrilled to announce that the esteemed Robert Sloan Leadership Award was given to Dr. Kurt Newman, former President & CEO of Children’s National. This distinguished award recognizes his outstanding years of service and exemplary leadership qualities that have left an enduring mark on the health care community in the District of Columbia and beyond.

“We owe a wealth of gratitude for the sacrifices from individuals like Dr. Newman. Their efforts help us prepare for a better health care system for the residents of DC,” said DCHA President & CEO Jacqueline D. Bowens. “Dr. Newman’s outstanding contribution and commitment to fostering successful relationships in the DC health care community has left a positive impact.”

DCHA extends its congratulations to Dr. Kurt Newman and looks forward to continuing to work as a unifying force to bring better outcomes in the health care system.

Dr. Newman joined Children’s National as a surgical fellow in 1984 and became surgeon-in-chief and senior vice president for the Joseph E. Robert, Jr., Center for Surgical Care in 2003. He was instrumental in developing the vision for the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National, inspired by the bold vision of making surgery for children minimally invasive and pain-free. When the institute was created in 2009 through a transformational $150 million gift, Dr. Newman served as founding vice president. Last year, Dr. Newman received the CEO of the Year award from the Washington Business Journal.

Under Dr. Newman’s leadership, Children’s National was ranked No. 5 nationally in the U.S. News & World Report 2022-23 Best Children’s Hospitals annual rankings, which marked the sixth straight year Children’s National made the Honor Roll list, which ranks the top 10 children’s hospitals nationwide. In addition, its neonatology program, which provides newborn intensive care, ranked No.1 among all children’s hospitals for the sixth year in a row.

DCHA Patient Safety & Quality Awards

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.

  • Ouro: Children’s National, Improving the Utilization of Palliative Care Consultation in the Neonatal Intensive Care Unit
    • Emily Rosenstein, Sofia Perazzo, and Jan Wilson
  • Prata: MedStar National Rehabilitation Hospital, Improving Patient Outcomes Through High Intensity Gait Training
    • Maria Stidham, Katherine Brundage, and Alyssa Herzog
  • Prata: 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.

Quality Showcase Publication: Best Practices from DC Hospitals

DC Hospitals are Leaders in Creating Quality Systems of Care
As the District of Columbia Hospital Association (DCHA) celebrates the milestone of 45 years acting as a unifying force advancing hospitals and health systems in the District, we are proud to share examples of our hospitals’ commitment to patient safety that drives positive outcomes. In collaboration with members and the community, we seek to promote policies and initiatives that strengthen our system of care, preserve access, eliminate disparities, and promote better health. We are proud to highlight the work of our hospital members to improve patient safety and quality in a time of competing priorities. The initiatives presented in this publication emphasize quality improvement methodology and highlight the innovative and effective projects taking place within District hospitals. These initiatives represent the dedication of our health leaders in the District to provide quality and equitable care for the communities we serve.

 

Sibley Memorial Hospital Addresses Equity, Diversity and Inclusion with its Ward Infinity Program

 

Ward Infinity is designed to partner with change agents to magnify and accelerate their capacity to radically improve underinvested communities’ health and well-being by reducing health disparities and building health equity through community-driven solutions. We partner with founders in Washington, D.C. that have an impact and show a commitment to creating wealth and solving for social determinants of health that significantly impact Wards 7 & 8. The goals of the program are to eliminate disparities, increase inclusion, build trust and ensure viability. The program also addresses food, relationships, environment, health technology and health care systems.

July 2023 Utilization Report

There was a slight increase in the percentage of psychiatric admissions compared to the January 2020 pre-COVID baseline from -23% in June to -22% in July. Also, of note regarding psychiatric admissions: The impact of St. Elizabeths Hospital reopening beds closed during COVID can be seen in tables 6 and 7 of the report where the percent change from the prior year ranges from 44.4% – 87.5%. All other utilization metrics highlighted in Fig. 1 below decreased from June to July a compared to the January 2020 baseline month. Although ambulatory surgery and observation volumes are among those that declined from June to July, information available in the report indicates that both have increased overall when comparing the most recent 12 months to the prior 12 month period by 3.25% (Table 16) and 6.48% (Table 17) respectively.

 

Minority-Owned Business Enterprises: Transforming Health Care And Advancing Health Equity

Equity is defined as the absence of systemic disparities between groups with different levels of underlying social advantage/disadvantage—wealth, power or prestige. From voter suppression to housing discrimination, racial differences in health outcomes can be explained by centuries of policies and practices that have intentionally excluded nonwhite groups from access to opportunity. Moreover, inequitable practices baked into the “institutions” that shape society sustain seemingly intractable disparities in health.

The institutions of medicine and health care are no exceptions. But as discussed below, many minority-owned business enterprises (MBEs) are challenging the status quo in health and health care, advancing health equity in transformative ways, and bridging the gap between health care and the many social factors that occur outside of care settings but have a huge impact on health.

Authors: Dr. Christopher King, Dean of School of Health, Georgetown University Medical Center and Deliya Banda Wesley, Senior Director of Health Equity, Mathematica

Chairman Vincent C. Gray and Dr. Kurt Newman to Receive Awards

Hospital and Health Care Advocates to Receive Awards at

DCHA’s 45th Anniversary Gala, November 16

 

Chairman Vincent C. Gray to Receive Health Equity Award

The DCHA Board of Directors has selected Chairman Vincent C. Gray (Ward 7 Councilmember and Chair, Committee on Hospital & Health Equity) as the first honoree to receive DCHA’s Health Equity Award. This much deserved recognition is in honor of Chairman Gray’s decades of service to the District of Columbia and his perseverance in ensuring that all residents have access to quality health care. Chairman Gray’s steadfast and unwavering commitment to creating a system of health care that ensures access that should not be limited based on zip code will soon be a reality with the opening of the Cedar Hill Regional Medical Center, slated to open the Fall of 2024. This is just one example of his legacy of commitment and dedication to eradicating health disparities.

Dr. Kurt Newman to Receive Robert L. Sloan Leadership Award 

The DCHA Board of Directors has selected Dr. Kurt Newman, former President & CEO of Children’s National Hospital, to receive the Robert L. Sloan Leadership Award for his years of service and demonstrated leadership qualities. Dr. Newman’s commitment to fostering successful relationships and partnering with the DC health care community, along with his high personal integrity and professional excellence, has made a positive impact on the residents of DC and beyond. The Robert L. Sloan Leadership Award is presented to a senior level individual from a DCHA member hospital for having demonstrated the qualities of leadership inspired by Mr. Sloan. Named in honor of the former President & CEO of Sibley Memorial Hospital from 1985 until 2012, he also served two terms as Chairman of the DCHA Board of Directors.

MedStar Washington Hospital Center Named Socially and Racially Responsible Hospital

MedStar Washington Hospital Center is the most socially responsible hospital in Washington, D.C. and is tops in the nation, according to the Lown Institute, a nonpartisan health care think tank.

The 2023-24 Lown Institute Hospitals Index evaluated more than 3,600 hospitals nationwide, and MedStar Washington Hospital Center ranked #1 in D.C. and is one of only 54 U.S. hospitals to earn Honor Roll status with “A” grades in all top categories: Social Responsibility, Health Equity, Value of Care, and Patient Outcomes — key performance metrics that contribute to the overall rating. It also named MedStar Washington the most racially inclusive hospital in the District.

In 2022, MedStar Washington Hospital Center earned the designation of “LGBTQ+ Healthcare Equality Leader” in the Human Rights Campaign Foundation’s Healthcare Equality Index (HEI), with the top score of 100. This designation recognizes the hospital’s continued commitment to an equitable, inclusive environment for both patients, visitors, and staff.

To compile its rankings, the Lown Institute used publicly available data from Medicare fee-for-service and Medicare Advantage claims, Centers for Medicare and Medicaid Services safety data and hospital cost reports, Internal Revenue Service 990 forms, and other sources. Learn more at LownHospitalsIndex.org.

Behavioral Health Emergency Room Dilemma: Children Waiting in Crisis

Logo of XFERRAL

While emergency department (ED) visits for other medical causes that affect children declined in the early stages of the pandemic, the number of children’s mental health-related ED visits rose 24% among 5- to 11-year-olds. It also surged 31% among 12- to 17-year-olds in April 2020 through October, compared to that period in 2019, according to a November Centers for Disease Control and Prevention report. During the pandemic we also saw a rise in ED visits for suspected suicide attempts among young people. Among teen girls, such visits were up 51% from February to March earlier this year compared to 2019, according to a June CDC report. These are staggering experiences facing youth and children today. Complicating these situations even more is the difficult experience of accessing care when crisis care is needed.

Most children and adolescents experiencing a behavioral health crisis wait hours or even days for placement in clinically appropriate therapeutic treatment. One study documents an average length of stay in the hospital emergency department for psychiatric admissions of 18 hours, compared to 5 hours for non-psychiatric admissions.1 Others have estimated average boarding times of between 6.8 hours and 34 hours for patients needing psychiatric treatment.2,3  Children’s hospitals reportedly saw a 45 percent increase in pediatric self-injury and suicide cases between January and July 2021. In 2020, pediatric mental health-related hospital emergency department visits increased 24% for children ages 5-11 and 31% for older children and adolescents.

“Extended ED boarding is detrimental for children and adolescents with behavioral health issues,” said Jennifer Wolff, PhD, an associate professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University, a staff psychologist at Rhode Island Hospital and Bradley hospitals, and the director of the Adolescent Mental Health Collaborative at Brown.

Dr. Wolff and her colleagues found a threefold increase in the number of pediatric patients who boarded in their children’s hospital ED over the past three years and a 60% increase in the average time spent boarding in the ED. (Adm Policy Ment Health. 2023 Jan;1; https://bit.ly/3KaUqJ0.)

Dr. Wolff said care delayed further can also exacerbate existing problems. “For some of these kids who have really chronic psychopathology and are going to need long-term care, we run the risk of them having a negative experience that is so detrimental that it is a deterrent to them seeking care later on,” she said. “People are becoming aware that the system is broken and that we need to do more to serve these kids, but I wish there was more help coming faster.”

In August of 2023, American Academy of Pediatrics published a The Management of Children and Youth with Pediatric Mental and Behavioral Health Emergencies with Recommendations for Optimizing and Improving Care of Pediatric Patients with Mental Health Emergencies which included referral networks and the use of technologies to improve care coordination which is where XFERALL helps.

XFERALL’s mission is to drastically save time for clinical staff and reduce the amount of time patients spend in EDs waiting for a transfer to the most appropriate care center by applying innovative technology solutions. XFERALL enables real-time communication so that clinicians needing to place a patient can request placement at as few or as many facilities as they choose; receive responses from facilities or programs that can accept and treat the patient; and share clinical information — all within minutes from a single source.

This coordinated approach allows caregivers and patients to be engaged in the decision-making process. In states that have adopted XFERALL, finding placement for youth and children went from multiple hours or days to sixty minutes or less on average.  In just a matter of minutes, providers can coordinate and provide options for families seeking care for their child.

XFERALL partners with health systems, mental health crisis teams and healthcare providers across the nation to expedite access to care for children and adolescents experiencing a mental health crisis. In July of 2023, the median time to secure placement on the XFERALL network was 36 minutes.  XFERALL is available nationwide and continues to expand with the mission of driving quality improvement through expediting access to care. To learn more about this program and how it can support improving access for youth in crisis visit us aqui.

Sources:

1 Nicks BA, Manthey DM. The impact of psychiatric patient boarding in emergency departments. Emerg Med Int 2012; 2012: 360308.

2 Weiss AP, Chang G, Rauch SL, et al. Patient and practice-related determinants of emergency department length of stay for patients with psychiatric illness. Ann Emerg Med. 2012;60(2):162–71.

3 Tuttle GA. Access to psychiatric beds and impact on emergency medicine. Chicago, IL: Council on Medical Service, American Medical Association; 2008.

4 Pediatricians, Child and Adolescent Psychiatrists and Children’s Hospitals Declare National Emergency in Children’s Mental Health, October 19, 2021.

© 2024. District of Columbia Hospital Association.