Denise White Perkins, MD, PhD serves as Director of the Institute on Multicultural Health at Henry Ford Health System (HFHS) where she develops innovative research, educational and community-based programs aimed at eliminating health and healthcare disparities. The Institute on Multicultural Health studies the disparities in healthcare among people from underrepresented racial and ethnic populations. Download Dr. Perkins' ROCCStar Profile.
The Healthcare Equity Scholars Program (HESP) is an outgrowth of their Healthcare Equity Campaign. These projects were both key efforts which contributed to HFHS's selection as a recent awardee of the AHA’s Equity of Care award. Piloted last year, the HESP is a year-long program designed to create experts in the field of healthcare equity who are able to conduct research and quality improvement work aimed at eliminating healthcare disparities and to create organizational change promoting equity at the departmental or institutional levels.
Please describe the Henry Ford Health System Healthcare Equity Scholars Program (HESP). Specifically, highlight the program’s goals, learners, curriculum, outcomes, and resident engagement.
The Healthcare Equity Scholars Program is an outgrowth of our HFHS Healthcare Equity Campaign. Piloted this past year, it is a year-long program designed to create experts in the field of healthcare equity who are able to conduct research and quality improvement work aimed at eliminating healthcare disparities and to create organizational change promoting equity at the departmental or institutional levels. Scholars participated in monthly ½ day CME workshops focused on topics such as social determinants of health, quality improvement, and organizational change. They were also encouraged to examine their own attitudes and biases during interactive reflective group exercises and discussions of current issues in the news. In addition to attending skills-based workshops, each of our twenty participants implemented an equity-focused research, educational or quality improvement project within their own department or business unit. A team of health system, academic and community experts assisted us in conducting the workshops and were available to provide technical assistance on the projects. Scholars presented their projects to health system board members and other leaders at our closing session. Additionally several have presented their work at our annual system Quality Expo, various system meetings, and at national conferences. These healthcare equity scholars are key to ensuring that we have a cadre of health system leaders capable of addressing the cultural and linguistic needs of diverse populations to ensure that there is equity in quality and safety, patient satisfaction, and employee engagement.
How many HESP-supported projects have been initiated? Please describe an example.
Our 17 graduating scholars completed 14 equity-related projects which are now in various phases of dissemination/implementation. One project examining the impact of using a community health worker as part of our diabetes education team was able to demonstrate an improvement in diabetes management and utilization of diabetes care services among those patients who interacted with the CHW. As a result, we were able to get leadership support for hiring a CHW to be a full-time permanent employee working as a member of the diabetes care center team. The project was also presented at our quality expo and at the Association for Community Health Improvement in 2015. Interest across the health system is now growing for exploring other chronic conditions or service challenges which might be better addressed by including a community health worker in our model of healthcare delivery.
What are some of the barriers and keys to success in developing and implementing a health equity training program?
The most important key to our success was identifying scholars who are passionate about promoting equity in healthcare, open to the challenge of critically examining contributing factors at multiple levels and dedicated to the lifelong work of walking in cultural humility. In addition, it was essential to have the support of visionary senior leaders who endorse equity as core to providing quality care in the organization.
Our biggest barrier was the challenge of obtaining quality/outcomes data that is stratified by race/ethnicity, language and other social determinants of health. Although HFHS has done an excellent job of race, ethnicity and preferred language data collection, we are now working towards optimizing how we can most efficiently stratify and monitor our key outcome measures using this information. I anticipate that with our focus on value-based care as well as increasing efforts to improve documentation of social determinants of health the electronic health record, this will become easier.
What recommendations do you have for others hoping to begin to develop similar programs at their own institutions?
It is important to involve health system leaders in the process of designing and recruiting for such a program. We obtained valuable feedback from senior leaders in quality, research, education and patient care which helped to shape the structure and focus of our course. Such discussions will help to ensure that the program participants have the needed support from their home department to optimize their success. For example, they will need the release time to attend sessions and they will likely need access to quality or other outcomes data from their home department. In addition, it is key to get the buy-in of system leaders at the C-suite level and those leaders of the department which the scholars represent so that you can ensure the scholars’ participation is supported and that their projects are strategically aligned with high priority issues of the system/department. This optimizes the potential impact of their project and increases the ability of their findings to have sustainable integrated changes.
Please describe the future development plans for the HESP.
We will begin recruiting for our second class of scholars during the 4th quarter of 2015. Presently we are following up with graduated scholars to get updates on progress towards implementation and/or dissemination of their equity recommendations/initiatives/research. The next step will be to meet with senior leadership and researchers to see if we can identify support to further implementation/dissemination. We have also been very focused on keeping our graduating scholars engaged by inviting them to participate in ongoing projects, conduct presentations etc. We anticipate having some of our 2015 scholars present or co-facilitate future HESP sessions. Long term goal is to offer this program to others outside of HFHS
- Innovations for Eliminating Health Care Disparities
- Health Care Equity and Organizational Change: Training for a Purpose