What is Health Equity?
Equitable care does not vary in quality because of personal characteristics such as gender identity, sexual orientation, gender expression, religion, race, ethnicity, preferred language, geographic location or socioeconomic status. Quality care cannot be achieved without equity.
Despite decades of evidence showing persistent health disparities impacting populations made vulnerable by racism and discrimination, progress is slow to close the gaps. Quality initiatives measuring only outcomes of general populations may conceal widening gaps in care or disparate outcomes of historically marginalized groups. Focused efforts are needed to uncover health disparities within health systems, train staff to better understand root causes of inequities in healthcare and partner with communities to address social needs.
Getting Started
Demographic Data Collection and Reporting
Collecting detailed patient demographics, in a respectful patient-centered way, allows for informative population health analysis, including the ability to detect health disparities. Washington is the first state in the country to require all hospitals to report detailed patient demographics including: race, ethnicity, language, sexual orientation, gender identity and disability. Hospitals are working to modify EHR and patient portals, mapping new codes to other reporting systems and developing workflows. While much has been accomplished, we seek to continuously improve data collection, patient experience and utility of demographic data reported.
Hospital Reporting of Demographic Data – WSHA webpage dedicated to sharing recommendations and resources to support WA hospitals collecting and submitting detailed patient self-reported demographics.
WSHA convened a small workgroup of subject matter experts to provide recommendations for hospital collection of sexual orientation and gender identity (SOGI) from youth. These are endorsed by the WSHA Board Clinical Excellence Committee.
WSHA Health Equity Workgroups
Join a WSHA Health Equity Workgroup! Participants in the workgroups commit to action that advances health justice for marginalized populations of WA state. Washington hospitals and health system members are invited to enroll using this signup link.
Each workgroup is topic-specific and aims to both support internal transformation efforts and set collective goals to achieve together:
Gender-Affirming Care Workgroup
Goal: To empower WA hospitals to provide safe respectful environments and care experiences for gender diverse and LGBT patients.
- We will elevate the “why” behind collecting gender information and the harms of misgendering patients. This workgroup will promote use of patient pronouns and patient-centered collection of gender identity and sexual orientation data. Community partners will be invited to participate.
- Gender-Affirming Care Workgroup Charter (August, 2023)
- Enroll as a WA hospital/health system participant
- Notify interest as a community or non-WSHA member
This workgroup is currently working towards launching a recognition program for hospitals implementing patient-centered collection of sexual orientation and gender identity (SOGI) data. Workgroup members meet monthly.
Equity Measures and Data Analytics Workgroup
Goal: To identify or design measures to inform health equity and disparities reduction action plans.
- Strategies will be shared to improve completeness and validity of patient sociodemographic data, stratification of clinical quality measures, development of health equity dashboards, and communication via reports. Guidance on analyzing data to identify health disparities and ensuring equity in data visualization will be provided.
- Equity and Data Analytics Workgroup Charter (July, 2023)
- Enroll as a WA hospital/health system participant
- Notify interest as a community or non-WSHA member
This workgroup is paused and will reconvene in 2025. If you need support on health equity related measures, reporting or disparities action planning, contact Abigail Berube. Clinical quality leaders are encouraged to include health equity in dashboard design and quality improvement data tracking. The 2024 Medicaid Quality Incentive program includes a measure for reporting demographic data.
Social Determinants of Heath Workgroup
Goal: Improve efforts within WA hospitals to universally screen for core health-related social needs (housing, transportation, food, utilities and interpersonal violence) and develop workflows to address or connect patients to needed community services.
- Community partners and healthcare need to work together predictably and reliably to bring social determinant resource to families. Specifically, this workgroup will begin by addressing food insecurity needs of our patients. This is one of the most frequent social needs identified through screening and has an immediate impact on health. By focusing on food insecurity initially, this workgroup will test and refine approaches to inform addressing other drivers of health.
- SDOH Workgroup Charter (July, 2023)
- Enroll as a WA hospital/health system participant
- Notify interest as a community or non-WSHA member
This workgroup is paused and will reconvene in 2025. Social needs screening and community-based referrals continue to be a priority of hospitals and health systems. This work aligns with CMS Inpatient Quality Reporting measures, Joint Commission elements of performance and new work underway in WA state to implement Medicaid Transformation Project 2.0 (1115 waiver).
Diversity, Equity and Inclusion (DEI) Roundtable
WSHA is working to identify WA hospital and healthcare professionals leading diversity, equity and inclusion (DEI) activities. This may include Health Equity Officers, DEI Directors/Coordinators/Managers, HEDI Committee Chairs at your health system and local facilities. To receive invitations to DEI related events hosted by WSHA, please complete the contact form.
DEI leaders are invited to meet with peers to discuss strategies and promising practices for creating inclusive environments for staff and patients and increasing health equity in WA state. The convening forum, titled DEI Roundtables, will take place virtually every other month. Each session will focus on a topic, the session in January will focus on policy review with an equity lens. Registration is restricted to our WA member hospitals and contracted out of state partners
DEI Roundtables are currently paused, will resume after the summer!
Tools and Resources
Roadmap to Reduce Disparities – a link to the Solving Disparities Roadmap to Reduce Disparities, a six-step framework for health care organizations to improve minority health and foster equity.
Equity of Care: A Toolkit for Eliminating Health Care Disparities – a PDF toolkit published by the Health Research and Education Trust for eliminating health care disparities.
A Guide to Reducing Disparities in Readmissions – a PDF document, this guide provides clear, concise, practical, and actionable recommendations for hospital leaders focused on health care quality, safety, and redesign.
National LGBTQIA+ Health Education Center, A Program of the Fenway Institute – Education and training on collection of sexual orientation and gender identity data, as well as health topics for supporting gender diverse and LGBTQ patients.
The Do No Harm Project, Urban Institute – The Do No Harm Guide body of work consists of several guides for how researchers and analysts can approach their work through a lens of diversity, equity, and inclusion.
Bree Collaborative Recommendations on Social Determinants of Health – a PDF document detailing a framework, checklists and tools for screening and referring patients with health-related social needs.
Past Programming
In 2021, 30 hospital and health system teams across WA and OR, representing over 50 sites of care, enrolled in the WSHA Health Equity Collaborative. They participated for 18-months in an “all teach, all learn” collaborative including the implementation of three 90-day implementation sprints. Sprint goals included improving effective language access services, collecting patient self-reported race and ethnicity data, promoting use of pronouns, designing health equity dashboards, screening and addressing health-related social needs and other foundational components of delivering equitable care. The Health Equity Collaborative concluded in Dec, 2022.
