System wide Efforts to Improve Everyday Clinical Practice and

Health EquitySaint Francis Hospital and Medical Center

Jeri Hepworth, Ph.D., DIOMarcus McKinney, PhD., VP, Community Engagement

Rebecca Crowell, Ph.D., Research Director

Align resources, policies, procedures, governance and scholarly activity to inform, engage and promote quality Improve outcomes through continuous/iterative learning

Strengths – Community-based academic medical center committed to improving population health.Barriers – Community-based academic medical center committed to improving population within the current healthcare environment.

Overall Goal

History and Mission of Saint Francis Hospital 1897 by the Sisters of St. Joseph of Chambéry as a response to poverty. $75M each year in Community Benefit Care.

Community Based Hartford has the highest concentration of adult and child poverty in

Connecticut. Over 31% of Hartford residents live below the federally established

poverty level (US Census, 2010) 42% of Hartford residents are Spanish dominant with low English

fluency. Educational Commitments

Has independent ACGME accredited residency and fellowships large teaching hospital for UCONN with over 500 residents (120 FTE)

and 200 students Interprofessional education

Integration of Practice Improvement, Health Equity,

Research and Education

In 2011 the Saint Francis Board resolved to “raise awareness of equity of care and implementing improvements to reduce disparities in care.” 

Our Equity Goals: Increase Diversity in governance and management Increase Cultural Competency Training Increase Collection & use of Health Equity Data to reduce disparities

Much of this work comes out of the Curtis D. Robinson Center for Health Equity: cultural/diversity inclusiveness training relevant disparity data for patients resources for patient navigation Inclusion of community organizations in patient care Health Equity Research

Healthcare Quality/Disparities

Build on Institutional Commitment and Mission Community members and organizations full partners –

Collaborative Engagement Build collaborative relationships with educators, nursing,

QI, research Health Equity can not be separated from Quality and

Safety Initiatives Start small, with activities that impact daily practice,

patients and clinicians Maintain a Scholarly approach – develop metrics,

assessment of education Leverage capacity of the new EPIC electronic health record

Guiding Principles

Community and Provider Focus Groups – What do we know? Learning Health System – Framing communication as a

clinical, quality/safety and compliance issue Equitable care depends on good communication Collaborate with Clinicians to shape needs assessment Pool disparate language services resources to Center for

Health Equity MARTI implementation –

8 - 26 units Educational simulation pilot program Broad training processes

Meaningful Change: Enhanced Access to Language Services