Physicians and other health professionals see health inequities play out among their patients on a daily basis, and that reality has been a longtime focus of discussion at many leading health systems. Targeted, systemic plans to advance health equity need to be implemented, and Rush University System for Health (RUSH) aims to do just that—put talk into action.
“At some point, we should stop presenting articles about how it [inequity] exists and start figuring out how to change it,” said Omar B. Lateef, DO, president and CEO of RUSH, during an episode of “AMA Update.”
That’s where David A. Ansell, MD, MPH, senior vice president of community health equity at RUSH University Medical Center, and his team was pivotal. They worked together with different hospitals and health systems across Chicago to find solutions to inequities in breast cancer outcomes.
“When you see it work, you realize that the solutions weren’t necessarily building a bigger ICU, but building more access, or figuring out what was at the root cause of people not knowing how to get access,” Dr. Lateef said.
Here is what RUSH has done—and other health systems should do too—to turn thought into action to make an impact on health equity.
Align resources to solve the gap
In Chicago, residents of the Gold Coast neighborhood will live 16 years longer than those who reside several subway stops west. But it’s not because of acute violence. It’s hypertension, uncontrolled diabetes and other common diseases.
“We know how to treat those diseases, so we should be able to extend the treatment of what we know how to treat to the people who have those diseases,” Dr. Lateef said. “It didn’t take long for anyone in health care to realize it takes more than giving a diabetes medication to help someone’s blood sugar.
“It takes access to healthy foods … affordable foods. It actually takes people having resources to buy healthy food. That’s where you get into the social determinants of health,” he added. “Once we realized all that, we put programs together strategically designed to tackle those specific challenges and then you see results and that’s where you start to feel like this is something more than just talk.”
Learn more about the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Among other benefits, members of the AMA Health System Program have access to the AMA Insight Network’s Quality, Safety and Equity community. This virtual forum provides an opportunity for like-minded leaders from across the country to hear more examples of how leading systems are finding innovative ways to address health care inequities in their communities.
Change the mission statement
“It’s one thing to have those experiences individually within communities or as doctors and nurses taking care of these patients. It’s another thing for an organization to take this on as a problem that we need to solve,” Dr. Ansell said.
At RUSH, the goal was to be the best in health care. Looking at metrics and measures of quality, RUSH has been among the top in the country. Yet people were still dying outside of their doors from common diseases.
That is why “changing our mission to improve the health of the populations we serve led us in this new strategic direction,” he said. “We embarked on it because we changed our mission and that led us to really think about what it would take to solve for the death gap.”
Work with the community
There hasn’t been a lot of trust between health organizations and communities or their leaders. That’s because you can’t discuss changes without helping communities understand what will happen and why.
“If you spoke and then you didn’t make the changes, you would very rapidly lose community trust and lose the ability to make a change,” Dr. Lateef said. “This comes by tabling egos and saying we’re going to partner and learn what the problems are we’re trying to solve, agree on a list of prioritizations and then go forth and solve those.”
“Actions speak louder than words,” he said, emphasizing that “you can’t embark on a journey like this without putting together tangible plans and delivering on those plans, otherwise you’ll lose the support of the community.”
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