It has been a while, but I am back and hopefully consistently so. Thanks to all of you who have encouraged engagement during my hiatus.
Let's explore the impact of disparate funding for black scientists. While studies like this can always be questioned as to method and reliability with over larger sample populations, the fact that the study was published in a reputable journal says that this issue is bigger than one of one race vs. another. This is an American problem. Disparity exists just like diversity does.
The questions are numerous: How well do we understand the impact of these disparities on our ability to compete globally? What is the impact of disparities such as those described in the study to our healthcare system overall?
As we examine the future of health, how science gets done and who does science is critical to our success in the U.S. and in a way globally given the historic impact of U.S. scientists. The conversation has to start even as far back as elementary education. This is significant, let's treat it as much bigger than we can see at present.
Biomedical Research Funding
NIH Uncovers Racial Disparity in Grant Awards
by Jocelyn Kaiser
It takes no more than a visit to a few labs or a glance at the crowd at a scientific meeting to know that African-American scientists are rare in biomedical research. But an in-depth analysis of grant data from the U.S. National Institutes of Health (NIH) on page 1015 in this issue of Science finds that the problem goes much deeper than impressions. Black Ph.D. scientists—and not other minorities—were far less likely to receive NIH funding for a research idea than a white scientist from a similar institution with the same research record. The gap was large: A black scientist's chance of winning NIH funding was 10 percentage points lower than that of a white scientist.
For whole article Click Here:
Showing posts with label health disparities. Show all posts
Showing posts with label health disparities. Show all posts
Tuesday, September 27, 2011
Sunday, October 25, 2009
Go Beyond the Surface
It has been a minute since I had an entry. It has not been a break from the conversation, just one from my writing about the cultural competence and quality on our blogs.
This one will be short. It often occurs to me that we often think about health disparities purely from a deficit model. We approach the prevalence of adverse health outcomes with the notion that our opportunity lies solely in fixing what's wrong.
It is natural to try to repair the wrongs, especially when they are driving our intention. The issue with this is that it is a purely past-based approach that inherently leaves us with limits. We are limited in the sense that we begin to look for the root of problem and then spend countless hours and endless conversations about changing the root.
The problem is that the root is resistant to change just like we are. In fact, if I were to stretch a little, I would say that where health disparities (aka quality disparities) are concerned, trying to get at the root causes and change them won't work. Of course, I don't think change works all that well either.
When we enter into the conversation about health disparities, it is important to do a strengths inventory as well as understand the dynamics of disparate outcomes on the negative side. In example, is the "Chicana effect" with birth outcomes. This term has been used to indicate that interesting fact that low birth weight birth outcomes are similar to that of whites and in some instances have been found to be lower regardless of social-economic status. It has led researchers to conclude that there are things socially and culturally within Latino/Chicano culture that are protective in nature.
If research and/or anecdote via our experience gives us insight into a positive health outcome in a particular community, it is vital that we look at the dynamics involved within that outcome. They may be sociocultural, they be structural, they can be a number of things. And it is possible that they can be leveraged in our cultural competence and quality efforts.
Make it a great day!
This one will be short. It often occurs to me that we often think about health disparities purely from a deficit model. We approach the prevalence of adverse health outcomes with the notion that our opportunity lies solely in fixing what's wrong.
It is natural to try to repair the wrongs, especially when they are driving our intention. The issue with this is that it is a purely past-based approach that inherently leaves us with limits. We are limited in the sense that we begin to look for the root of problem and then spend countless hours and endless conversations about changing the root.
The problem is that the root is resistant to change just like we are. In fact, if I were to stretch a little, I would say that where health disparities (aka quality disparities) are concerned, trying to get at the root causes and change them won't work. Of course, I don't think change works all that well either.
When we enter into the conversation about health disparities, it is important to do a strengths inventory as well as understand the dynamics of disparate outcomes on the negative side. In example, is the "Chicana effect" with birth outcomes. This term has been used to indicate that interesting fact that low birth weight birth outcomes are similar to that of whites and in some instances have been found to be lower regardless of social-economic status. It has led researchers to conclude that there are things socially and culturally within Latino/Chicano culture that are protective in nature.
If research and/or anecdote via our experience gives us insight into a positive health outcome in a particular community, it is vital that we look at the dynamics involved within that outcome. They may be sociocultural, they be structural, they can be a number of things. And it is possible that they can be leveraged in our cultural competence and quality efforts.
Make it a great day!
Tuesday, July 14, 2009
Cultural Competence is a Strategy
Human capital strategy is often considered to be a process that consists of many parts that operate separately. While this is a practical way to get certain things accomplished or checked off of a list, it is not a strategy.
What is a strategy?
I found many definitions for the term "strategy" when doing a search. Most of them were framed around military strategies. This one from Wikipedia resonated most:
A strategy is a plan of action designed to achieve a particular goal. The word strategy has military connotations, because it derives from the Greek word for general.
Strategy is different from tactics. In military terms, tactics is concerned with the conduct of an engagement while strategy is concerned with how different engagements are linked. In other words, how a battle is fought is a matter of tactics: whether it should be fought at all is a matter of strategy.
As our Cultural Competence-Quality Framework evolves and begins to be adopted by healthcare organizations, one fundamental premise is that the CC-Q Framework is to be leveraged as an integrated human capital strategy inclusive of and dependent upon many parts working in concert, fostering sustainable quality for every individual and organization that you seek to influence through your healthcare organization.
For example, in many organizations the focus of the quality efforts are relegated to those responsible for core measures. Occasionally, there will be a report in a leadership meeting and questions will be asked about certain things. However, it is the exceptional organization that is talking to those responsible for cultural competence, diversity, and inclusion about nuances based on individual values, beliefs, and responses that may be confounding core measures, leaving valuable information as a missing variable to ensuring a consistently positive patient experience.
This is not to say that every individual is going to be 100% satisfied with their care; however, knowing how certain dynamics play out creates the possibility.
Now, from this example there is a chain reaction: While the individual, committee, or outside consultant that is leading the efforts for cultural competence adds to the understanding of the quality/core measures leaders, the knowledge that is gained only has impact if those clinical and non-clinical professionals who are the touch points of patients and their families are made aware of what they can contribute to the fostering sustainable quality. It requires connecting with them, sharing with them, and getting their input in response.
Going further (interconnectedness is multi-faceted and inexhaustible but I won't go on and on after this example--maybe in a white paper ;-)) consider that soliciting and getting contributions from myriad areas and levels of employees, community members, volunteers, etc. fosters a level of engagement that creates ownership. Ownership of a thing, process, or idea fosters a relationship to it that engenders not just a good feeling but a level of commitment that leads to a greater contribution to the original idea as well as the many things that one might perceive support the original idea.
Jeremy Dean at PsyBlog says this about the psychology of ownership:
Effort increases perceived value: A table I have bought and struggled to build myself has more value to me than the same table I bought, for the same price, ready assembled. Expending our own effort means we've invested ourselves in an object, so it has more perceived value to us. Other people don't recognize this (and there's no reason why they should).
The bottom line is that when we leverage cultural competence as a strategy (and/or a core piece of your overall strategy) and we look for mechanisms to connect the dots from tactic to tactic, we naturally find how the pieces are seamlessly linked.
This is not to say that this is always easy. When we have been doing things a certain way for a long time change is challenging at its best. Nonetheless, when we truly understand cultural competence as a strategic approach vs. a tactic that speaks to checking something off of a list, the ROI can be tremendous.
Make it a great day!
What is a strategy?
I found many definitions for the term "strategy" when doing a search. Most of them were framed around military strategies. This one from Wikipedia resonated most:
A strategy is a plan of action designed to achieve a particular goal. The word strategy has military connotations, because it derives from the Greek word for general.
Strategy is different from tactics. In military terms, tactics is concerned with the conduct of an engagement while strategy is concerned with how different engagements are linked. In other words, how a battle is fought is a matter of tactics: whether it should be fought at all is a matter of strategy.
As our Cultural Competence-Quality Framework evolves and begins to be adopted by healthcare organizations, one fundamental premise is that the CC-Q Framework is to be leveraged as an integrated human capital strategy inclusive of and dependent upon many parts working in concert, fostering sustainable quality for every individual and organization that you seek to influence through your healthcare organization.
For example, in many organizations the focus of the quality efforts are relegated to those responsible for core measures. Occasionally, there will be a report in a leadership meeting and questions will be asked about certain things. However, it is the exceptional organization that is talking to those responsible for cultural competence, diversity, and inclusion about nuances based on individual values, beliefs, and responses that may be confounding core measures, leaving valuable information as a missing variable to ensuring a consistently positive patient experience.
This is not to say that every individual is going to be 100% satisfied with their care; however, knowing how certain dynamics play out creates the possibility.
Now, from this example there is a chain reaction: While the individual, committee, or outside consultant that is leading the efforts for cultural competence adds to the understanding of the quality/core measures leaders, the knowledge that is gained only has impact if those clinical and non-clinical professionals who are the touch points of patients and their families are made aware of what they can contribute to the fostering sustainable quality. It requires connecting with them, sharing with them, and getting their input in response.
Going further (interconnectedness is multi-faceted and inexhaustible but I won't go on and on after this example--maybe in a white paper ;-)) consider that soliciting and getting contributions from myriad areas and levels of employees, community members, volunteers, etc. fosters a level of engagement that creates ownership. Ownership of a thing, process, or idea fosters a relationship to it that engenders not just a good feeling but a level of commitment that leads to a greater contribution to the original idea as well as the many things that one might perceive support the original idea.
Jeremy Dean at PsyBlog says this about the psychology of ownership:
Effort increases perceived value: A table I have bought and struggled to build myself has more value to me than the same table I bought, for the same price, ready assembled. Expending our own effort means we've invested ourselves in an object, so it has more perceived value to us. Other people don't recognize this (and there's no reason why they should).
The bottom line is that when we leverage cultural competence as a strategy (and/or a core piece of your overall strategy) and we look for mechanisms to connect the dots from tactic to tactic, we naturally find how the pieces are seamlessly linked.
This is not to say that this is always easy. When we have been doing things a certain way for a long time change is challenging at its best. Nonetheless, when we truly understand cultural competence as a strategic approach vs. a tactic that speaks to checking something off of a list, the ROI can be tremendous.
Make it a great day!
Saturday, July 4, 2009
Health Disparities are Quality Disparities
The 2008 National Healthcare Quality Report and the National Healthcare Disparities Report from the Agency for Health Research and Quality were and are generally published each year at the same time.
This is very much appropriate, but it is hard to know if people are making the connection between the two reports. If we have health and/or healthcare disparities, particularly in the sense that with most things equal (SES, access, etc.) there are still disparate outcomes or disparities, what does that speak to?
Well, there are few things that we can consider.
1) Genetics: While the data on genetic predisposition is emerging there are pros and cons to this variable. A 2005 editorial The Role of Race and Genetics in Health Disparities Research out of the American Journal of Public Health summarizes the potential role of the human genome mapping in our evaluating causes and approaches to health disparities quite succinctly.
My experience is that given the long history of disparate outcome by race coupled with the emerging understanding of disparities in the LGBT, Disabilities, and other communities, genetics may play a role but the role that they play will be at best complementary.
2) Social, Environmental, Behavioral Factors: Health behaviors differ from person to person. Some of these behaviors are influenced by cultural health models and beliefs, experiences and responses to the health system and healthcare providers, and environmental circumstances. Behavior has and will always have an influence on health outcomes and behaviors will always be influenced by the behaviors of healthcare providers. So, the dynamic is a two-way street. There is evidence that experiences of healthcare providers (of all ethnic backgrounds) influence how treatments and recommendations for treatment are allocated. One classic study of this is a New England Journal of Medicine Article by Schumann, et. al.: The Effect of Race and Sex on Physicians' Recommendations for Cardiac Catheterization.
While there were subsequent articles that questioned the authors' findings and the subsequent media attention that was generated, there was no denying the unequal treatment recommendations were prevalent and conclusive from the data collected in the study. This leads me to one last consideration (for now):
3) Quality Disparities: What do I mean by "quality disparities"? Let's move outside of healthcare for a minute and consider other industries where quality is vital (assume all industries believe it is).
For example, as the president of a company you have been delivering a high-quality product or service for quite sometime. Based on your evaluation and the responses of the customers, you are receiving feedback that what you are producing is consistently good amongst a majority of your customers. You are committed to quality because of your dedication to maintaining integrity but also due to the fact that your competition is fierce and while you are leading the pack, you never take your success for granted.
One day, it is brought to your attention that over 25% of your customers (by industry vertical, geography, or some other variable) are experiencing negative outcomes in the utilization of your product or service, yielding on average 2 times more problems than the other 75%.
What is your response? What do you think?
Well, one response is to say, "we have been delivering quality for so long, what is it with these 25%? We give everyone the same service consistently."
Another response is to say, "where is the breakdown?" Followed by, "is there something that we don't really understand about our customers that will help us serve them better?"
In an environment of stiff competition, you will do your research to understand who these 25% are, what exactly their challenges are and develop solutions to narrow the outcomes gap.
Or, you will decide that these 25% of customers are the problem and let them go, concluding that the 80/20 rule says that they are not necessarily benefiting you that much anyway. This may work or it may take you out of the #1 spot as the industry leader, especially if those segments are fast growing.
Back to healthcare. If 20% or more of our patients are experiencing worse health outcomes than the other 80%, obviously there are disparities there. More than likely, this is also what I would consider a quality issue even if we know that "we are treating everyone the same".
Why is this a quality issue? In fact, why are health disparities quality disparities? The answer lies not in the fact that hospitals are not delivering quality services. I believe that most facilities and individual practitioners are delivering very high quality services. I also think there are distinctions in what translates as quality.
Patient-centered care asks us to treat patients as individuals. It suggests that each patient is functioning and managing their health under a unique set of circumstances and if those circumstances are not understood to as great of an extent as possible, we may miss the mark on their needs short and long term and thus contribute to less than the best outcomes.
Missing the mark is reflective of the quality of services delivered for each person based on their unique needs that can sometimes be a result of archetypal dynamics of a particular group identity.
If over time, certain demographic segments are experiencing poor outcomes (just like a certain vertical or segment of a non-healthcare company) quality is being compromised. Your integrity is not compromised--you are doing all that you know how to do--but your outcomes are unequal and therefore certain groups are not getting what you intend for them to get and in some cases what you promise them based on previous experiences.
The response in healthcare has to be the first response described above for the hypothetical company--understand this population and develop solutions to address their problems. The second option of letting these customers go is not an option in healthcare. While there have been instances in which populations with greatest needs have been met with barriers to treatment because of the challenges they present, this is a response that given the times we are in and the realities of demography, we simply will not and cannot consider. We cannot do it morally nor can we shoulder it economically.
Aligning cultural competence with quality, affordable and accessible care is what the DHW Cultural Competence-Quality Framework for Healthcare Excellence is all about. Understanding that integrated efforts towards eliminating health and healthcare disparities (a core part of our CC-Q Framework) are a critical and central tenant in the quality care that all Americans desire is vital to assuring our success in reforming the healthcare system.
This post is a very short exploration of health disparities being considered as quality disparities. I would like to explore the idea of health disparities compromising our goal of quality affordable care in more detail. Please share your thoughts with me, the Diversity HealthWorks community and all those visiting our blogs.
Make it a great day!
This is very much appropriate, but it is hard to know if people are making the connection between the two reports. If we have health and/or healthcare disparities, particularly in the sense that with most things equal (SES, access, etc.) there are still disparate outcomes or disparities, what does that speak to?
Well, there are few things that we can consider.
1) Genetics: While the data on genetic predisposition is emerging there are pros and cons to this variable. A 2005 editorial The Role of Race and Genetics in Health Disparities Research out of the American Journal of Public Health summarizes the potential role of the human genome mapping in our evaluating causes and approaches to health disparities quite succinctly.
My experience is that given the long history of disparate outcome by race coupled with the emerging understanding of disparities in the LGBT, Disabilities, and other communities, genetics may play a role but the role that they play will be at best complementary.
2) Social, Environmental, Behavioral Factors: Health behaviors differ from person to person. Some of these behaviors are influenced by cultural health models and beliefs, experiences and responses to the health system and healthcare providers, and environmental circumstances. Behavior has and will always have an influence on health outcomes and behaviors will always be influenced by the behaviors of healthcare providers. So, the dynamic is a two-way street. There is evidence that experiences of healthcare providers (of all ethnic backgrounds) influence how treatments and recommendations for treatment are allocated. One classic study of this is a New England Journal of Medicine Article by Schumann, et. al.: The Effect of Race and Sex on Physicians' Recommendations for Cardiac Catheterization.
While there were subsequent articles that questioned the authors' findings and the subsequent media attention that was generated, there was no denying the unequal treatment recommendations were prevalent and conclusive from the data collected in the study. This leads me to one last consideration (for now):
3) Quality Disparities: What do I mean by "quality disparities"? Let's move outside of healthcare for a minute and consider other industries where quality is vital (assume all industries believe it is).
For example, as the president of a company you have been delivering a high-quality product or service for quite sometime. Based on your evaluation and the responses of the customers, you are receiving feedback that what you are producing is consistently good amongst a majority of your customers. You are committed to quality because of your dedication to maintaining integrity but also due to the fact that your competition is fierce and while you are leading the pack, you never take your success for granted.
One day, it is brought to your attention that over 25% of your customers (by industry vertical, geography, or some other variable) are experiencing negative outcomes in the utilization of your product or service, yielding on average 2 times more problems than the other 75%.
What is your response? What do you think?
Well, one response is to say, "we have been delivering quality for so long, what is it with these 25%? We give everyone the same service consistently."
Another response is to say, "where is the breakdown?" Followed by, "is there something that we don't really understand about our customers that will help us serve them better?"
In an environment of stiff competition, you will do your research to understand who these 25% are, what exactly their challenges are and develop solutions to narrow the outcomes gap.
Or, you will decide that these 25% of customers are the problem and let them go, concluding that the 80/20 rule says that they are not necessarily benefiting you that much anyway. This may work or it may take you out of the #1 spot as the industry leader, especially if those segments are fast growing.
Back to healthcare. If 20% or more of our patients are experiencing worse health outcomes than the other 80%, obviously there are disparities there. More than likely, this is also what I would consider a quality issue even if we know that "we are treating everyone the same".
Why is this a quality issue? In fact, why are health disparities quality disparities? The answer lies not in the fact that hospitals are not delivering quality services. I believe that most facilities and individual practitioners are delivering very high quality services. I also think there are distinctions in what translates as quality.
Patient-centered care asks us to treat patients as individuals. It suggests that each patient is functioning and managing their health under a unique set of circumstances and if those circumstances are not understood to as great of an extent as possible, we may miss the mark on their needs short and long term and thus contribute to less than the best outcomes.
Missing the mark is reflective of the quality of services delivered for each person based on their unique needs that can sometimes be a result of archetypal dynamics of a particular group identity.
If over time, certain demographic segments are experiencing poor outcomes (just like a certain vertical or segment of a non-healthcare company) quality is being compromised. Your integrity is not compromised--you are doing all that you know how to do--but your outcomes are unequal and therefore certain groups are not getting what you intend for them to get and in some cases what you promise them based on previous experiences.
The response in healthcare has to be the first response described above for the hypothetical company--understand this population and develop solutions to address their problems. The second option of letting these customers go is not an option in healthcare. While there have been instances in which populations with greatest needs have been met with barriers to treatment because of the challenges they present, this is a response that given the times we are in and the realities of demography, we simply will not and cannot consider. We cannot do it morally nor can we shoulder it economically.
Aligning cultural competence with quality, affordable and accessible care is what the DHW Cultural Competence-Quality Framework for Healthcare Excellence is all about. Understanding that integrated efforts towards eliminating health and healthcare disparities (a core part of our CC-Q Framework) are a critical and central tenant in the quality care that all Americans desire is vital to assuring our success in reforming the healthcare system.
This post is a very short exploration of health disparities being considered as quality disparities. I would like to explore the idea of health disparities compromising our goal of quality affordable care in more detail. Please share your thoughts with me, the Diversity HealthWorks community and all those visiting our blogs.
Make it a great day!
Thursday, June 11, 2009
Minority Politicians and Health Disparities: The Messenger, the Message
In 2002 the Institute of Medicine through the actions, concern and political will of the minority caucuses of the U.S. (primarily House Democrats)making a request to the National Academy of Sciences to create a comprehensive report (Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care) on ethnic and racial disparities that has become one of the definitive if not the most definitive report on health disparities that has ever been published.
The publications created a foundational conversation that, as I have shared before in other writings, politicized the issue and raised the level of the conversation. This has been a very good thing.
However, what has not happened is a moving of the health disparities conversation from a single-faceted issue to one that is central to the success of our healthcare system and to the overall success of health reform.
Quality accessible healthcare, cultural competency, eliminating disparities, workforce diversity, patient-centered care and many other aspects of what one would consider successful outcomes of healthcare organizational excellence are all necessary to consistently make successful outcomes a reality.
Now, more so, than perhaps any other period in recent history is time to align our message and enroll messengers to deliver it consistently.
So, on Monday(6/8)there was a flurry of activity in the media announcing that the Congressional Black Caucus (CBC) sent President Obama a letter outlining their desire to assure that health disparities are a core issue in the health reform conversation. They had a meeting about this and subsequently, Health and Human Services Secretary Sebelius published a report (I say a Brief) entitled Health Disparities: A Case for Closing the Gap that outlined some of the pertinent health disparities issues connoting a need for the issue to be addressed comprehensively as part of health reform. It was published on HealthReform.gov.
I agree with the need to focus, who wouldn't. However, I am concerned by two things in particular:
1) The Messenger. Health disparities is a very broad and complicated issue. Even though racial and ethnic disparities are very prevalent and have been central to the issue, what we are facing is much bigger. We are facing the dynamics of access combined with multiple populations that are vulnerable to adverse health outcomes regardless of accessibility of services and not because of their race or ethnicity.
HEALTH DISPARITIES IS AN ISSUE THAT IMPACTS ALL AMERICANS.
So, my concern is that the messenger is generally minority. This is not a bad thing, someone has to say something. The challenge is that when the CBC and other minority caucuses are the predominant leaders in this conversation about how to make health disparities a part of the overall health reform agenda, the issue settles consciously or unconsciously in many of our minds as an issue that they are responsible for. An issue that is all about them.
By not consistently engaging and enrolling a variety of groups such as representatives from the Lesbian, Gay, Bisexual, and Trans-gender communities, the disabled, veterans, non-minority women, and others we miss the opportunity to frame health disparities, health equity, and cultural competency as an issue that simultaneously is inclusive of and transcends "minorities". It is an issue that affects everyone living in the U.S. directly or indirectly.
2) The Message.
--What is framework for the health disparities conversation within the context of health reform?
--What does it need to be?
--As a health professional or other professional, if you believe that addressing health disparities, quality affordable/accessible care, cultural competence, patient-centered care are important: How do you articulate their interdependence? (more)
The publications created a foundational conversation that, as I have shared before in other writings, politicized the issue and raised the level of the conversation. This has been a very good thing.
However, what has not happened is a moving of the health disparities conversation from a single-faceted issue to one that is central to the success of our healthcare system and to the overall success of health reform.
Quality accessible healthcare, cultural competency, eliminating disparities, workforce diversity, patient-centered care and many other aspects of what one would consider successful outcomes of healthcare organizational excellence are all necessary to consistently make successful outcomes a reality.
Now, more so, than perhaps any other period in recent history is time to align our message and enroll messengers to deliver it consistently.
So, on Monday(6/8)there was a flurry of activity in the media announcing that the Congressional Black Caucus (CBC) sent President Obama a letter outlining their desire to assure that health disparities are a core issue in the health reform conversation. They had a meeting about this and subsequently, Health and Human Services Secretary Sebelius published a report (I say a Brief) entitled Health Disparities: A Case for Closing the Gap that outlined some of the pertinent health disparities issues connoting a need for the issue to be addressed comprehensively as part of health reform. It was published on HealthReform.gov.
I agree with the need to focus, who wouldn't. However, I am concerned by two things in particular:
1) The Messenger. Health disparities is a very broad and complicated issue. Even though racial and ethnic disparities are very prevalent and have been central to the issue, what we are facing is much bigger. We are facing the dynamics of access combined with multiple populations that are vulnerable to adverse health outcomes regardless of accessibility of services and not because of their race or ethnicity.
HEALTH DISPARITIES IS AN ISSUE THAT IMPACTS ALL AMERICANS.
So, my concern is that the messenger is generally minority. This is not a bad thing, someone has to say something. The challenge is that when the CBC and other minority caucuses are the predominant leaders in this conversation about how to make health disparities a part of the overall health reform agenda, the issue settles consciously or unconsciously in many of our minds as an issue that they are responsible for. An issue that is all about them.
By not consistently engaging and enrolling a variety of groups such as representatives from the Lesbian, Gay, Bisexual, and Trans-gender communities, the disabled, veterans, non-minority women, and others we miss the opportunity to frame health disparities, health equity, and cultural competency as an issue that simultaneously is inclusive of and transcends "minorities". It is an issue that affects everyone living in the U.S. directly or indirectly.
2) The Message.
--What is framework for the health disparities conversation within the context of health reform?
--What does it need to be?
--As a health professional or other professional, if you believe that addressing health disparities, quality affordable/accessible care, cultural competence, patient-centered care are important: How do you articulate their interdependence? (more)
Wednesday, May 20, 2009
I Determine What is Relevant
Since May 11th and the President's remarks on May 11th about reforming the healthcare reform, I thought that I needed to write something in context about cultural competency and quality or at the least give my perspective on how health disparities have to be considered if we are going to make any sustainable change in healthcare as a whole.
I pondered what to write and even scratched out an outline of the points I wanted to make sure I explained thoroughly. After pondering and outlining and pondering some more, I realized that I needed more perspective. So, I began to read more blogs and opinions and tweets of those for universal coverage and those against what is being labeled as "socialized medicine".
The amount of information and disinformation and opinion is startling. I have a decent grasp of how the healthcare system works from point of care to process of payment and beyond. Yet, making sense of all the opinions about what health care reform must do, what it will create negatively and positively, to those who believe that the system is fine and that changing it will cause health plans to fail, to those "Good Americans" that simply want everyone to pay their way, is mind boggling to me. I cannot imagine what a person who has not been trained in these dynamics experiences when trying to connect the dots.
My conclusion is that "I determine what is relevant". Now, the "I" in this statement does include, I, Amri. It also includes you, reader. It also include you, pundit, politician, President, Peter, Paul, and Poppins, and potificatoblogwriterspindoctorsincerejournalistpeacemakerparent. (More)
I pondered what to write and even scratched out an outline of the points I wanted to make sure I explained thoroughly. After pondering and outlining and pondering some more, I realized that I needed more perspective. So, I began to read more blogs and opinions and tweets of those for universal coverage and those against what is being labeled as "socialized medicine".
The amount of information and disinformation and opinion is startling. I have a decent grasp of how the healthcare system works from point of care to process of payment and beyond. Yet, making sense of all the opinions about what health care reform must do, what it will create negatively and positively, to those who believe that the system is fine and that changing it will cause health plans to fail, to those "Good Americans" that simply want everyone to pay their way, is mind boggling to me. I cannot imagine what a person who has not been trained in these dynamics experiences when trying to connect the dots.
My conclusion is that "I determine what is relevant". Now, the "I" in this statement does include, I, Amri. It also includes you, reader. It also include you, pundit, politician, President, Peter, Paul, and Poppins, and potificatoblogwriterspindoctorsincerejournalistpeacemakerparent. (More)
Thursday, May 7, 2009
Culture and Quality Part III--10 Resources
In lieu of another article in this part, I decided that sharing resources that will help you frame culture and quality together would be valuable. While I intended to share these resources in the final quarter so to speak, I thought they would be helpful now.
By no means is this meant to be a definitive list. In fact, I welcome suggestions on what should be added to it that allows us to see the connections between cultural competency and quality more clearly. We want (continuing for some and beginning for others) to make this an integral part of our foundation for creating seamless connections of cultural competency, diversity, and inclusion with our collective organizational quality development, mission, and of course, for healthcare reform.
Culture and Quality: Joining the Levers (2002)
Dr. Mark D. Smith, MD, MBA, CEO of the California Healthcare Foundation clearly illustrates the movements of cultural competency and quality and their connection. He frames the presentation around “What are we going to do?” It is important to note that this was 2002 when Dr. Smith presented at the Third National Conference on Quality Health Care for Culturally Diverse Populations. It is 2009, the issue has risen in priority, the presentation is very timely to this day.
The Providers Guide to Quality and Culture
Management Sciences for Health has created a very comprehensive website focused on Quality and Culture for healthcare providers. This site is very comprehensive and frames the quality dynamics with succinct descriptions and a broad grouping of subjects. The site was created with the U.S. Department of Health and Human Services, Health Resources and Services Administration, and the Bureau of Primary Health Care.
National Center for Quality Assurance (NCQA) Efforts
NCQA has taken great efforts to align quality and cultural competency for health plans. In fact, many health plans have been actively making cultural competency and the reduction/elimination of health disparities a priority for years. (more)
By no means is this meant to be a definitive list. In fact, I welcome suggestions on what should be added to it that allows us to see the connections between cultural competency and quality more clearly. We want (continuing for some and beginning for others) to make this an integral part of our foundation for creating seamless connections of cultural competency, diversity, and inclusion with our collective organizational quality development, mission, and of course, for healthcare reform.
Culture and Quality: Joining the Levers (2002)
Dr. Mark D. Smith, MD, MBA, CEO of the California Healthcare Foundation clearly illustrates the movements of cultural competency and quality and their connection. He frames the presentation around “What are we going to do?” It is important to note that this was 2002 when Dr. Smith presented at the Third National Conference on Quality Health Care for Culturally Diverse Populations. It is 2009, the issue has risen in priority, the presentation is very timely to this day.
The Providers Guide to Quality and Culture
Management Sciences for Health has created a very comprehensive website focused on Quality and Culture for healthcare providers. This site is very comprehensive and frames the quality dynamics with succinct descriptions and a broad grouping of subjects. The site was created with the U.S. Department of Health and Human Services, Health Resources and Services Administration, and the Bureau of Primary Health Care.
National Center for Quality Assurance (NCQA) Efforts
NCQA has taken great efforts to align quality and cultural competency for health plans. In fact, many health plans have been actively making cultural competency and the reduction/elimination of health disparities a priority for years. (more)
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