Health Equity, Diversity & Inclusion Measures for Hospitals and Health System Dashboards
Health equity is achieved when individuals reach their highest potential for health. Hospitals and health systems are actively engaged in addressing inequities, reducing disparities and increasing opportunities for diversity and inclusion to strengthen their connection to the communities, they serve. A basic level health equity, diversity and inclusion dashboard may include the following: race, ethnicity and language preference data collection, stratification and use, cultural competency training, diversity and inclusion in governance and leadership, and community partnerships. This dashboard can provide health care leaders with the necessary information, tools and resources to advance their health equity, diversity and inclusion journey. For your convenience, we have created both a downloadable PDF version and an interactive dashboard.
How to Use this Dashboard
- Assemble an interdisciplinary team that is ultimately reporting to C-suite executives responsible for driving health equity, diversity and inclusion initiatives within hospitals and health systems, is best positioned to utilize this document.
- The measures under each goal are intended to be easily integrated into existing dashboards.
- The “Operationalizing this Measure” column describes ways in which hospitals and health systems may engage stakeholders across the system.
- The supporting tools and resources feature briefs, guides and toolkits that will help hospitals and health systems make progress toward achieving that specific measure and ultimately advancing health equity, diversity and inclusion in hospitals, health systems and the communities they serve.
- Click on the interactive dashboard below to access desired outcomes and measures, ways to operationalize measures, and tools and resources to support growth for each goal.
Domain 4: Strengthen Community Partnerships
Desired Outcome
Increase, improve, strengthen and evaluate partnerships with community-based organizations, faith-based organizations, government agencies (including public health departments), businesses, educational institutions and other organizations to meet patients’ and communities’ needs.
Measure
- Percent of community partners that align with strategic priorities of the hospital or health system or community health needs assessment.
Intent of Measure/KPI
Increasing, improving and/or strengthening existing community partnerships can help hospitals and health systems better implement community health strategies to improve care, create a network of sustainable partnerships to address social needs and optimize patient navigation strategies.
Operationalizing the Measure
After analyzing data and evaluating community health efforts, hospitals and health systems can outreach to specific community-based organizations to help meet their needs toward achieving their community health goals. Hospitals and health systems can also utilize community partners to serve as key stakeholders to help plan targeted interventions to improve community health efforts. Evaluating the effectiveness of community partnerships can be assessed through partner engagement, teamwork and community responsiveness. For example, Henry Ford Allegiance Health in Michigan supports a unified community effort to identify emerging issues, take effective action and meet people’s needs during the pandemic.
Tools and Resources
Domain 1: Data Collection, Stratification and Use
Desired Outcomes
Increase the collection, stratification and use of race, ethnicity, language (REaL) preference data.
Measures
- Percent of workforce (staff and clinicians) trained regarding collection of self-reported REaL data.
- Percent of patient records with REaL data preference complete with opportunity for verification at multiple points of care, beyond just registration.
Intent of Measures/KPI
Data collection, stratification and use are essential to developing initiatives to eliminate disparities in health outcomes. By collecting, stratifying and using REaL patient data along with other data points such as sexual orientation, gender identity, geographic location, veteran status and disability status, hospitals and health systems can better identify disparities in patient populations.
Operationalizing the Measures
REaL data can be collected at various points of care or within the community. For example, Henry Ford Health System, an AHA 2020 Carolyn Boone Lewis Equity of Care Award Honoree, collects REaL data for more than 90% of patients, as a result of their “We Ask Because We Care” campaign. The data is stratified and used to implement programs and improve outcomes in maternal and infant health, diabetes management and prevention, and other areas.
Tools and Resources
Increase the collection, stratification and use of data (sexual orientation, gender identity and disability status) among broader culturally diverse populations.
Measures
- Percent of patient records with sexual orientation, gender identity and disability status data complete with opportunity for verification at multiple points of care, beyond just registration.
- Percent of workforce trained regarding collection of sexual orientation, gender identity and disability status for patients.
Intent of Measures/KPI
Data collection, stratification and use are essential to developing initiatives to eliminate disparities in health outcomes. By collecting, stratifying and using REaL patient data along with other data points such as sexual orientation, gender identity, geographic location, veteran status and disability status, hospitals and health systems can better identify disparities in patient populations.
Operationalizing the Measures
Atrium Health, AHA’s 2019 Carolyn Boone Lewis Equity of Care Award Honoree, developed a “Demographic Data Wall,” which is used to identify disparities in population health measures and stratifies race, ethnicity, language, sexual orientation and gender identity data allowing clinical leaders to identify gaps in outcomes across populations.
Tools and Resources
Identify and monitor the collection and use of patient social needs such as: food insecurity, housing stability, transportation needs, education needs, social support, financial stability, employment, physical safety and other measures that are specific to your population’s needs.
Measures
- Percent of patient records with social needs data complete with opportunity for verification at multiple points of care, beyond just registration.
- Percent of workforce trained regarding collection of social needs areas for patients.
Intent of Measures/KPI
Data collection, stratification and use are essential to developing initiatives to eliminate disparities in health outcomes. By collecting, stratifying and using REaL patient data along with other data points such as sexual orientation, gender identity, geographic location, veteran status and disability status, hospitals and health systems can better identify disparities in patient populations.
Operationalizing the Measures
Rush University Medical Center, an AHA 2019 Carolyn Boone Lewis Equity of Care Award Honoree, implemented social needs screening across the system and community settings to identify risk factors associated with social needs (food insecurity, housing instability and transportation). For example, Rush works to mitigate the social determinants of health (SDOH) through strategic partnerships that provide food delivery services to older adults.
Domain 3: Diversity & Inclusion in Leadership and Governance
Desired Outcome
Identify and act on opportunities to increase and foster diversity, equity and inclusion in governance and leadership to reflect the community your organization serves.
Measures
- Percent of community partners that align with strategic priorities of the hospital or health system or community health needs assessment.
- Percent of leadership who represent diverse and inclusive backgrounds.
- Percent of emerging leaders who represent diverse and inclusive backgrounds.
- Percent of diverse and inclusive employees who participate in employee resource groups.
Intent of Measures/KPI
Increasing diversity, equity and inclusion in governance and leadership will support hospitals and health systems to reflect communities they serve and most importantly to reduce health care disparities. It also aides in increasing employee engagement as well as promoting or attracting talent.
Operationalizing the Measures
Northwell Health, an AHA 2019 Carolyn Boone Lewis Equity of Care Award Honoree, is committed to diversifying their workforce through a health care workforce development program. Women represent 72 percent of Northwell Health’s workforce with 44 percent serving in executive roles.
Tools and Resources
Certification
Certificate in Diversity Management in Health Care
Increase transparency of data sharing with the governance body through ensuring health equity, diversity and inclusion data-driven practices are embedded within governance committees.
Measure
- Percent of opportunities in which health equity, diversity and inclusion data are used to drive strategic decisions with governance committees.
Intent of Measure/KPI
Increasing diversity, equity and inclusion in governance and leadership will support hospitals and health systems to reflect communities they serve and most importantly to reduce health care disparities. It also aides in increasing employee engagement as well as promoting or attracting talent.
Operationalizing the Measure
Hospitals and health systems can work to establish a health equity, diversity and inclusion committee at the governance level and this committee could report data at a frequency deemed appropriate by the board. This committee may also operate as a subcommittee of the quality and patient safety committee of the board.
Tools and Resources
Assess and disseminate accountability and collaboration of executives responsible for driving health equity, diversity and inclusion initiatives and programs.
Measure
- Percent of executives/leaders who have explicit roles or goals related to driving health equity, diversity and inclusion practices in their performance expectations.
Intent of Measure/KPI
Increasing diversity, equity and inclusion in governance and leadership will support hospitals and health systems to reflect communities they serve and most importantly to reduce health care disparities. It also aides in increasing employee engagement as well as promoting or attracting talent.
Operationalizing the Measure
Hiring health equity, diversity and inclusion professionals or aligning initiatives related to health equity, diversity and inclusion amongst existing executives is a widely recognized practice for driving initiatives within the system, especially when outcomes are tied to executive compensation.
Tools and Resources
Certification
Certificate in Diversity Management in Health Care
Domain 2: Cultural Competency Training
Desired Outcome
Implement and/or monitor cultural competency training amongst all employees and clinicians to ensure culturally responsive care within strategic planning efforts, operations, yearly employee trainings, clinical care, social services and other areas specific to your organization.
Measures
- Percent of employees and clinicians who have completed cultural competency training.
- Percent of patient and family complaints related to cultural competency.
- Rate of patient satisfaction scores (HCAHPS, CG-CAHPS) pre- and post- cultural competency training stratified by race, ethnicity and language preference.
Intent of Measures/KPI
Cultural competency and unconscious/implicit bias trainings increase health care professionals’ understanding of factors that are important to patients and play a key role in care decisions. These trainings also provide an opportunity for health care professionals to be mindful of unconscious and implicit biases that may occur when interacting with patients and team members.
Operationalizing the Measures
Chatham Hospital, a member of the University of North Carolina Health System and an AHA 2020 Carolyn Boone Lewis Equity of Care Honoree, administers trainings in communication, cultural competency and unconscious bias to employees. These trainings can be implemented yearly as part of continuing education for employees.
Increase unconscious and implicit bias training amongst all employees and clinicians to ensure that associations or attitudes that are reflexive do not alter perceptions, behaviors, interactions or decision-making.
Measures
- Percent of employees and clinicians who have completed unconscious/implicit bias training.
- Rate of patient satisfaction scores (HCAHPS, CG-CAHPS) pre- and post- unconscious/implicit bias training. .
Intent of Measures/KPI
Cultural competency and unconscious/implicit bias trainings increase health care professionals’ understanding of factors that are important to patients and play a key role in care decisions. These trainings also provide an opportunity for health care professionals to be mindful of unconscious and implicit biases that may occur when interacting with patients and team members.