A Proposed Framework for Integration of Quality Performance Measures for Health Literacy, Cultural Competence, and Language Access Services Proceedings of a Workshop (2018) / Chapter Skim
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5 Moderated Discussion with Implementer Panel 2
5 Moderated Discussion with Implementer Panel 2
Pages 49-60
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From page 49... ...
He noted that, though the commissioned paper does state that the goal of the framework is to use an integrated approach to improve quality and 1 This section is based on the comments of George Isham, senior advisor to HealthPartners; Alicia Wilson, executive director of La Clínica del Pueblo; Knitasha Washington, executive director of Consumers Advancing Patient Safety; and James Crall, chair of the Division of Public Health and Community Dentistry at the University of California, Los Angeles (UCLA) , School of Dentistry and director of the UCLA First 5 L.A.
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From page 50... ...
He posed the question of whether the framework should focus on vulnerable populations or the entire population, and whether it should include all of health care, ranging from small practices to large health care systems that include health plans. While Isham did applaud putting patient-centeredness as the framework's core concept, given its importance in realigning care away from being provider centered to better respond to the individual backgrounds, preferences, and concerns of patients, he said he did not see anything in the commissioned paper about the structure of data needed to show how individual practitioners respond to their patients' preferences.
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From page 51... ...
To illustrate that point, she said that during the more than 15 years she has been working as a health care professional, she has lived two separate lives, one focusing on improving safety and quality and the other on improving equity, with the former paying the bills and the latter being her passion. However, when she lost her father to a preventable medical error, she then saw the connection of how a lack of cultural competency and health literacy affects both quality and safety.
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From page 52... ...
Speaking from his perspective as an oral health specialist, Crall said he strongly supports the framework's patient-centered focus and the role it can play in helping the dental profession in its work to become more patient centered. He is a member of the Dental Quality Alliance, a collection of dental and other health care provider groups and payers working with the Joint Commission, NCQA, and federal agencies to create a focus around measurement, quality improvement, and performance improvement with a
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From page 53... ...
He noted the concept of mass customization, or use cases, to align staff, data, and investments toward improving community health. Commenting specifically on health literacy, Isham said that what is needed is a strategy that moves upstream from the health care enterprise, one that addresses the large percentage of people in the United States with
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From page 54... ...
Standardized data and more detailed information about an organization's patient population could also improve risk stratification methodology, which is becoming more of an issue as the nation's health care enterprise moves toward outcomes-based payments. Such data could also enable research aimed at better understanding the connections between social determinants, such as low literacy, and health outcomes.
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From page 55... ...
Washington said that the movement to look at person and family engagement as part of quality improvement has been widely accepted, though there is a great deal of foundational literature that she believes is stale and should be challenged because it does not include equity. In her opinion, moving forward with the patient-centered care emphasis of this foundation should include emphasizing that the equity piece is missing from many of the programs the field is developing.
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From page 56... ...
In her view, reducing structural inequities and barriers to care should start with measures of the structural responses to addressing disparities, accessibility challenges, and difficulties with navigation. At the same time, outcome measures would enable her to provide evidence, rather than simply anecdotes, that improving language access leads to better patient outcomes and reduced costs for the health care system.
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From page 57... ...
She noted that as she tours organizations across the country, diversity and inclusion do not exist to a large extent, though there is a strong movement across the country to create patient and family advisory councils for health care organizations. Washington's organization, working with the National Partnership for Patients, has developed five metrics for diversity and inclusion in the overall evaluation of some 3,900 hospitals in the partnership.
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From page 58... ...
His organization has invested resources in building behavioral health facilities and revamping emergency department processes to better serve those individuals with severe mental illness, though there has been no economic reward for doing so. In the primary care area, HealthPartners has integrated the care of patients with depression and is moving to include other common mental illnesses.
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From page 59... ...
MODERATED DISCUSSION WITH IMPLEMENTER PANEL 2 59 as well as evidence-based practices, said Bau. The point of this approach is to focus on identifying what works in these communities, which often means using peer mental health workers.
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