COVID-19 Resources on Vulnerable Populations

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH)

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) has compiled Federal resources on the 2019 Novel Coronavirus (COVID-19) to assist our partners who work with those most vulnerable—such as older adults, those with underlying medical conditions, racial and ethnic minorities, rural communities, and people with disabilities.

Hospital Roadmap for Person and Family Engagement (PFE): Achieving the Five PFE Best Practices to Improve Patient Safety and Health Equity

American Institutes for Research (AIR)/IPRO HQIC

This PFE Roadmap provides practical guidance to help hospitals implement five PFE best practices:

  1. Implementation of a planning checklist for patients who have a planned admission
  2. Implementation of a discharge planning checklist
  3. Conducting shift change huddles and bedside reporting with patients and families
  4. Designation of a PFE leader in the hospital
  5. Active Person and Family Engagement Committee or other committees where patients are represented and report to the board

MODERNIZING HEALTH CARE TO IMPROVE PHYSICAL ACCESSIBILITY

Centers for Medicare and Medicaid Services (CMS)

The resources in this inventory include guidance on how to increase physical accessibility of medical services, tools to assess your practice or facility’s accessibility for individuals disabilities, and tips and training materials to support efforts to reduce barriers and improve quality of care. This document is intended to provide recommendations on how to improve accessibility in order to improve quality of care for patients with disabilities.

Best Practice Strategies for Organizational Health Equity

Adapted from HSAG by IPRO QIN-QIO HQIC, Network of Quality Improvement and Innovation Contractors (NQIIC), Centers for Medicare & Medicaid Services Quality Improvement and Innovation Group

This resource provides best practice strategies, tasks, and tools for each of the seven Health Equity Organizational Assessment (HEOA) categories.

Re-Engineered Discharge (RED) Toolkit

Agency for Healthcare Research and Quality (AHRQ)

A variety of forces are pushing hospitals to improve their discharge processes to reduce readmissions. Researchers at the Boston University Medical Center (BUMC) developed and tested the Re-Engineered Discharge (RED). Research showed that the RED was effective at reducing readmissions and posthospital emergency department (ED) visits. The Agency for Healthcare Research and Quality contracted with BUMC to develop this toolkit to assist hospitals, particularly those that serve diverse populations, to replicate the RED.

Designing and Delivering Whole-Person Transitional Care; The Hospital Guide to Reducing Medicaid Readmissions

Agency for Healthcare Research and Quality (AHRQ)

Reducing readmissions is a national priority for payers, providers, and policymakers seeking to improve health care and lower costs. Readmissions are a significant issue among patients with Medicaid. The Agency for Healthcare Research and Quality (AHRQ) commissioned this guide to identify ways evidence-based strategies to reduce readmissions can be adapted or expanded to better address the transitional care needs of the adult Medicaid population. The guide has been field tested by individual hospitals and groups of hospital quality improvement collaboratives. Based on a series of coaching and feedback calls with hospitals, the second release of this guide has been updated to provide updated tools and clearer guidance on who should use the tools and what to do with the output of the tools. It also offers new tools that can be used in the day-to-day working environment of hospital-based teams and cross-setting partnerships.

Hospital Guide to Reducing Medicaid Readmissions Toolbox

Agency for Healthcare Research and Quality (AHRQ)

Offers in depth information about the unique factors driving Medicaid readmissions and a step-by-step process for designing a locally relevant portfolio of strategies to reduce Medicaid readmissions. Toolkit includes patient and family interview process.

Mapping Medicare Disparities

Centers for Medicare and Medicaid Services (CMS), Office of Minority Health (OMH)

Chronic diseases pose a significant problem in the United States resulting in substantial morbidity, mortality, disability, and cost. The CMS Office of Minority Health has designed an interactive map, the Mapping Medicare Disparities Tool, to identify areas of disparities between subgroups of Medicare beneficiaries (e.g., racial and ethnic groups) in health outcomes, utilization, and spending. It is an excellent starting point to understand and investigate geographic and racial and ethnic differences in health outcomes. This information may be used to inform policy decisions and to target populations and geographies for potential interventions.

Eliminating Disparities to Advance Health Equity and Improve Quality

MHA Keystone Center

The MHA Keystone Center encourages organizations to use this guide to assess the current level of hospital implementation around key strategies aimed at reducing disparities to achieve equity and improving quality. This resource will guide organizations to prioritize and act on identified gaps so that deliberate and purposeful action is taken to ensure that the outcomes across all patient populations are equitable. Sections of the guide include:

Section 1: Understanding Key Terms

Section 2: Why Equity in Care Matters

Section 3: Strategic Pillars on the Journey Toward Equity

Section 4: Recommendations for Action

Section 5: Levels of Implementation

Section 6: The MHA Keystone Center’s Dedication to

Achieving Health Equity

Section 7: Resource Compendium

Safer Together: A National Action Plan to Advance Patient Safety

Institute for Healthcare Improvement (IHI)

Safer Together: A National Action Plan to Advance Patient Safety provides clear direction that health care leaders, delivery organizations, and associations can use to make significant advances toward safer care and reduced harm across the continuum of care. This resource also includes a Self-Assessment Tool & Implementation Resource Guide. Resource also includes case examples on engaging patients and families in safety.

Training and the Culture of Learning: Health Equity Resource Series

American Hospital Association (AHA) Institute for Diversity and Health Equity (IFDHE)

To support hospitals and health systems starting from different points on their journey to achieve health equity, the AHA’s Institute for Diversity and Health Equity (IFDHE) is releasing a series of toolkits to share evidence-based practices to inform organizational next steps for the following topics:

  • Data collection, validation, stratification and application of patient information to address disparate outcomes
  • Cultural humility and implicit bias training and education
  • Diversity and inclusion in leadership and governance roles
  • Sustainable community partnerships focused on improving equity

Each toolkit is designed to be informative, whether organizations have already deployed health equity tactics and strategies or if they are at the early stages of implementation. Each helps lay the groundwork for an in-development equity roadmap to support hospitals’ and health systems’ efforts toward achieving high-quality, equitable care for all. This toolkit focuses on training and education strategies and approaches to encourage cultural humility and overcome implicit bias.

Person and Family Engagement and Health Equity – Summary

This material was prepared by American Institutes for Research (AIR). It is redistributed by IPRO HQIC, a Hospital Quality Improvement Contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS).

This is a summary table that describes the six strategies for engaging with patients and families in equitable and meaningful ways. Although the order of the strategies in the table is based on hospitals’ experiences, hospitals do not need to implement all six strategies at once, or in this order.