Health Equity: 05/07/08

Wednesday, May 7, 2008

[EQ] Knowing what Works in Health Care: A Roadmap

Knowing what Works in Health Care: A Roadmap for the Nation

Institute of Medicine (IOM). 2008. Washington, DC: The National Academies Press, 2008

Available online at: http://books.nap.edu/catalog.php?record_id=12038&utm_medium=etmail&utm_source=National%20Academies%20Press&utm_campaign=New+from+NAP+5.06.08&utm_content=Downloader&utm_term=

“….There is currently heightened interest in optimizing health care through the generation of new knowledge on the effectiveness of health care services. The United States must sustantially strengthen its capacity for assessing evidence on what is known and not known about "what works" in health care. Even the most sophisticated clinicians and consumers struggle to learn which care is appropriate and under what circumstances.

Knowing What Works in Health Care looks at the three fundamental health care issues in the United States--
- setting priorities for evidence assessment,
- assessing evidence (systematic review), and
- developing evidence-based clinical practice guidelines--and how each of these contributes to the end goal of effective, practical health care systems.

This book provides an overall vision and roadmap for improving how the nation uses scientific evidence to identify the most effective clinical services. …”

Content:

Summary

1 Introduction

2 An Imperative for Change

3 Setting Priorities for Evidence Assessment

4 Systematic Reviews: The Central Link Between Evidence and Clinical Decision Making

5 Developing Trusted Clinical Practice Guidelines

6 Building a Foundation for Knowing What Works in Health Care

Appendix A: Acronyms and Abbreviations

Appendix B: Workshop Agendas and Questions to Panelists

Appendix C: Template for Submissions of Topics to the Agency for Healthcare Research and Quality

Appendix D: Standards for Reporting Meta-Analyses of Clinical Trials and Observational Studies: QUOROM and MOOSE

Appendix E: Examples of ECRI Institute and Hayes, Inc., Quick Turnaround Reports

Appendix F: Guideline Standards: The AGREE Instrument and COGS Checklist

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] Use of Health Impact Assessment in the U.S: 27 Case Studies

Use of Health Impact Assessment in the U.S.:
27 Case Studies, 1999–2007

Andrew L. Dannenberg, Rajiv Bhatia, Brian L. Cole, Sarah K. Heaton, Jason D. Feldman, Candace D. Rutt

Am J Prev Med 2008;34(3):224–233- 2008 American Journal of Preventive Medicine

Website: http://www.elsevier.com/wps/find/journaldescription.cws_home/600644/description?navopenmenu=-2

Available online at: http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6VHT-4RSS76V-C-1&_cdi=6075&_user=3824252&_orig=browse&_coverDate=03%2F31%2F2008&_sk=999659996&view=c&wchp=dGLbVtb-zSkzV&md5=0d1d34ea74fa704c3321c1e8b995788d&ie=/sdarticle.pdf

Objectives: To document the growing use in the United States of health impact assessment (HIA) methods to help planners and others consider the health consequences of their decisions.

Methods: Using multiple search strategies, 27 HIAs were identified that were completed in the U.S. during 1999 –2007. Key characteristics of each HIA were abstracted from published and unpublished sources.

Results: Topics examined in these HIAs ranged from policies about living wages and after-school programs to projects about power plants and public transit. Most HIAs were funded by local health departments, foundations, or federal agencies. Concerns about health disparities were especially important in HIAs on housing, urban redevelopment, home energy subsidies, and wage policy. The use of quantitative and nonquantitative methods varied among HIAs. Most HIAs presented recommendations for policy or project changes to improve health. Impacts of the HIAs were infrequently documented.

Conclusions: These completed HIAs are useful for helping conduct future HIAs and for training public health officials and others about HIAs. More work is needed to document the impact of HIAs and thereby increase their value in decision-making processes…”

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[EQ] Creating Equity Reports - A Guide for Hospitals

Creating Equity Reports - A Guide for Hospitals

Robin M.Weinick, Katherine Flaherty and Steffanie J. Bristol
The Disparities Solutions Center, Massachusetts General Hospital, May 2008

Available online PDF [78p.] at: http://www.rwjf.org/files/research/050608hospitalequityreport.pdf

This is a guide for hospitals planning to prepare equity reports. These reports identify ethnic and racial disparities in organizations and suggest ways to reduce them. The authors include case studies of hospitals that have already implemented equity reports.

This guide focuses on the role of equity reports in reducing those disparities by helping health organizations to identify the inequalities in the care they provide and to monitor changes over time. While the majority of hospitals collect data on patients’ race and ethnicity, few use the information to assess quality of care, health outcomes and patient satisfaction. In preparing this guide to equity reports, the authors drew on the experiences of hospitals across the United States and make the following recommendations for any hospital planning to address potential inequalities in the care it provides:

· Obtain management buy-in and the support of hospital leadership.

· Determine which data will be collected and how they will be collected, used and stored.

· Maintain integrity in the data collection process.

· Include anecdotes that will bring the report to life.

· Inform the public.

Table of Contents

Introduction

Chapter 1: Why Create a Hospital Equity Report?

Overview:What is an Equity Report?

Racial and Ethnic Inequalities are a Significant Problem

Definitions

The Importance of Measuring Equity

Benefits of a Hospital Equity Report

Chapter 2: Leading the Effort

Overview

“Not in My Hospital”

Getting the Board on Board

Leading Change

Summary

Chapter 3: Collecting the Data: Race, Ethnicity, Language, and Socioeconomic Status

Overview

Planning

What Data to Collect

How to Collect the Data

Training Staff to Collect the Data

Where the Data Are Stored, How They Are Accessed, and By Whom

Data Quality Assurance

Developing a Plan for Informing Staff, Patients and the Public about these Efforts

Chapter 4: Measures

Overview

Types of Measures

Specific Quality Measures to Consider

Considerations in Selecting Measures

Changing Measures in Subsequent Reports

Chapter 5: Presenting the Data

Overview:Telling the Story

Advice for Presenting the Data

Sample Data Displays

Outline of an Equity Report

What Else to Include in the Report

Chapter 6: Using the Report

Summary

References

Appendices

Appendix I: The Massachusetts General Hospital Disparities Dashboard

Appendix II: Measures Used in Hospital-Based Research Studies of Inequalities

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