Children's Hospitals Today - Spring 2022 - 21

EQUITY / FEATURE
T
he
social
justice movements
and disparities revealed by the
pandemic in 2020 put a spotlight
on systemic inequities. This led to a renewed
interest among many hospitals
in diversity, equity and inclusion (DEI)
efforts. The challenge for hospital leaders
is not that inequities have suddenly
appeared where few were before, but
that inequities have long been-and
continue to be-pervasive, even in pediatric
health care organizations with
long-standing missions to provide excellent
care to all children.
The problem of unfairness in care and
outcomes is not new, but realizing the
full depth and breadth of this issue can
feel overwhelming. Where do you start?
Is having DEI experts at the hospital
enough to handle issues that exist fundamentally
in all hospital areas every
day? If not, what else can you do?
it needed to be. Stubborn, deep-seated
problems remained in the hospital operations
and in the care provided. No
matter how many special projects or
processes were created to address the
issues, the hospital needed more than
a DEI ecosystem to make health care
equity a reality.
Health equity is like safety
A fundamental barrier was identified:
Across the organization, leaders and
staff members viewed the growing
group of champions and experts as
problem-solvers who would take care
of whatever problems emerged. Their
presence allowed others to go about
their " regular work " while the experts
focused on DEI-related efforts. The
result of this perception was a set of
DEI-related advances that were often
superficial, temporary or limited to the
Health care equity can only occur
when everyone in the system co-owns
the responsibility to make it happen.
At Children's Mercy Kansas City, leaders
have supported the growth of a DEI
ecosystem for 13 years. The first step, in
2008, was the formation of the Office
of Equity and Diversity and the Equity
and Diversity Council, which provided
a coordinating base for DEI work. Over
time, a broad network of DEI-focused
groups was created, including committees,
champions and projects in patient
care, human resources, faculty affairs,
research, community engagement, and
more, as well as employee resource
groups and an array of patient family
advisory councils. Despite successes
coming from this ecosystem, teams recognized
almost a decade into the work
that, even with considerable progress,
the organization was not close to where
scope of a special project or effort. They
did not get to the root of an issue.
While working with quality and
safety teams, the DEI groups had a
revelation: Health care equity is like
safety. It can only occur when everyone
involved in the system co-owns
the responsibility to make it happen.
No amount of safety experts or special
safety projects can make a hospital
safe. Safety only manifests when every
individual owns the responsibility to
be safe in everything they do. The same
is true for health equity-it will never
occur unless every member of the hospital
community owns it. Regular daily
activities must be founded on equitable
practices, behaviors and attitudes, just
as they should also be based in safety.
This revelation opened new roads toward
health equity for leaders, the hospital's
DEI ecosystem, and the hospital
at large. In addition to ongoing cultivation
of DEI champions and experts, the
hospital set a goal to instill equitable
practices into every team's daily work.
Just as hospitals leaders today might
be asking, " where do I begin? " when
they see the enormity of the task ahead,
Children's Mercy needed to find a place
to create and test a new approach to systematic
integration of health care equity
and DEI. To do so, the hospital turned to
its quality and safety colleagues.
Finding a new approach
The first step toward a systematic
approach to integration was the creation
of The Health Equity Integration
Project (HEIP) in 2018. This effort was
created to pilot a small-scale consultation
strategy for departments within
the hospital's Improvement Center. The
goal was to provide a proof of concept
for partnering with teams to identify
and implement sustainable, meaningful
heath equity-focused changes into
their daily work. The first phase of
the project involved pairing a physician
leader from the Office of Equity
& Diversity with a project coordinator
from the Improvement Center to form
the HEIP team. They used Lean and QI
tools to create the following approach
with each department:
1. Meet with department leadership
to introduce HEIP goals and assess
for interest and readiness.
2. Meet with department staff as a
group to identify and celebrate
existing health equity and DEI
perspectives in their work.
3. Explore adaptations or additions
to their standard work that
would better " automate " the inclusion
of health equity and DEI
perspectives, emphasizing group
ownership of the process.
CHILDREN'S HOSPITALS TODAY Spring 2022
21
Children's Hospitals Today - Spring 2022

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