Children's Hospitals Today - Spring 2022 - 23

EQUITY / FEATURE
Achieving outcomes
The most immediate outcome of HEIP
was
The Patient and Family Engagement
the successful integration of
health equity and DEI-related activities
into participating teams' standard
work. Team-specific metrics guided ongoing
revision of activities and helped
spread successful tactics from team
to team. Specific outcomes include
how many times a question was asked
during interviews following a serious
safety event, and then tracking the
increase of the DEI-related question being
asked. In addition, multiple departments
described how participation in
HEIP created new team dynamics and
changed team culture.
In addition to quantifiable metrics,
the team collected numerous " impact
stories " from leaders and staff that
show how mindsets shifted and new
habits formed as a result of integration
processes. For example, a team member
from Evidence-Based Practice reported
that she saw a best practice guide on
eczema with new eyes because of the
HEIP. She noted to the group developing
the guide that all the photos used as examples
of eczema were of children with
lighter skin, a problem that the group
promptly addressed. She said she never
would have noticed this before taking
part in HEIP consultations.
team recognized that while they had
previously performed multiple patient/
family " tracers " with families who spoke
languages other than English, they witnessed
how a bilingual staff member
could get much deeper, more detailed
feedback than they had ever gotten
through an interpreter.
Another key outcome was the spontaneous
spread of the HEIP approach
within and between departments. In
Clinical Safety, the medical director took
the universal question created for serious
safety event interviews and incorporated
it into other key conversation
scripts, such as code blue debriefings.
Departments outside the Improvement
Center learned of HEIP tools and consultation
and requested, modified, and
spread them on their own. For example,
the Chaplaincy group asked for a brief
HEIP introduction, elected to adopt the
DEI checklist, and then set a goal to
take it to all the committees their group
members take part in as well.
The successes of the first year led to
a busy second year, as the Black Lives
Matter movement grew, and disparities
became more evident during the pandemic.
The team spent the year fielding
requests for consultation internally and
from other hospitals and organizations
throughout the country. While the need
for operational approaches to health equity
had become more urgent, effective
solutions were scarce. The team presented
and shared their tools at the national
level, including the universal question
approach and the DEI checklist, in a generic
form that could be modified to suit
an organization's needs.
The hospital also adapted the DEI
checklist for use in Children's Mercy's
strategic planning process, where 19
strategy teams incorporated the tool
into their discussions and reported to
leadership on " DEI takeaways " for all
tactics proposed across the strategic
plan's five goal areas. Post-planning
interviews with strategy team leaders
showed good uptake and a clear effect
of the tool on strategy team outcomes.
Throughout 2021, goals turned to scaling
the HEIP approach for Children's
Mercy's more than 8,500 employees,
while continuing to offer support to outside
organizations looking for new ways
to advance health equity.
John Cowden, M.D., M.P.H., is the
health equity integration project leader,
and Jessi Van Roekel, M.P.A., is health
equity specialist at Children's Mercy
Kansas City.
Send questions or comments to
magazine@childrenshospitals.org.
A consultative approach
allows for adaptation.
Identify teams' understanding
of how health equity relates to
their work and adapt support
accordingly. Teams and individuals
have different levels of
buy-in. Children's Mercy uses
a motivational interviewing
model to assess readiness for
change and makes recommendations
that fit.
Centralized and de-centralized
integration methods can
complement each other.
Hospitals have created or are
planning a centralized DEI
structure, such as a department.
This provides an impetus, initial
resources and planning for
integration, but decentralized
methods foster co-ownership.
They offer flexibility and encourage
the spontaneous and rapid
spread of ideas and practices.
The effect of health equity
work goes beyond the
quantitative measurement
of program outcomes or
disparity reduction.
The deepest effect of integration
is a shift in consciousness
and culture within teams
and among the larger staff.
Children's Mercy's goal is for
leaders and their teams to
understand the importance of
considering health equity in
every process, every structure,
and every project, every time.
The organization has seen how
a change in mindset opens new
perspectives, leads to realizations
and changes behavior.
Through meaningful connections
and careful messaging,
health equity integration is
improving the care the hospital
provides and the relationships
and environment that define
the workplace.
CHILDREN'S HOSPITALS TODAY Spring 2022
23
Children's Hospitals Today - Spring 2022

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