A 360-degree approach for healthcare organizations to address equity
Raising the Bar offers a framework for taking action
As healthcare organizations rebuild and redefine themselves amid ongoing COVID-19 challenges, there is an opportunity and obligation to place health equity at the center of their enterprises. It is not enough to recognize the need for deeper involvement in communities; acknowledgement must lead to action. To help organizations set and implement concrete plans, the Robert Wood Johnson Foundation developed Raising the Bar: an actionable framework to embed and advance equity and excellence throughout healthcare. Below, Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation, discusses how Raising the Bar can fit into organizations’ efforts to advance equity.
Why is this the right time for healthcare organizations to focus on inequities in healthcare?
JM: Health inequities across race, disability status and socioeconomic criteria have been measured for decades, but COVID-19 exacerbated these disparities and shined a bright light on the extent of this crisis. Leaders inside and outside healthcare now recognize that people of color and other marginalized communities have borne the brunt of COVID, experiencing higher rates of hospitalization and death during the pandemic’s peak. That recognition underscores the troubling fact that, despite spending more per capita on healthcare than any other nation, U.S. health outcomes are worse than other wealthy countries, especially for Black and Brown individuals. There are myriad reasons for this, and healthcare organizations have an obligation to examine these issues and act.
What is the most important thing an organization can do to advance equity?
JM: As we envision a future for health and well-being beyond COVID-19, healthcare organizations have a unique opportunity to use their power to meet the diverse needs of the people they serve and leverage resources to enhance their communities. But it is going to take sincere commitment and effective action at the executive leadership and board levels. Leaders need to empower staff to take transformative action and make equity a strategic priority. While many healthcare organizations already have various staff members, committees and task forces working to improve health equity, these efforts must be visibly championed as top priorities by leaders.
What does it mean to adopt the Raising the Bar framework?
JM: Raising the Bar is a framework that takes a 360-degree perspective on health equity. It is a comprehensive, coordinated approach that aligns all the roles healthcare plays: as a caregiver, an employer, a community partner and an advocate for equity. This approach is important because health equity is not just what a healthcare organization does in the community. It is not just how it treats patients, and it is not just about the workforce. It is about approaching every aspect of a healthcare organization as a tool to advance health equity differently.
Explain the process for creating Raising the Bar.
JM: RWJF provided a grant to the National Alliance to impact the Social Determinants of Health (NASDOH) to lead discussions with providers, hospitals, payers, community leaders and patients about how healthcare can help achieve optimal well-being for everyone. The process was deeply informed by those who give, get and pay for healthcare, including people with lived experiences of inequity. They identified and vetted concrete principles, roles and actions healthcare organizations can review to guide and “gut check” their work.
How can Raising the Bar help healthcare organizations advance equity?
JM: Healthcare organizations have stated their commitment to improving health equity but seek guidance to turn words into action. Our work revealed there is no “one size fits all” approach. Each community is unique, so approaches to equity can’t be cookie-cutter.
Raising the Bar provides an actionable framework that can be adapted to meet different circumstances, and offers case examples to help organizations put five key principles into practice:
Committing to a mission of improving health and well-being; Systematically pursuing health equity and racial justice; Authentically partnering with community; Sharing resources, voice and power; and Earning and sustaining trust.
The Raising the Bar framework helps organizations think about equity strategies holistically. Raising the Bar can also help organizations set goals, examine their role in the community, inform workforce practices and policies to promote equity, and improve health equity performance. It’s a huge contribution that can help organizations progress on this journey. This Executive Insight was produced and brought to you by: