Unfulfilled Promise of Quality: Building Patient-Centered and Equitable Health Systems in California

How can patient-centeredness and equity, two of the six elements of high-quality health systems, as outlined by the Institute of Medicine in its Crossing the Quality Chasm report, be integrated into the continuous improvement of our health systems? This presentation will provide an overview of concepts and frameworks, change strategies and best practice models to advance patient-centered and equitable health care, with a focus on health systems in California. Examples used will be taken from projects and activities funded over the past eight years by The California Endowment, a private health foundation.

Discussion of concepts will include parallel and overlapping frameworks and definitions of quality improvement, patient-centered care, culturally and linguistically appropriate services, cultural competency, community-oriented primary care, medical homes and health care disparities reduction. How can one use these frameworks to best “make the case” (patient safety, risk management, regulatory compliance, improved patient outcomes, marketing, patient and provider satisfaction, social justice, etc.) for investing in improvements on these issues? Is there sufficient data to make these cases for change?

Discussion of change strategies and best practice models at the national, state and institutional policy level, at the health systems level, at the organizational level, at the clinical provider level and from patient/consumer engagement and empowerment perspectives will include work with national accreditation and quality improvement organizations, state government purchaser and regulatory agencies, hospital and health systems, health plans, local health departments, community health centers, physician associations, employer and purchaser associations, ethnic media and consumer and community-based organizations. How can such efforts result in synergy and catalyze broader and deeper change within health systems? What is the role of individual and institutional leadership in such change strategies? How can educational and training pathways for the health workforce facilitate these organizational changes? Evaluation results and outcomes data will be presented.

Finally, session participants will be invited to share their own change strategies, best practices and results from their own experiences.