Ten Best Practices of High Quality Minority Serving (HQMS) Hospitals

Research objective: This study identified best practices of high quality minority serving hospitals (HQMS). Specifically, we identified how they achieve high quality care to your minority patients.

Study Design: Using state inpatient discharge data from 13 states, we identified 166 minority serving hospitals. Minority serving hospitals were defined as those hospitals where more than 50 percent of their discharges were African American, Hispanic or Asian patients. We defined high quality hospitals based on their performance according to the AHRQ inpatient quality indicators (IQIs) and patient safety indicators (PSIs). We identified 31 HQMS hospitals based on the IQI composite score and 47 HQMS hospitals based on their PSI composite score. From these hospitals, we selected 6 HQMS hospitals and conducted site visits.

Population Studied: We interviewed the CEO, CFO, medical director, quality improvement officer and head of nursing at each hospital to discuss the challenges they face in providing high quality care to their minority patients. The interview instrument covered five domains: quality improvement initiatives, cultural competency, workforce diversity, the adoption of IT and other new technologies, and financial issues.

Principal Findings: Among the best practices we found: 1) HQMS hospitals have consistent, stable, committed leadership who demand excellence from their senior managers and staff. Leaders of HQMS hospitals establish a culture where disparities in quality are not tolerated. 2) HQMS hospitals have quality improvement efforts that incorporate unit staff by providing them with information and real time feedback on performance. 3) HQMS hospitals are keenly aware of their patients' needs. In particular they are sensitive to unique language and cultural needs of patients. HQMS hospitals have developed ways to communicate these needs to other units in their hospitals and incorporate them in their training and patient care materials. 4) HQMS hospitals invest their limited resources wisely. They know how to set spending priorities. Despite limited resources, they managed to invest in their physical plant to meet current and future patient care needs. 5) HQMS hospitals know how to leverage their funds with other sources to better serve their patients and communities.

Conclusions: HQMS hospitals have developed effective strategies to deliver high quality care to their patients despite fiscal pressure and the unique needs minority patients. Best practices of HQMS hospitals can be replicated in other hospitals, particular those serving minorities.