Washington | 50 states of population health

GARY KAPLAN, MD. Chairman and CEO of Virginia Mason Health System (Seattle)

On the top challenge

"Providing equitable care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socioeconomic status is one of the six aims for the U.S. healthcare system, as established by the Institute of Medicine in its 2001 report, 'Crossing the Quality Chasm.'

Unfortunately, equitable is still more a vision than a reality in healthcare. A person's access to timely, quality, sensitive and respectful healthcare is too often restricted because of inertia, fear and prejudices toward their sexual orientation or the color of their skin, or because they are homeless or unable to speak English."

On the hospital's response   

"We use tools of the Virginia Mason Production System, our organization's management methodology, to continually improve by eliminating waste from our processes; engaging patients as our partners in our ongoing work to advance quality; and being transparent to help individuals better understand their healthcare choices and expenses. For example, we post online the estimated prices of our most common minor outpatient surgeries. Our financial navigators also provide patients with estimates of their out-of-pocket cost before or after medical exams or procedures.

We are also embracing new strategies for meeting the needs of the medically underserved. Our goal is to achieve more than equality, where everyone is treated equally with a template approach to healthcare. Instead, we're striving for equity, where we gain a deeper understanding of individuals and provide the customized healthcare they need.

One of our early efforts is focused on the lesbian, gay, bisexual, transgender and queer/questioning community. We've partnered with the Seattle Police Department to become an official Safe Place for LGBTQ individuals and others who seek safety from threatening situations. We've held interactive workshops for our organization's leaders, care providers and other team members that emphasize health equity, diversity and respect for people. All Virginia Mason employees must complete instructional courses that explain LGBTQ identities, provide guidance for respectful conversations, and address diversity and discrimination as health issues.

As an organization, we are committed to ensuring everyone has fair and just opportunities to be as healthy as possible. Taking steps to improve health equity is a natural extension of our organizational priority of Respect for People. We believe the diversity of our team and our patients is a strength, and we should provide healthcare accordingly."

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