Maryland hospital CEO's 5-step plan to address diversity, health equity

Due to the roles they play in their communities, healthcare leaders are well poised to tackle racism and health inequity, and they must have a specific action plan to do so, according to Meritus Health executive Maulik Joshi, DrPH.

In an article published July 13 by NEJM Catalyst, Dr. Joshi, president and CEO of Hagerstown, Md.-based Meritus, said healthcare leaders can "have an outsize impact on the ills that stem from the persistent pestilence" of racism and health inequity that plagues society and healthcare.

He noted the importance of heightened awareness about systemic racism and health inequity — in the form of statements and frameworks and commitments throughout society and healthcare organizations. But he said a specific action plan, with a defined goal and timeline, is crucial.

He suggested healthcare leaders focus on four core areas: unconscious bias, disparities in care, racial and ethnic diversity in leadership, and social determinants of health.

He then proposed a five-point action plan for healthcare leaders:

1. Provide mandatory unconscious bias training to staff by Aug. 1, 2021 — if it has not already occurred in the last 12 months.

2. To identify care disparities, choose three meaningful quality measures and stratify them by race and ethnicity. If disparities are found, healthcare organizations should develop a performance improvement team charter defining how they will address the disparities. Dr. Joshi recommended doing this by Aug. 1, 2021 — if the organization has not done so in the last 12 months.

3. Report the race and ethnicity breakdown of the community the healthcare organization serves and the healthcare organization's leaders online within 30 days. If those breakdowns do not match, Dr. Joshi recommended mandating that each open healthcare leader position has at least one racially/ethnically diverse candidate as a finalist. He said organizations should report updated leader and diversity percentages by Aug. 1, 2021.

4. Begin collecting social determinants of health data on each new patient encounter by Aug. 1, 2021, and link identified social determinants to community resources.

5. Publicly commit to these actions "as soon as possible."


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