Suppr超能文献

将健康公平研究纳入学习型卫生系统的路线图。

Roadmap for embedding health equity research into learning health systems.

机构信息

Institute for Excellence in Health Equity, NYU Langone Health, New York, New York, USA

Department of Medicine, NYU Langone Health, New York, New York, USA.

出版信息

BMJ Lead. 2023 Dec 20;7(4):261-265. doi: 10.1136/leader-2022-000720.

Abstract

BACKGROUND

Achieving health equity is vital to fulfil the quadruple aim for optimal healthcare system performance. Traditionally, academic medicine and healthcare systems have focused their efforts on addressing health inequities with an emphasis on improving workforce diversity. Although this approach is , a diverse workforce alone is not sufficient; rather holistic health equity should be established as the anchoring principal mission of all academic medical centres, residing at the intersection of clinical care, education, research and community.

METHODS

NYU Langone Health (NYULH) has embarked on significant institutional changes to position itself as an equity-focused learning health system. One-way NYULH accomplishes this is through the establishment of a , which serves as the organising framework through which we conduct embedded pragmatic research in our healthcare delivery system to target and eliminate health inequities across our tripartite mission of patient care, medical education and research.

RESULTS

This article outlines each of the six elements of the NYULH . These elements include: (1) developing processes for collecting accurate disaggregate data on race, ethnicity and language, sexual orientation and gender identity and disability; (2) using a data-driven approach to identify health equity gaps; (3) creating performance and metric-based quality improvement goals to measure progress toward elimination of health equity gaps; (4) investigating the root cause of the identified health equity gap; (5) developing and evaluating evidence-based solutions to address and resolve the inequities; and (6) continuous monitoring and feedback for system improvements.

CONCLUSION

Application of each element of the can provide a model for how academic medical centres can use pragmatic research to embed a culture of health equity into their health system.

摘要

背景

实现健康公平对于优化医疗体系绩效的四重目标至关重要。传统上,学术医学和医疗体系一直致力于解决健康不公平问题,并强调提高劳动力多样性。尽管这种方法是必要的,但多样化的劳动力本身是不够的;相反,应该将整体健康公平确立为所有学术医疗中心的主要使命,作为临床护理、教育、研究和社区的交叉点。

方法

纽约大学朗格尼健康中心(NYULH)已经进行了重大的机构变革,将自己定位为以公平为重点的学习型医疗体系。NYULH 实现这一目标的一种方式是建立一个框架,作为组织框架,通过在我们的医疗服务系统中进行嵌入式实用研究,针对和消除我们在患者护理、医学教育和研究这三项使命中的健康不公平现象。

结果

本文概述了 NYULH 的六个要素。这些要素包括:(1)制定收集关于种族、民族和语言、性取向和性别认同以及残疾的准确分解数据的流程;(2)使用数据驱动的方法来识别健康公平差距;(3)制定基于绩效和指标的质量改进目标,以衡量消除健康公平差距的进展;(4)调查确定的健康公平差距的根本原因;(5)制定和评估循证解决方案,以解决和解决不公平现象;(6)持续监测和反馈以改进系统。

结论

应用框架的每个要素可以为学术医疗中心如何利用实用研究将健康公平文化嵌入其医疗系统提供一个模型。

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