Why It Matters
"Health equity leaders must deal with a range of demands, but they do not have to do it alone."
Today’s health care equity leaders are facing multiple, sometimes competing, priorities for attention and resources: increasing health disparities, a contentious political environment, waning trust. Even justifying the budget for a Chief Diversity Officer or Chief Equity Officer is becoming an all-too-common hurdle. However, it is well recognized that leadership support, up to the executive and board levels, is essential for health care organizations to advance health equity.
How can health care organizations tackle the imperative to improve health equity while ensuring sufficient leadership buy-in for efforts to be sustained? The Institute for Healthcare Improvement (IHI) has written extensively about the need to make equity a strategic organizational priority. Hospitals and health systems must identify people to steward the work, provide the necessary funding, measure the impact of interventions, and share transparently within and outside of the organization.
Participants in an Equity Action Community convened by Blue Cross Blue Shield of Massachusetts (BCBSMA), with support from IHI, also have lessons learned to share:
- Meet people where they are. Leaders must be agile and adaptable when addressing various audiences about the importance of closing inequities in care. They must recognize that different colleagues, departments, or even hospital locations may be approaching equity work from different starting points. As Katelyn Ferreira, Health Equity Program Manager, Southcoast Health shared, “As I’ve been on the journey of health equity leadership, it has surprised me how much I have had to think on my toes to consider the ‘starting place’ of everyone I’m interacting with.” Be prepared to talk about foundational learning regarding racism, social drivers of health, or racial justice. As Ferreira added, “Some colleagues and collaborators have thought a lot about health equity explicitly. Others have been doing the work of health equity without using this language.”
- Don’t worry alone. Participants in the Equity Action Community learn about quality improvement, the importance of having a dedicated health equity team, and an involved leadership team with clear views of the frontline work. They are also encouraged to learn from one another and to give and receive support across this community of practice. Elizabeth Molina, Medical Director for Health Equity at Atrius Health, found value in interacting with colleagues from across disciplines and backgrounds. “It behooves us to effectively learn from one another, build best practices, and share our successes to make systematic changes that will have long lasting benefits for our patients,” Molina said.
- Stay open to having your assumptions challenged. Michael McDonald, Director of Advanced Practice Providers, Baycare Health Partners, Inc., described how his proficiency with health equity concepts has grown while he has taken part in the BCBSMA Equity Action Community and IHI’s Leadership for Health Equity Professional Development Program. “I don’t believe that I had a good understanding of health equity [before],” McDonald noted. “Previously, I would have identified patient non-compliance, financial, and logistical barriers as the main drivers of health inequity, but now I realize that there are many more factors to consider.”
Health equity leaders must deal with a range of demands, but they do not have to do it alone. IHI continues to convene spaces for equity leaders across health care to build relationships and share innovative approaches for addressing inequities in care. Providing these opportunities for collaborative learning are necessary because the humility and personal connections required for local equity work also extend to leaders’ needs for growth and development. They also help leaders build the supportive ecosystem necessary to thrive and collectively drive meaningful change in the pursuit of a more equitable health care system.
Nikki Tennermann, LICSW, MBA, is a Senior Project Director at the Institute for Healthcare Improvement. To learn more about health equity leadership, please join RS04: “Fostering Provider/Payer Collaboration to Advance Health Equity” and MH04: “Leadership for Health Equity” at the IHI Forum (December 10–13, 2023).