In the diabetes care management example, the graphic illustrates a persisting disparity in diabetes care
within a cohort of Baylor’s primary care practices. When presented to the physicians’ quality
improvement committee, these data became a powerful tool for creating organizational prioritization
and improvement momentum.
The annual HEPA report resides on the BHCS intranet, and the system uses the report to focus
resources and efforts to reduce observed disparities and improve the quality of care among the patients
and communities it serves.
In 2010, the OHE launched its first hospital-based health equity improvement strategy. This pilot
intervention is a collaboration between OHE and the leadership and staff of two hospitals within the
health care system. As part of this work, the staffs are using a continuous quality improvement process
with rapid cycle improvement identifying possible causes of observed racial and ethnic differences in
patient experience and testing workflow solutions to reduce and eliminate the disparity.
Additionally, in 2011OHE launched its ambulatory care health equity improvement work with Baylor’s
employed physician organization, Health Texas Provider Network. Since 2009, patients have self-declared
their race, ethnicity, and primary language at the point of service, and the data have been analyzed to
identify disparities in care. In 2010, data on diabetes care management pointed to significant differences
in the percentage of non-Hispanic and Hispanic patients with superior diabetes control (HgbA1c levels
less than 7%), with Hispanics meeting the management goal significantly less often than non-Hispanics.
Within the last 24 months, physicians within the network were placed at financial risk for selected
quality of care measures. One outcome has been an expressed interest in understanding if a physician’s
or clinic’s overall performance in diabetes care is affected by disparities in a particular subpopulation’s
achievement of key diabetes care management measures.
As a result of this work, an important and promising project has been launched exporting lessons
learned from a successful OHE health equity pilot, the Diabetes Equity Project (DEP). The DEP, funded
Improving Health Equity Through Data Collection AND Use: Case Study 4
A Guide for Hospital Leaders