Quick Wins and Longer term Strategies by akgame


									Analysis of Health Equity Plans

                          Quick Wins and Longer term Strategies
                                  Sanjeev Sridharan, Bob Gardner, April Nakaima

  The Hospital Health Equity Plans revealed and                          kind of information has seldom been
  reinforced a number of near-term actions or quick                      systematically shared. It points to the
  wins’ that could be undertaken in the next year that                   value of creating forums and
  would address significant health equity issues and                     mechanisms for exchanging promising
  accelerate progress on longer-term needs                               practices and lessons learned.

    •   Potential “Quick Win” Coordination: TCLHIN             Immediate action to develop a performance
        needs to develop and implement a near-term             measurement and management system for
        action plan in the next six months. In addition        health equity. These are all projects that could
        to addressing significant issues, implementing         be initiated within months and have timelines of
        some of these initiatives can lead to greater          no more than a year. They will all build
        buy-in from hospitals for the process of               organizational and system momentum for
        addressing health inequities. Such an action           change on equity and will together flesh out a
        plan will need to be developed collaboratively         coherent overall strategy.
        with the hospitals and community providers.
        It will need to leverage existing collaborations          •   Refresh Hospital Health Equity Plans:
        and activities; address barriers and challenges               Hospitals should be required to refresh
        identified in TCLHIN planning and community                   their plan for addressing health equities
        engagement, and pull the range of equity-                     within the next year. Some of the
        focused initiatives together into a coherent                  questions the plan needs to address
        overall strategy. Initiatives that need                       include: What coherent set of activities
        immediate attention and where there are                       do the hospitals propose to do to impact
        opportunities for immediate action and                        health inequities? What is their timeline
        progress include:                                             of impact? How will success be defined in
                                                                      the short and long run?
            o Coordination of services for language               •   A coordinated data collection strategy:
              interpretation/ translation services.                   The TC LHIN could immediately establish
              Lack of services and challenges of                      a workgroup consisting of key hospital
              fragmentation and coordination were                     and community stakeholders to help
              identified as critical barriers in many                 address some of the data needs
              plans. The potential to build on                        identified. The workgroup should make
              existing interpretation resources and                   concrete recommendations for a hospital
              expertise and develop a more                            level data collection system to the LHIN
              coordinated system is immense and                       within a year.
              realizable;                                         •   Build Equity Into Service Accountability
            o Coordinating best practice                              Agreements: There is an opportunity to
              dissemination. The very process of                      build obligations into the Hospital Service
              collecting program information on the                   Accountability Agreements including that
              large number of equity initiatives in                   hospitals are to participate in “quick win”
              the hospital plans and sharing the                      initiatives such as a TCLHIN interpretation
              plans highlighted the fact that this                    service, and collecting a common dataset.
Analysis of Health Equity Plans

         •   Conduct a ‘Taking Stock’ Annual Forum                  Building into the mid and longer term
             for Health Service Providers: The LHIN
             could take the lead in organizing an            TCLHIN also need to take the lead in addressing a
             annual forum for health service providers       number of vital mid to longer term challenges and
             to report on their equity-focused               possible lines of action. Key directions include:
             program planning, service delivery and
             outreach initiatives. This annual forum            •     Analyzing the implications of the very
             would provide opportunities to learn                     different missions, scope of services and
             from the multiple stakeholders involved                  resources of the various hospitals: for
             in addressing health inequities and to                   example, what is the most effective mix of
             take stock on where the various                          hospital-specific and common measures?
             organizations are in responding to health                How can this be incorporated into Service
             inequities.                                              Accountability Agreements? It is important
         •   Project to make recommendations on                       to note that these questions will be as
             integrating health equity perspectives                   critical and likely more complicated when
             within existing balanced scorecards or                   the LHIN considers health equity measures
             other strategic planning and                             for the community and long-term care
             performance management tools: A                          sectors in years to come.
             critical task for the LHIN will be to provide      •     Related to the point above, the TC LHIN and
             guidance to incorporate heath equity                     hospitals will need to figure out what
             considerations into hospital balanced                    indicators are best to assess at an individual
             scorecards and other key planning                        hospital level, and what to monitor at a
             processes. The LHIN will also need to                    system-wide level. Where there are different
             explore if such integration of health                    equity objectives and indicators, how can
             equity considerations into balanced                      they be effectively dovetailed?
             scorecards can be done uniformly across            •     Developing better understanding of the cost
             all hospitals. To implement this, TCLHIN                 of health disparities and the cost-
             needs to consider funding a collaborative                effectiveness of different interventions
             project to help integrate health equity            •     Further developing a coherent evaluation
             considerations into hospital balanced                    and monitoring strategy to be able to assess
             scorecards or similar tools. The project                 progress, identify successful and promising
             should consider how guiding principles                   programs and services, and build on what
             and lessons learned in this hospital                     works well
             specific initiative can also be extended to        •     Building effective and responsive
             other health service providers.                          partnerships between hospitals and
                                                                      community. This includes thinking through
                                                                      how to use hospital and eventually
  The significance and impact of these                                community HSP health equity plans and
  recommendations will extend far beyond Toronto                      accountability agreements as mechanisms to
  Central. TCLHIN should liaise with MOHLTC and                       promote cross-sectoral partnerships (e.g.
  other LHINs as its action plans are developed and as                through joint hospital and community equity
  the specific projects progress. It is quite possible                planning efforts on a sector or
  that some of these initiatives should be conceived as               neighbourhood basis) .
  joint projects of Toronto Central and other LHINs

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