Pragmatic Framework for Establishing Meaningful Measurements for Equity

The authors of this commentary in the NEJM Catalyst digital journal outline a four-tier model that offers a framework for interconnected measures to advance equity for patients and healthcare staff. The lack of standards and benchmarks contribute to a fragmented equity landscape where:

  • organizations stumble across and/or react to inequities rather than systematically and proactively seeking them out
  • each institution uses a distinct set of measures and approaches which prevents meaningful comparison
  • where organizational equity work is siloed and disconnected due to a lack of commitment and strategy
  • local success rarely translates to system-level improvements that address and correct inequities

Advancing equity requires the identification and widespread adoption of measures that, in aggregate, should create a meaningful narrative that describes the journey and experience of patients as they move through the healthcare system. The measures should be common, relevant and within the control of all institutions, especially if incentives are attached.

The framework includes four distinct categories of measures – Access, Transitions, Quality of Care, and Socioeconomic/Environmental Impact – that in sequence, gives organizations and regulatory bodies the ability to assess equity, prioritize efforts and maximize impact. Read the commentary.