Agendas

Topics & Objectives

1. Introduction to Health Equity and Quality Improvement
   1.  Define health equity.
   2.  Describe the difference between equity and equality.
   3. Describe how quality improvement will be integrated into the curriculum for this program.
   4. Characterize the historical origins of quality improvement in healthcare and other industries.
      

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Topics & Objectives

1. Cultural Sensitivity – Foundational Awareness
2. Understanding the basics of Infection Control infrastructure
   1. Describe the cultural sensitivity spectrum.
   2. Define cultural sensitivity.
   3. Describe the ways in which facility-level policies and procedures can support COVID-19 infection prevention and control.
   4. Identify changes to facility-level policies and procedures which can improve COVID-19 infection prevention and control for patients who are at higher risk and historically underserved.
      

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Topics & Objectives

1. Promoting COVID-19 Vaccination: Strategies and Communication
2. Understanding Cultural Values and Attitudes
   1. Recognize the barriers to vaccine access and confidence that are most likely to impact patients who are at higher risk and historically underserved, including racial and ethnic minority populations and people living in rural communities.
   2. Integrate knowledge of these barriers into conversations with staff regarding vaccine hesitancy.
   3. Define cultural values, beliefs, and practices.

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Topics & Objectives

1. Health Equity Historical Context
2. Quality Improvement Human Factors and Systems Thinking
   1. Recognize and explain the role of human factors in work processes and error analysis in healthcare
   2. Describe systems thinking and how this relates to the Swiss Cheese Model
   3. Give a historical example of medical racism.
   4. Recognize the present-day impact of historical medical experimentation.

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Topics & Objectives

1. Long-term complications of COVID-19 (part 1)
2. Cultural attitudes (part 2)
   1. Identify the long-term complications associated with COVID-19 infection.
   2. Apply best practices in the management of long-term complications associated with COVID-19 infection to tests of change in your facility.
   3. Reflect on how their own cultural values and beliefs impact their engagement with COVID-19 prevention and control efforts.

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Topics & Objectives

1. Infection Prevention and Control Risk Assessment
2. Different Forms of Racism
   1. Characterize the principles of effective risk assessment for CoVID-19.
   2. Apply these principles to risk assessment in your facility to identify areas for intervention and improvement.
   3. Demonstrate how structural racism impacts health care.
   4. Differentiate between the different forms of racism (i.e., structural; systemic; interpersonal; etc.).
      

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Topics & Objectives

1. Cultural Practices (part 3/3) (behaviors)
2. QI Root Causes 1/6: What is the problem you are trying to solve?
   1. Describe three examples of cultural practices.
   2. Identify the characteristics of effective problem statements and their role in supporting quality improvement.
   3. Demonstrate the ability to develop effective problem statements for quality improvement projects in your facility.

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Topics & Objectives 

1. Social Determinants of Health 1/6: overview; socioecological model
2. QI Root Causes 2/6: What is your process?
   1. Recognize the impact that social and structural factors have on health outcomes.
   2. Recognize the importance of process mapping as a foundational step in quality improvement projects.
   3. Apply process mapping to quality improvement projects in your facility.

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Topics & Objectives

1. Social Determinants of Health 2/6: economic stability.
2. QI Root Causes 3/6: Where are the known or potential points of failure?
   1. Explain how inequities in housing, employment, food security, and income affect health outcomes.
   2. Recognize effective methods for identifying potential points of failure or human error in a process.
   3. Illustrate how these methods can be applied to improve the reliability of processes in your facility.

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Topics & Objectives

1. Social Determinants of Health 3/6: education access and quality.
2. QI Root Causes 4/6: How will you know your process is reliable?
   1. Describe how inequities in early childhood education and development, higher education, and language and literacy affect health outcomes.
   2. Identify the key characteristics of a reliable process.
   3. Relate these characteristics to both existing and new processes in your facility to understand whether they are likely to be reliably implemented.

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Topics & Objectives

1. Social Determinants of Health 4/6:  neighborhood and built environment. 
2. QI Root Causes 5/6: Why are these parts of the process unreliable?
   1. Discuss the impact that crime, violence, and environmental conditions have on a person's health outcomes
   2. Recognize effective methods for identifying the root cause of potential points of failure or human error in a process.
   3. Apply these methods to learn about the root causes of unreliability in processes in your facility.

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Topics & Objectives

1. Social Determinants of Health 5/6: health care access and quality.
2. QI Root Causes 6/6: What would success look like? (Aim Statements)
   1. Identify the impact that access to health care and health literacy have on a person's health outcomes.
   2. Identify the characteristics of effective aim statements and their role in framing quality improvement projects.
   3. Demonstrate the ability to develop effective aim statements for quality improvement projects in your facility.
      

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Topics & Objectives

1. SDOH 6/6: social and community context
2. IPC: COVID-19 Management and Treatment Updates
   1. Apply a determinants of health approach to providing patient care.
   2. Describe changes to guidance on COVID-19 management and treatment over the course of the pandemic.
   3. Articulate the research basis for recent changes in COVID-19 management and treatment.

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Topics & Objectives

1. CS: Communications across cultures
2. IPC: Long-term Complications of COVID-19 Infection (part 2)
   1. CS: Explain differences in communication styles across cultures.
   2. IPC-1. Characterize the ways in which our understanding of the long-term complications associated with COVID-19 infection has evolved in the last six months.
   3. IPC-2. Identify resources in your facility or community that can be leveraged to address these complications.

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Topics & Objectives

1. CS: Explicit bias.
2. QI: Change management (part 1/2): Strategies for Managing through Failure
   1. CS: Reflect on an explicit bias they hold.
   2. QI-1. Describe the constructive role that failure plays in the quality improvement process.
   3. QI-2. Discuss strategies for preserving motivation and morale in health care teams working through failure.

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Topics & Objectives

1. CS: Implicit bias.
2. QI: Change management (part 2/2): Securing Buy-in and “Selling” Your Improvements
   1. CS-1: Describe an example of implicit bias.
   2. CS-2: Differentiate between explicit and implicit bias.
   3. QI-1. Articulate effective strategies for securing buy-in from leadership and key stakeholders.
   4. QI-2. Discuss strategies for aligning your QI project with institutional priorities.

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Topics & Objectives

1. IPC Outbreak Identification & Response
2. QI: Applying QI tools to root cause identification and management 
   1. IPC-1. Describe the critical elements of an effective approach to COVID-19 surveillance.
   2. IPC-2. Articulate the principles of an effective outbreak response strategy for COVID-19.
   3. QI-1. Apply QI tools to the identification of the root causes of error in improvement projects relevant to COVID-19.

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Topics & Objectives

1. HE: Communicating health equity; emotional intelligence.
2. IPC: Antibiotic Stewardship
   1. HE-1: Define emotional intelligence.
   2. HE-2: Name one health equity guiding principle for inclusive communication.
   3. IPC-1: Define and characterize antimicrobial stewardship in the context of COVID-19 pandemic.
   4. IPC-2: Discuss strategies for improving antimicrobial stewardship during and after a pandemic.

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Topics & Objectives

1. CS-1: Enhancing sensitivity to cultural similarities and differences
2. CS-2: Fostering a culturally responsive health care setting
   1. CS-1: Define cultural sensitivity and its application.
   2. CS-2: Demonstrate behaviors and language that create a culturally responsive health care setting.
   3. CS-3: Describe examples of cultural sensitivity in health care settings with an emphasis on Native Americans.

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Topics & Objectives

1. HE: Organizational considerations to advance health equity
2. IPC: Setting Up an Employee Health Program
   1. HE-1: Describe one organizational policy to advance health equity.
   2. HE-2: Discuss interpersonal, interpersonal, and institutional factors that contribute to advancing health equity.
   3. IPC-1: Discuss components of Infection Prevention Program for Healthcare Providers.
   4. IPC-2: Explain how to establish pre-employment assessments for Healthcare Providers.
   5. IPC-3: Discuss how to manage exposures and illness in Healthcare Providers.

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Topics & Objectives 

1. HE: Utilizing data to assess health disparities (part 1/2)
2. QI: Formulation of solutions (part 1/2): Are there particular groups who are impacted? (Segmentation)
   1. HE: Assess data to better understand health disparities.
   2. QI-1: Name the audiences who are most likely to be impacted by your improvements.
   3. QI-2: Identify early adopters to maximize success.

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Topics & Objectives

1. HE: Utilizing data to assess health disparities (part 2/2)
2. QI: Formulation of solutions (part 2/2): Evaluate likelihood of success of solutions proposed
   1. HE: Analyze data to determine health disparities.
   2. QI-1. Describe the characteristics of effective approaches to measuring the success of improvements.
   3. QI-2. Articulate the difference between outcome and process measures.

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Topics & Objectives

1. IPC: Vaccine Access & Vaccination
2. CS-Microaggressions
   1. IPC-1. Characterize how the options for COVID-19 vaccines have changed in the last eight months.
   2. IPC-2. Identify common current concerns regarding vaccination and resources in your facility or community that can be leveraged to address them.
   3. CS-1. Define microaggressions.
   4. CS-2. Demonstrate a call-in response to a microaggressions.

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Topics & Objectives

1. CS Recap
2. QI: Measurement: How will you know that you have improved your process?
   1. CS-1. Describe key cultural sensitivity concepts covered over the course of this ECHO program.
   2. QI-1. Differentiate between process and outcome measures.
   3. QI-2. Apply process and outcome measures to example quality improvement projects relevant to COVID-19 and health equity.

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Topics & Objectives

1. HE: Recap
2. IPC: COVID-19 Updates for Healthcare Personnel
   1. HE-1: Describe key health equity concepts covered over the course of this ECHO Program.
   2. IPC-1: Discuss how COVID-19 vaccination status impacts employee health in healthcare settings
   3. IPC-2: Identify how best practices for isolation and precaution have evolved since the onset of COVID-19
   4. IPC-3: Describe how best practices in COVID-19 safety and prevention can mitigate the risk of transmission among healthcare employees

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Topics & Objectives 

1. CS: Sexual Orientation
2. QI: How Can you Facilitate Discussion about Change?
   1. C/S-1: Recognize that sexuality is a spectrum.
   2. C/S-2: Demonstrate ways to affirm a patient's sexuality in a healthcare context.
   3. C/S-3: Identify barriers to healthcare that not straight-oriented individuals face.
   4. C/S-4: Express ways to make your space a welcoming environment for not straight-oriented individuals.
   5. QI-1. Discuss strategies for generating ideas for changes
   6. QI-2. Utilize quality improvement tools to identify changes that are most likely to be successful

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Topics & Objectives

1. HE: Leveraging Clinical/Public Health Data to Eliminate Health Disparities (part 1/2)
2. QI: How to be Successful at Change
   1. HE-1: Formulate or adapt an intervention to mitigate or eliminate an identified health disparity.
   2. QI-1. Identify strategies for structuring quality improvement projects to accelerate learning
   3. QI-2. Describe how to communicate short- and long-term impact

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Topics & Objectives

1. HE: Leveraging Clinical/Public Health Data to Eliminate Health Disparities (part 2/2)
2. QI Recap: Q&A from Participants

   1. HE-1: Identify strategies to eliminate health disparities                                                                                          

   2. HE-2: Outline the implementation steps for one strategy to eliminate health disparities
   3. QI-1.  Discuss how to apply the content from QI sessions to project implementation   

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Topics & Objectives

1. CS: Gender Expression and Identity  
   1. CS-1: Identify barriers to healthcare that transgender/gender non-conforming patients experience                                                                                                     
   2. CS-2: Describe at least three ways that a healthcare facility can be more inclusive of patients across the gender identity/expression spectrum.
   3. CS-3: Examine the gender binary  

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Topics & Objectives

1. IPC: Ensuring an Effective Environmental Cleaning and Disinfection Program   
   1. IPC-1: Identify the process to review the disinfectants available in the facility and to ensure proper coverage for anticipated microorganisms in the facility
   2. IPC-2: Discuss guidelines and best practices surrounding the selection of disinfectants to meet infection prevention and control needs in your facility
   3. IPC-3: Describe elements of an environmental cleaning and disinfection audit for the purpose of quality assurance practices and improving compliance 

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Topics & Objectives

1. QI: Spread and Scale
   1. Objective 1: Differentiate between spread and scale as strategies for expanding on successful tests of change
   2. Objective 2: Describe the factors that indicate whether spread or scale is a more appropriate next step for your project
   3. Objective 3: Analyze project examples to determine whether spread or scale is a more appropriate next step

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Topics & Objectives

1. HE: Community and Stakeholder Engagement
   1. Objective 1: Explain at least one strategy to engage community members
   2. Objective 2: Define criteria for identifying and prioritizing stakeholders
   3. Objective 3: Describe community-oriented medicine

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Topics & Objectives

1. QI: Sustaining Changes
   1. Objective 1: Describe how outcomes metrics help you plan and measure sustained change
   2. Objective 2: Describe how a process metric impacts your ability to sustain
   3. Objective 3: Articulate the roles and responsibilities required to sustain a change over time

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Topics & Objectives

1. HE: Trauma-Informed Approaches to Providing Care
   1. Objective 1: Describe NEAR Science
   2. Objective 2: List the six trauma-informed principles
   3. Objective 3: Identify an example of trauma-informed communications style

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Topics & Objectives

1. Injection Safety and Infection Prevention
   1. Objective 1: Define safe needle use never shared between patients; limited to only one needle, one syringe, and only one time
   2. Objective 2: Describe clean areas for safe medication and injection preparation
   3. Objective 3: List at least three differences between single-dose vials and multi-dose vials

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Topics & Objectives

Health Equity: Disability and American Sign Language

1. List important needs deaf and hard of hearing (DHH) American Sign Language (ASL) users have when accessing healthcare
2. Identify different accommodation and interpreting needs among DHH, including ASL users
3. Discuss strategies for increasing inclusion for DHH ASL users at your healthcare institution

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Topics & Objectives

Health Equity & Cultural Sensitivity Wrap-Up: Case Studies

1. Health Equity & Cultural Sensitivity Objective 1: Describe key health equity considerations in a case example.
2. Health Equity & Cultural Sensitivity Objective 2: Describe key cultural sensitivity considerations in a case example.
3. Health Equity & Cultural Sensitivity Objective 3: Discuss how health equity and cultural sensitivity content from this ECHO has been applied to organizational improvements.

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Topics & Objectives

Infection Prevention and Control: Implications of this ECHO for Infection Prevention and Control

1. Infection Prevention and Control Objective 1: Recognize how our understanding of effective infection prevention and control (IPC) has changed since the onset of the COVID-19 pandemic.
2. Infection Prevention and Control Objective 2: Discuss how IPC content from this ECHO has been applied to organizational improvements.
3. Infection Prevention and Control Objective 3: Associate core principles of IPC from this ECHO with improvements of organizational preparation for future pandemics and outbreaks.

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