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3 ways equity impacts healthcare performance

Recent events—including, but certainly not limited to, a global healthcare crisis—have turned a spotlight on equity and the critical role it plays across healthcare. Whether we’re talking about caring for patients, communities, or employees and staff, driving toward equity improves outcomes, engagement, and satisfaction, and medical systems become more sustainable in the long term.  

The rise of equity-focused articles in journals and industry media points to the urgent need for healthcare to solve equity gaps. Special issues or collections in Health Affairs, JAMA, Institute for Healthcare Improvement, and others are devoted to equity. At Press Ganey's very own National Client Conference last February, more presentations focused on equity than ever before. Equity collaboratives are springing up, such as the American Hospital Association (AHA) Institute for Diversity and Health Equity, National Collaborative for Health Equity, and The Equity Collaborative within the Carol Emmott Foundation, and the Press Ganey Equity Partnership. And equity has been infused into various policy, payment, and accreditation programs like the ACO REACH Model, QHP Enrollee Survey, HESS for MA plans, and NCQA’s Health Equity Accreditation. 

Prioritizing equity is not only the right thing to do, but it also impacts critical outcomes in several areas of your organization.  

1. Equity improves patient experience

Patient experience (PX) is a key area where equity has a direct impact. According to Press Ganey proprietary data, larger gaps in equity are associated with lower PX performance. You need to understand how your patients experience care and uncover any differences that exist in their experiences by identity group. 

Equity gaps differ by clinical condition as well as across care settings. It’s important to understand national patterns and how they uniquely play out across different types of episodes. For example, in the inpatient setting across all patients (Figure 1, under “Overall”), patients who identify as Black or African American evaluate certain elements of their care more favorably (blue bars) and others less favorably (red bars). Among Black/African American patients, the attributes of care that are meeting their needs follow a similar pattern for those being medically treated and surgically treated. However, maternity patients who identify as Black or African American evaluate nearly all inpatient measures less favorably than the national score for patients having babies.  

Figure 1 (click here to expand

"Black or African American Experience" bar chartYou can only begin to prioritize and address disparities in PX data when you know what and where they are. By focusing on equity and improving patient experiences for the groups reporting the lowest perceptions of care, your organization can be the tide that lifts all boats and reduces disparities between groups. If your organization is just starting out on its equity journey, here’s what you need to know about segmenting data by race and ethnicity.

2. A culture of equity drives employee engagement and retention

Beyond patient experience, equity plays a huge role in the employee experience (EX). A culture of equity is associated with higher engagement (i.e., perception of Diversity and Equity is correlated at 0.83 with overall staff engagement)—a relationship that’s consistent across racial identities (i.e., correlations range from 0.70 to 0.82 across racial/ethnic groups). Establishing a culture that's fair and just and embraces diversity is necessary to drive engagement among all team members.   

The same can be said for retention. A culture of equity is associated with keeping high performers at your organization. For example, a staff member's risk of leaving the organization if offered a similar job elsewhere is 4.6x higher among those who don’t believe their organization values people from different backgrounds. Asking your workforce about their perceptions of diversity and equity at your institution will give you an important view into future retention—allowing you to monitor overall turnover risk as well as for specific work groups and teams. 

Figure 2 (click here to expand

"Diversity & Equity Items and Intent to Stay" illustrationOrganizations that are just beginning to explore employee engagement as it relates to equity must focus first on the key fundamentals for DEI culture transformation. Download this workbook to get started.

3. Equity is entwined with safety

Inequity in and of itself is a form of harm. And we know that a culture of diversity and equity is positively associated with safety culture outcomes, like Prevention & Reporting, Pride & Reputation, and Teamwork & Resources. Both an equitable environment, where all feel valued and a sense of belonging, and a clinically safe environment, where employees feel free to raise and report concerns without fear of reprimand or retribution, underpin psychological safety. To achieve this ecosystem, organizations must analyze safety through an equity lens and apply high reliability safety principles to their equity work.  

Figure 3 (click here to expand

"Safety Culture Composites Are Related to Perceptions of Diversity & Inclusion" scatter graph


Join the Press Ganey Equity Partnership to supercharge this important work at your organization 

The evidence shows that equity is critical for improving patient experience, workforce experience, and safety. In Press Ganey’s Equity Partnership, we discuss strategies for integrating these often-siloed areas of quality to help organizations more effectively and efficiently improve outcomes.  

The Press Ganey Equity Partnership helps you bring the equity lens to every element of your data. Organizations in the Equity Partnership not only enjoy access to our validated Diversity & Equity module to incorporate into their own engagement surveys, but they also tap into national data analyses showing the relationship of the DEI module to engagement based on job type, race/ethnicity, and gender.  

Joining the Press Ganey Equity Partnership offers access to webinars, best practices, and other resources as well as an insightful, forward-thinking community that collaborates nonstop to accelerate equity within healthcare. Through the partnership, your account team will make specific recommendations for improving the quality of your administrative data’s identity information for patients and staff. They'll also provide the evidence-based strategies to segment and assess the current state of equity and key changes to drive the outcomes you’re working toward. 

What’s more, joining this partnership is free to any organization looking to further this important mission with us.  When we join forces and work together, ensuring equity for all is within reach. Come join leading organizations who are advancing equity across our industry—sign up for the Press Ganey Equity Partnership today.

About the author

In a joint role as Executive Director, Institute for Innovation, and Senior Vice President, Research & Analytics, Deirdre is responsible for advancing the understanding of the entire patient experience, including patient satisfaction, clinical process, and outcomes. Through the Institute, Mylod partners with leading healthcare providers to study and implement transformative concepts for improving the patient experience. Deirdre is the architect of Press Ganey’s Suffering Framework, which reframes the view of the patient experience as a means to understand unmet patient needs and reduce patient suffering.

Profile Photo of Deirdre Mylod, PhD