Clinical Care Strategy
Our clinical care agenda is set by what we see as the largest health equity gaps that exist through our research and data. We find the greatest need and focus on those areas intensely.
Clinical care focus areas for The Accelerator:
- Equity in Pregnancy
- Infectious Diseases
- Behavioral Health
- Chronic Conditions
- Oncology and ESRD
The Accelerator’s approach is to incorporate three foundational vectors that are often siloed in healthcare: research, clinical care, and community, including SDoH.
For each of these areas, we will investigate and address both the upstream and the clinical factors that contribute to inequities in health access, patient experience, and outcomes.
These three elements form the three legs of a metaphorical stool: they all work together, and they won't work without all three in place. From there, we aim to extend the impact of the Accelerator's reach through the fourth vector: policy and advocacy.
Specifically, we envision the Accelerator to take these action steps:
- Deploy advanced research methodologies
- Provide data science and analytics tools
- Implement innovations and transform care
- Listen to patient needs and goals
- Form and sustain community partnerships
Accelerator In Action: Maternal and Child Health
Any approach to dealing with a clinical issue begins with a deep understanding of the underlying causes and factors that are creating an identifiable health disparity for birthing people of color and their children. Given the complexities that often exist when dealing with health disparities, we use a broad range of research inputs that are continually updated and refined as learnings are uncovered and progress is made.
Two objectives have been established under this clinical care area:
- Use clinical data to better understand the rate of severe maternal morbidity (SMM) for mothers of color compared to white mothers
- Enhance our understanding of race when it comes to babies who are born small for gestational age (SGA)
To address those objectives, the following research methodologies are being employed:
- Employing quantitative ‘Community Insights’ surveys with communities of color
- Conducting qualitative interviews with frontline clinicians to better understand issues from the perspective of the healthcare professional
Our research work in this space allows us to develop actionable insights into the health equity gaps that exist within SMM and SGA and develop the recommendations that will help us close that gap at BMCHS and beyond. The work being done is reflected in strategic foundational interventions to help provide expedited care for these mothers and their children as well as inform additional future research efforts.
The proposed paths forward below address maternal and child health in multiple ways and reflects the innovative thinking that the Accelerator is advancing:
- Leveraging technology to implement predictive modeling, remote monitoring, and AI-driven engagements where appropriate.
- Optimizing the clinical culture through the inclusion of Birth Sisters, staff training, and the review of protocols in multiple languages
- Creating a more holistic patient experience by incorporating mobile care teams, providing greater access to interpreters, and advancing our community partnerships
- Evaluation of upstream factors, such as economic mobility and SDoH.
- Tracking key measures by race and evaluating the impact of initiatives through ongoing research, data collection, and analytics, as well as publishing our findings to all audiences
If you would like to know more about our Maternal and Child Health program or partner with the Accelerator on this initiative, please contact us at: BMCHS.Equity@bmc.org
Accelerator In Action: COVID-19
Our first opportunity to test a shift in our approach to racial equity was during the early phase of the COVID-19 surge in 2020, when people of color accounted for than three-quarters of reported COVID-19. The present economic inequities in Boston made physical distancing and remote work impossible for many people of color, which put them at greater risk for disease transmission at a time when hospitals were being challenged by the volume of new cases on a daily basis.
BMC's response to the pandemic was supported by the organization’s longstanding commitment to addressing inequities by developing partnerships within the surrounding community and establishing leadership positions specifically tasked with this goal. In addition to this partnership strategy, a focus was also placed on recruiting, developing, and retaining a diverse workforce that mirrors the patient population and the surrounding community.
To empower communities of color to make informed decisions about getting vaccinated, a multi-channel strategy was developed and executed against in the following ways:
- Leveraging pre-existing community relationships to provide vaccine information as well as create community and pop-up vaccination sites
- Development of a vaccine awareness and education campaign promoted through multiple audience-specific channels, including social media
- Providing direct communication from healthcare professionals to the community in multiple forms, including personal phone calls
- Partnering with Boston-area community health centers (CHCs) to provide access to vaccines in convenient locations for the most vulnerable communities
Results: Although there is still much more work to do, this inclusive approach has proven successful in increasing equity in COVID-19 vaccine distribution. As of mid-September 2021, approximately 46% of patients vaccinated at BMC and our community vaccination sites have been people of color, compared with approximately 22% of the total number of people vaccinated throughout Massachusetts.
In addition, more than 25% of individuals vaccinated have been in the top two tiers of the social vulnerability index (SVI), a Centers for Disease Control measure that helps local officials identify communities that may need support before, during, or after disasters. We will continue to build a strong and dynamic infrastructure that supports health equity within Massachusetts and beyond.
If you would like to know more about our COVID-19 program, please contact us at: BMCHS.Equity@bmc.org
Health Equity Report
To learn more about The Accelerator, please download our report, The Health Equity Accelerator: The Next Step in Our Commitment to Equity. We provide additional insight into the people, the work, and the possibilities.