PALOMAR MEDICAL CENTER

1. Top 10 Disparities

2. Equity Plan

On 08/21/2025, A team presented the top 10 disparities for Palomar Escondido, Palomar Poway, and Palomar Health as a system. Our top 10 disparities for Escondido were readmissions by Age (35 to 49, 50 to 64, 65+ vs 18 to 34), Race/Ethnicity (AI/AN, Black, Multiracial, NH/PI vs Hispanic/Latino), Payer (Medicare vs Private), and unique disparities: Failure-to-Rescue (Male vs Female), Pneumonia Mortality (White vs Hispanic/Latino) and Patient safety Indicator Death among surgical inpatients with serious complications for male patients.
Our system's top disparities include recurrent 30-day readmission gaps (Medicare; older age cohorts; and Black/African American vs reference), plus patient safety and access differences. We will apply a system wide improvement bundle with local tailoring at each hospital.

Readmission Disparity:
Key actions: Our actions will include education to our providers and nursing staff, which will include working with our Case Management team to develop transitional care bundle(s). These care bundles will include but will not be limited to follow-up instructions by the provider and nurse at discharge, discharge medications provided to the patient before discharge, accurate medication reconciliation to ensure no medication duplications, patient and or family education to include teach-back. Palomar Medical Center will initiate home phone calls to this group of patients within 72 hours to ensure patient understanding of aftercare instructions. The RNs will provide education to the SNFs on continuity of care to ensure that the next level of care is able to facilitate care to avoid a readmission. Paloma Medical Center has SDOH screening and referrals, language-interpreters, and make every effort to provide concordant instructions, and culturally informed patient engagement.
Time frame and Objectives for readmission:
Reduce readmissions in disparity groups by greater than or equal to 20% in 12 months, and narrow the rate ratio gap by greater than or equal to 25% over 24 months
Palomar Medical Center Disparity: Pneumonia Mortality rate white ethnicity.
Palomar Medical Center has an Antibiotic Stewardship Committee that reviews all antibiotics to ensure they are the right choice and duration based on severity and risk factors of the patient. Palomar will engage with the Antibiotic Stewardship Committee and the providers to review their evidence based order set to ensure that they follow either CDC recommendations or Diseases Society of American. By using our SDOH data, we can also determine if any of the mortalities were linked to socioeconomic factors, like income, insurance or homelessness.
Palomar Medical Center Escondido will also review and as needed revise their plan of care for patients admitted with pneumonia and develop short and long term goals such as;
Patient will have appropriate blood cultures drawn before the administration of an antibiotic and in ICU continue to implement the ventilator associated pneumonia bundles to include, head of bed elevated, daily sedation vacation, and subglottic suctioning.
Goal and Time frame:
Reduce pneumonia mortality rates in disparity group (White vs Hispanic/Latino) by greater than or equal to 10% in 12 months and narrow the gap by greater than or equal to 15% over 24 months
Key Issues:
Death rate among surgical inpatients with serious treatable conditions, disparity white male
Palomar Medical Center does utilize a surgical checklist for surgical patients aligned with The Joint Commission Universal Protocol standard for a performance measure. This checklist does follow recommendations for patient safety during a surgical and after a surgical procedure. The Director for Surgical Services will work with the surgical team and the providers to determine if a revision of the current surgical checklist should be done to include some elements of the WHO Surgical Safety Checklist. The Who Surgical Checklist does include assessments performed by the providers before surgery. The current Standardized Procedure and Adult Inpatient Standards, include post-operative monitoring and infection control monitoring for the care of the surgical patient. The Antibiotic Stewardship Committee will be engaged if continued use of antibiotics is required for the surgical patient beyond the initial provider order. Palomar Medical Center, Escondido will also utilize the SDOH data when preparing patients for surgery to determine other unknown risks to the surgical patient during recovery.
Goal and Time frame:
Reduce surgical mortality rates in disparity group by greater than or equal to 15% in 12 months and narrow the gap by greater than or equal to 20% over 24 months

Stratify PSI metrics by payer/age/race; unit dashboards; escalation simulations; and by greater than or equal to 15% reduction in disparity-linked PSI events as reducing surgical mortality and pneumonia rates

3. Structural Measures

5. Download Equity Measures Report

Click on the link below to download the equity measures report.

6. Looking for Related Reports?

• Hospital Supplier Diversity Plan
• Hospital Fair Billing Policies
• Hospital Profile