VALLEY CHILDREN’S HOSPITAL
1. Top 10 Disparities
The following table lists the ten largest health equity disparities identified for this reporting period.
Disparities for each hospital equity measure are identified by comparing the rate ratios by stratification groups. Rate ratios are calculated differently for measures with preferred low rates and those with preferred high rates. Rate ratios are calculated after applying the California Health and Human Services Agency's "Data De-Identification Guidelines (DDG)," dated September 23, 2016.
The table below highlights the ten widest health equity disparities identified by hospitals and hospital systems during this reporting period. Measure names have been shortened for display purposes. To view each measure in full, please download the complete Hospital Equity Report using the link below.
| Measure | Stratification | Stratification Group | Stratification Group Rate | Reference Group | Reference Rate | Rate Ratio |
|---|---|---|---|---|---|---|
|
1.
HCAI 30-Day readmission
|
Race/Ethnicity | White | 6.6% | Black or African American | 3.7% | 1.80 |
|
2.
HCAI 30-Day readmission
|
Age | 15 years and older | 8.7% | 0–4 years | 5.2% | 1.70 |
|
3.
HCAI 30-Day readmission
|
Race/Ethnicity | Hispanic or Latino | 6.0% | Black or African American | 3.7% | 1.60 |
|
4.
HCAI 30-Day readmission
|
Race/Ethnicity | Asian | 5.7% | Black or African American | 3.7% | 1.60 |
|
5.
HCAI 30-Day readmission
|
Expected Payor | Medicaid | 6.6% | Private | 4.3% | 1.50 |
|
6.
HCAI 30-Day readmission
|
Age | 5–9 years | 6.4% | 0–4 years | 5.2% | 1.20 |
|
7.
Pediatric survey recommend hospital
|
Expected Payor | Self-Pay | 76.5% | Medicaid | 89.8% | 1.20 |
|
8.
Pediatric survey recommend hospital
|
Race/Ethnicity | American Indian or Alaska Native | 85.4% | Native Hawaiian or Pacific Islander | 98.4% | 1.20 |
|
9.
HCAI 30-Day readmission
|
Age | 10–14 years | 5.9% | 0–4 years | 5.2% | 1.10 |
|
10.
Pediatric survey recommend hospital
|
Race/Ethnicity | Black or African American | 87.1% | Native Hawaiian or Pacific Islander | 98.4% | 1.10 |
2. Equity Plan
Seven of the 10 disparities identified at Valley Children’s were related to the California Department of Health Care Access and Information (HCAI) All-Cause 30-Day Readmission Rate, with the top disparities occurring among the age and race and/or ethnicity stratification groups. While the calculated rate ratios suggest a possible disparity, chart review of individual cases found no evidence of inappropriate or substandard care. These results can be attributed to the efforts of our Health Equity Steering Committee, which was established to analyze clinical outcomes and identify potential disparities. As part of their ongoing work, the committee monitors hospital readmissions to ensure care is both appropriate and effective. To date, no disparities in clinical outcomes have been found.
To reduce and prevent disparities within readmission rates, several best practices have been implemented hospital wide. These include scheduling follow-up appointments prior to discharge, developing care plans for high-risk patients, conducting post discharge follow-up calls to high-risk patients, providing patients with clear and understandable discharge instructions in their native language, and explaining potential problems and what to do or who to contact if a problem arises. We ensure our patients understand their discharge instructions thoroughly before leaving the hospital via return demonstration when applicable. As part of our continuous and never-ending improvement, the Quality and Performance Improvement team reviews same-cause hospital readmissions weekly to ensure the care during the initial hospitalization was appropriate. Metrics being tracked to monitor potential disparities include health conditions, race/ethnicity, Child Opportunity Index (COI) and payer status.
We are confident in the care we provide for our patients and their families regardless of race or ethnicity, as evidenced by the results of our pediatric experience survey which showed little to no disparities when comparing race. Over the next 12 months, we will maintain our efforts by applying best practices and tracking outcomes to ensure care remains equitable, safe, effective, timely, efficient and patient centered.
3. Structural Measures
| Centers for Medicare & Medicaid Services (CMS) Hospital Commitment to Health Equity Structural (HCHE) Measure | Yes/No |
|---|---|
Our hospital system strategic plan identifies priority populations who currently experience health disparities |
Yes |
Our hospital system strategic plan identifies healthcare equity goals and discrete action steps to achieve these goals |
Yes |
Our hospital system strategic plan outlines specific resources that have been dedicated to achieving our equity goals |
Yes |
Our hospital system strategic plan describes our approach for engaging key stakeholders, such as community-based organizations |
Yes |
Our hospital strategic plan identifies healthcare equity goals and discrete action steps to achieve these goals |
Yes |
Our hospital system has training for staff in culturally sensitive collection of demographics and/or social determinant of health information |
Yes |
Our hospital system inputs demographic and/or social determinant of health information collected from patients into structured, interoperable data elements using a certified EHR technology |
Yes |
Our hospital system stratifies key performance indicators by demographic and/or social determinants of health variables to identify equity gaps and includes this information in hospital performance dashboards |
Yes |
Our hospital system participates in local, regional or national quality improvement activities focused on reducing health disparities |
Yes |
Our hospital system senior leadership, including chief executives and the entire hospital board of trustees, annually reviews our strategic plan for achieving health equity |
Yes |
Our hospital system senior leadership, including chief executives and the entire hospital board of trustees, annually reviews key performance indicators stratified by demographic and/or social factors |
Yes |
4. Web Address for Equity Report
5. Download Equity Measures Report
Click on the link below to download the equity measures report.
Click on the link below to download all equity measures reports.