VENTURA COUNTY MEDICAL CENTER

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	Age (excluding maternal measures)	65 and older	15.6%	18 to 34	7.2%	2.20
2. HCAI 30-Day readmission	Age (excluding maternal measures)	50 to 64	15.6%	18 to 34	7.2%	2.20
3. HCAI 30-Day readmission	Expected Payor	Medicare	18.6%	Private	9.0%	2.10
4. HCAI 30-Day readmission NOBH	Sex Assigned at Birth	Male	13.5%	Female	9.5%	1.40
5. HCAI 30-Day readmission	Age (excluding maternal measures)	35 to 49	9.8%	18 to 34	7.2%	1.40
6. HCAI 30-Day readmission	Expected Payor	Medicaid	11.1%	Private	9.0%	1.20
7. HCAI 30-Day readmission	Preferred Language	Spanish Language	14.9%	English Language	12.2%	1.20
8. CMQCC breast milk feeding	Race and/or Ethnicity	Hispanic or Latino	68.5%	White	82.1%	1.20
9. HCAI 30-Day readmission	Race and/or Ethnicity	White	13.6%	Hispanic or Latino	12.2%	1.10
10. CMQCC breast milk feeding	Age (for maternal measures only)	30 to 39	67.4%	18 to 29	72.1%	1.10

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2. Equity Plan

The Ventura County Medical System envisions a community where everyone can attain their full potential for health and well-being. Committed to providing equitable care to the communities we serve, we have systematically worked to improve the delivery of health care that is culturally responsive, accessible, evidence-based and high quality in delivery and patient outcomes. We commit to the absence of unfair, avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other dimensions of inequality (e.g. sex, gender, ethnicity, disability, or sexual orientation). We commit to the use of data to measure outcomes, identify disparities, and design changes in our system protocols, practices and customs, aimed at increasing health equity for our community.
VCMC and SPH have integrated health equity measures and outcomes into our 5-year Strategic Plan, identifying needs such as a Patient Family Partnership and Language Access program, as well as Social Determinants of Health (SDOH) measures and referral strategies, and defining outcomes over 5 years in these areas.

Specifically, Ventura County Medical Center (VCMC) and Santa Paula Hospital (SPH) have focused improvements that address both readmission rates and exclusive breastfeeding (the practice of feeding a baby only breast milk for the first 6 months of life), covering the top 10 disparities identified. For example, the following initiatives address these areas:
• Patient Family & Advisory Council (PFAC) — The creation of a PFAC will enable us to address culturally responsive care. Specific and detailed qualitative patient feedback will enable us to further identify needs for improved language access and supportive services.
• SDOH, Safety Net Support, Navigation and Care Management — As part of a larger public safety net system, we have been able to partner with the County's Public Health, Whole Person Care, and Behavioral Health Departments on actions, such as access to transportation and food insecurity.
• Language Access — Through partnership with local advocacy groups and the creation of an enhanced language access department, we have increased our patients' access to culturally competent care, breastfeeding, and reduced readmissions due to better transitions of care and patient follow-up.
• Readmission Prevention — Through targeted data analysis and cross-functional solution design, the Hospitals are implementing measures such as proactive patient flag upon Emergency Department admission, which is used to identify missed follow-up or preventative care. This notification is used to examine the need for a series of care coordination measures, specifically designed to address the risk of readmission for Medicare patients in certain age groups (as with the disparity-identified group of male patients 60+ with Medicare).

VCMC and SPH use data, including patient outcomes, and patient experience data to identify needs, including for such projects as Perinatal Outcomes for Non-US Born Hispanic/Latinx, and focused Readmission work (see responses to "Priority Areas" for specifics).

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

VENTURA COUNTY MEDICAL CENTER