Background: Although hospitals and hospitalists often engage in work to improve patient care and quality, rarely does such work directly seek engagement from patients and communities. Even when direct to patient surveys are distributed, historically marginalized populations are often underrepresented. Understanding how to authentically engage with communities is integral to improving patient experience and ensuring health equity.
Purpose: To develop an approach to understanding community healthcare needs through fostering a relationship between our division of hospital medicine and a local community based organization, with the eventual goal to inform inpatient health equity and improvement work.
Description: Two years ago, our division of hospital medicine, which is based in an urban academic health system, sought to more deeply engage with the historically marginalized communities we serve. We identified GLIDE, a well established local Community Based Organization (CBO), with a stated mission and values that were aligned with our own. Preliminary conversations explored expectations and goals of a potential relationship (Table 1). Based off GLIDE’s recommendation, four members of our division partnered with two members from GLIDE to develop opportunities for healthcare workers to participate in a 3-day Institutionally sponsored training program coordinated by GLIDE to meet face-to-face, in service and dialogue, with individuals impacted by racism, homelessness, and substance use disorders, with the goal of leveraging interpersonal connections and understanding to reduce stigma and harm experienced by patients in the hospital. Over the next 18 months, we deepened the engagement, creating ways for hospitalists to participate in the program, inviting our GLIDE colleagues to speak at Divisional meetings, and partnering in obtaining funding to further this work. This collaboration eventually resulted in a successful $80,000 grant to pilot a series of community listening sessions. All sessions were hosted by GLIDE, with a specific goal of better understanding their clients’ experiences with our hospital and to identify areas for improvement from their perspectives. Participants for the listening sessions were recruited directly by the GLIDE in partnership with another local CBO who focused on care of historically marginalized communities in our local area and were compensated for their time. Twenty-six people participated in the first two hour-long listening sessions. Each session was facilitated by a member of the GLIDE to create a safe space where community members could feel comfortable speaking without perceptions that their comments might impact future care received at our hospital. Listening sessions were recorded and analyzed using thematic analysis generating a list of themes and recommendations (Table 2). These were then shared back with participants to ensure accuracy in interpretation.
Conclusions: Partnering with CBOs provides a crucial opportunity to incorporate patient and community voices, especially from historically marginalized populations, to inform inpatient health equity focused improvement work. Divisional investment, taking time to build a relationship, and deference to CBOs expertise to guide involvement are important first steps.
