Dr. Komal Bajaj, NYC Health + Hospitals, talks health equity

Providing safe, high-quality, equitable care is a top priority for many healthcare leaders working to reduce disparities. In 2023, the Centers for Medicare and Medicaid Services will ask hospitals to include data on social drivers of health as part of their reported quality measures. How exactly does equity tie into safety and quality work, and how does it relate to your position on the Agency for Healthcare Research and Quality’s National Advisory Council?

While equity has been a stated goal for a very long time, it’s clear that some of our structures, processes and biases impact healthcare, so certain groups experience differences in access, prevention and outcomes. We can, and must, do better. The Institute for Healthcare Improvement surveyed healthcare leaders in July 2021, and overwhelmingly, the sentiment was that there cannot be any progress in healthcare quality unless there’s progress in health equity. When I think about healthcare equity, I think about this notion that everyone can live their healthiest life—no matter who they are, where they are, how much they make, what language they speak or the color of their skin. You can’t consider healthcare to be high-quality, unless it is equitable.

The AHRQ’s mission is to produce evidence related to high-quality care—and going one step further, to make sure that evidence is understood and translated. As a healthcare leader, there’s been a lot of products that have come from the AHRQ that have been transformative for my practice. Things like the TeamSTEPPS playbook, the National Healthcare Quality and Disparities Report, resources that equip patients to get the most out of their interaction, and new resources related to diagnostic safety. I think the AHRQ is poised to make an impact on healthcare quality, as defined as inclusive of equitable care.

You are uniquely positioned with experience working in the Chicagoland area and New York neighborhoods like the Bronx, and a background in obstetrics, gynecology and genetics. What are some of the main safety and quality issues you’ve witnessed in your work with communities of color and populations that are medically disadvantaged?

So much of health is impacted by what happens outside of our physical or virtual “four walls.” While quality and safety leaders, rightfully so, are focused on things that happen in the care environment—catheter-associated urinary tract infections, cancer screenings, falls, et cetera—what keeps me motivated is thinking about how we can impact health across that continuum, recognizing that so much of health happens upstream. How can we impact things like community safety, housing instability and access to healthy food? Because at the end of the day, these are some of the really important components to health. I was talking to some international healthcare leaders recently, and while their practice settings are very different, and the needs of their communities are very different, this sentiment and thinking about the totality of health shone through.