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Vulnerable patient populations, including the poor, uninsured and those with multiple chronic conditions, have complex health needs exacerbated by social determinants such as food insecurity, unstable housing and lack of transportation. In the United States, safety-net hospitals deliver care to a significant number of these patients. Yet safety-net hospitals may have relatively fewer resources than other health care organizations, creating unique challenges to becoming high-performing organizations. Recognizing these challenges and the ongoing need to improve care delivery within the U.S. health care safety net, the AHA Board of Trustees created the Task Force on Ensuring Access in Vulnerable Communities. Supporting the work of safety-net hospitals also aligns with the AHA’s Path Forward, which focuses on a commitment to access, value, partners, well-being and coordination to advance health for everyone in America.

The Path Forward identifies performance improvement as a key strategic priority for hospitals to improve the health of individuals and communities. A deeper dive into the use and impact of successful performance improvement approaches in safety-net hospitals is critical to contributing to health equity and transforming health care delivery for the most vulnerable.

The AHA’s Health Research & Educational Trust is leading a study to understand the factors that facilitate successful performance improvement in safety-net hospitals in the United States with generous support from The Commonwealth Fund, a leader in improving care for vulnerable populations and delivery system reform.  Partners in this study include NORC at the University of Chicago and a national advisory council of subject matter experts. Long-term goals of the project are to:

  • Provide information and tools for the safety-net community to adopt and implement for performance improvement
  • Build a stronger evidence base for redesigning care for vulnerable populations
  • Inform policy decisions that affect safety-net organizations

For this study, HRET will conduct an analysis of the U.S. safety-net hospital performance improvement landscape and capture key elements of successful models in order to report on best practices and lessons learned.  Our team will develop several issue briefs, produce a comprehensive report and disseminate findings broadly to our member hospitals; state, regional and metropolitan hospital associations; policymakers; philanthropies; and other key stakeholders.

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Jay Bhatt, D.O., is chief medical officer of the AHA and president of HRET.

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