As health care institutions push to address health equity, the underlying assumption is that all that is needed is more internal work; that institutions can simply hold themselves accountable. While this is a necessary component, it is insufficient. As evidenced by the persistence of health inequities, there also needs to be strong mechanisms by which others–including employees, patients, community residents, policymakers, and government–can hold healthcare institutions accountable. Adapted from robust ideas and research in other sectors for how institutions can build these systems of accountability, HealthBegins has outlined Five Mechanisms of External Accountability for Health Equity.
In this blog series, we’ll review each of these mechanisms. At the core of all of these mechanisms is the need for community-driven governance and monitoring, which is the focus of this first piece in the series. As organizational psychologist Judy Freiwirth writes, this approach is “based upon the philosophy that a constituent’s ‘lived experiences,’ knowledge, and right to self-determination are critical values for organizations to embrace.” Embracing community-driven governance and monitoring helps ensure the success of everything a healthcare institution does to advance health equity. It holds the other four external mechanisms of accountability together, and it is also a way to monitor how well healthcare leaders are implementing interventions and internal mechanisms of accountability–such as using dashboards and performance incentives–to advance health equity. (author introduction)
#P4HEwebinarJune2023