Priorities and Recommendations
Priority 1: Equity Equity is one of the Guiding Principles of the committee’s overall work, and there are important equity-related considerations for each of the priority areas. Yet, while equity should not be restricted to its own priority, there are important issues and opportunities that need focused attention—equity needs to be on equal footing with cost, quality, access, and other priorities. The central goal of the IAHS must be to reduce and eliminate disparities in health care and health among its patients. Achieving this goal will necessitate the IAHS focusing on what happens both within its walls and in the community. Through both the focus groups and community conversations, personal stories were shared of interactions with the existing healthcare system in Rhode Island (not limited to the Care New England and Lifespan systems) that were impacted by implicit bias, a lack of cultural sensitivity and awareness, and the overall need for a more diverse healthcare workforce. Significant health disparities have existed for far too long in Rhode Island, and the consolidation has the potential to have unintended consequences on historically marginalized communities, which could exacerbate these disparities. Our community input process highlighted the underlying distrust of academic health systems, particularly among communities of color. There is a need to ensure true and sustained connection and partnership with community-based organizations and residents in the communities the IAHS will serve. A healthcare system that isn’t connected to, or reflective of, the community will be unable to address biases—unconscious and conscious—and create a system that provides equitable, culturally appropriate care, while also addressing the Social Determinants of Health. Embedding a stronger focus on equity into the state’s healthcare system is already underway, led by many community-based organizations. For example, SISTA Fire's ongoing work to address maternal health disparities by pushing for greater accountability, as well as changes to policy and practice by Women & Infants Hospital. The proposed merger, and the related attention and resources, provide an opportunity to “lift up” and directly support those others doing work to create a more equitable system.
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