Duke in Program to Reduce Disparities in Heart Care
DURHAM, N.C. -- Duke University Hospital has joined nine
other U.S. hospitals in a new national effort that officials
believe will help improve heart care for African-Americans and
Hispanics. The new program is funded by the Robert Wood Johnson
The 10 hospitals selected all have significant minority
patient populations, treat many cardiac patients, and have
demonstrated an ability to design programs to develop and test
best practices to reduce disparities in cardiac care, according
to RWJF officials.
"For years, research has shown that patients from certain
racial or ethnic backgrounds are more likely to receive
lower-quality care," said Risa Lavizzo-Mourey, M.D., RWJF
president and CEO. "We are not interested in placing the blame
for these unacceptable gaps at anyone's door. What we most want
to do is find partners, like these ten hospitals, to help us
work toward solutions."
The hospitals in the program also represent a mix of urban
and rural facilities, as well as community and academic
Participating hospitals will develop a collaborative
"learning network" to test new ideas, quantify results, and
share lessons learned. Program successes will be shared
nationwide throughout the four-and-a-half year initiative and
potentially adopted at hospitals and medical centers across the
country, the Duke participants said.
"It has been well-documented by many studies that our
country has troubling racial and ethnic disparities in the
treatments patients receive and how they fare," said William
Fulkerson, M.D., CEO of Duke University Hospital. "This program
should not only help us reduce the disparities in our own
community, but hopefully what we learn will allow us to
participate in the national solution."
While participants said that improving the immediate
cardiovascular care for African-Americans and Hispanics is one
of the major goals, there are long-term objectives as well.
"We hope to develop effective and replicable
quality-improvement strategies for treating and following
minority patients, as well as encouraging the spread of these
strategies and models to medical specialties outside of cardiac
care," said Duke cardiologist Eric Velazquez, M.D., who will
coordinate Duke's efforts within the consortium of
"The types of hospitals chosen and where they are located
represent a real-life slice of what is happening in cardiac
care in African-American and Hispanic communities across the
country," Velazquez continued. "When the project is complete,
we as a consortium will share relevant lessons with health care
providers and policymakers nationwide."
Importantly, Velazquez continued, the consortium will focus
both on what therapies patients receive while in the hospital,
as well as what happens outside the hospital. While there is
evidence showing that inpatients are increasingly receiving
care that clinical trials and studies have shown to be
effective in saving lives, there is less data on the challenges
faced by patients after discharge. These factors, ranging from
barriers to outpatient appointments to follow-up care to an
inability to afford medications to travel difficulties, can all
play a role, Velazquez said.
Velazquez said that a critical way to address and reduce
racial and ethnic gaps in treatment is to improve the
collection and tracking of patient data by race, ethnicity, and
spoken language; to evaluate whether specific patient
populations are not getting the recommended standard of care;
and to design interventions that will consistently improve the
quality of care for all patients, especially those most at risk
of receiving lower-quality care.
The consortium will be coordinated by The George Washington
University Medical Center School of Public Health and Health
Services. The other nine hospitals are:
Del Sol Medical Center, El Paso, Texas
Delta Regional Medical Center, Greenville, Miss.
Memorial Healthcare System, Hollywood, Fla.
Montefiore Medical Center, New York
Mount Sinai Hospital Medical Center, Chicago
Sinai-Grace Hospital, Detroit
University Health System, San Antonio
University of Mississippi Medical Center, Jackson, Miss.
Washington Hospital Center, Washington, DC