Health care transformation calls for engaging hospitals, trustees and communities to ensure that all patients receive high-quality care. Hospital leaders need to consider a variety of issues as they meet future challenges, and several key issues link to equity of care. Providing high-quality, equitable care with diverse leadership can reduce costs and financial risks — and be transformational.

As outlined in the American Hospital Association’s Leadership Toolkit for Redefining the H: Engaging Trustees and Communities, these issues include:

• managing variation in the rapid pace of change

• adapting to new payment and delivery system models with little experience and knowledge about their intended and unintended consequences

• confronting the challenge of disruptive innovators that offer convenience and reduced complexity for the consumer

• managing new and sometimes difficult partnerships in which cultures clash and missions do not align

• ensuring sustainability in an evolving business model

• assembling and developing the right talent in the hospital and in the community

In addition, two key issues address the importance of providing equitable care:

• ensuring diversity of age, gender, race and ethnicity that reflects the community, at all levels of the organization — from the board to management to front-line staff

• developing a deep understanding of the community’s level of health and wellness, its burden of disease and its needs

A Toolkit for Quality Care

Equity of Care: A Toolkit for Eliminating Health Care Disparities is a collection of resources for hospital and system leaders in three areas: increasing the collection and use of race, ethnicity and language preference data; increasing cultural competency training; and increasing diversity in governance and leadership. Equity of Care, a call to action by the AHA and four national partners, has outlined these focus areas to provide equitable care and eliminate disparities.

Equitable care is one of the Institute of Medicine’s six aims for improvement. The Equity of Care Toolkit can assist hospital leaders in developing, executing and sustaining targeted interventions to improve quality and access to care for underserved populations.

More Effective, Diverse Boards

A diverse board — one that is most representative of the community and can develop a high level of understanding in areas crucial to organizational success and performance — will be the most effective. The Equity of Care Toolkit includes several resources to increase diversity at the governance and leadership levels. These resources focus on:

• communicating across the organization the business imperative of having a leadership team and board that reflect the communities served

• developing chief diversity officer roles to elevate diversity as a strategic priority

• thinking long term to ensure a deep pool of qualified candidates

The Business Imperative

Research studies confirm that health care disparities lead to increased costs of care because of excessive testing, medical errors, increased length of stay and avoidable readmissions. It is estimated that eliminating these disparities would reduce direct medical expenditures by nearly $230 billion. The Equity of Care Toolkit includes a presentation for hospital leaders to customize to make the business case for equitable care. 

To access the Equity of Care Toolkit, a free resource, visit the Equity of Care website at

Cynthia Hedges Greising ( is a communications specialist and Katya Seligman ( is a program specialist, both at the Health Research & Educational Trust, Chicago.