In an effort to identify and reduce health care disparities based on sociodemographic characteristics, Stony Brook Medicine maintains a number of Health Equity dashboards that stratify key quality and safety data by race, sex, age, ethnicity, socioeconomic status, and preferred spoken language. Analysis of this and other key sources of data has led to a number of improvements and has resulted in more equitable care in a number of areas. Some examples include:
Stony Brook University Hospital:
- Differences in testing for A1c among male and female patients with diabetes were identified. Protocols on units with disparities were reviewed to ascertain whether updates were required. It was determined that the expectation for testing was not appropriate in all cases and a re-assessment was performed. Disparities have been greatly reduced and we continue to monitor.
- A difference in diagnostic colonoscopy wait times was identified among underinsured and insured patients. Hence, an opportunity was identified to increase access and decrease wait time for outpatient colonoscopies and create a more equitable process. A gastroenterology coordinator was hired and regular meetings between members of the Gastroenterology care team were initiated to continually identify and optimize scheduling opportunities. The gap in wait times was closed as a result and monitoring continues.
Stony Brook Southampton Hospital:
- HIV testing was selected as a project area of focus to promote equity, inclusivity, and accessibility in relation to HIV testing for the diverse community of Stony Brook Southampton Hospital due to an identified low rate of patients opting to receive HIV testing. Data will be segmented to identify any significant disparities among sociodemographic groups; the existing protocol for recommending HIV testing and associated staff training materials will be adapted based on the identified areas of opportunity with the goal of minimizing any disparities identified and increasing the rate of HIV testing overall.
- Social determinants of health screening data indicated a persistent need amongst Stony Brook Southampton Hospital patients related to difficulty paying for prescription medications (DPPM). A project team was convened with several goals, including educating staff on health disparities, specifically DPPM, restructuring and expanding existing projects addressing DDPM, and optimizing teamwork to identify community-based solutions.
- Recent Community Health Needs Assessments and other surveys performed across Suffolk County identify food insecurity as one of the main social determinants of health affecting local residents. To address these findings, Stony Brook Southampton Hospital Health Equity team members and stakeholders chose food insecurity as a social determinant of focus. A new data collection tool and protocol was introduced to consistently screen patients on a number of social determinants of health, including food insecurity. The patient referral process for food insecurity was also updated and a Food Pack provision program was launched.
- In 2021 Stony Brook Medicine, in collaboration with over 30 community partners, conducted the first ever health needs survey of LGBTQ* adults in Nassau and Suffolk County. The survey was the first comprehensive health needs assessment of the LGBTQ* population on Long Island, filling a gap of knowledge where no quantitative data specific to our region was available. One survey finding indicated the need for improved provider training on the treatment of LGBTQ* patients in personalized, affirming, and culturally competent manner. LGBTQ* Department Champions were identified and an LGBTQ* Education Initiative was launched.
Stony Brook Eastern Long Island Hospital:
- Recent data segmented by sociodemographic characteristics indicated differences in the A1c clinical testing and diabetes diagnosis rates at Stony Brook Eastern Long Island Hospital. The project team assembled aims to improve and make more equitable A1c clinical testing rates when indicated and improve the dissemination of diabetes education with the goal of improving the management and care of all diabetic inpatients at Stony Brook Eastern Long Island Hospital.
- Recent data collected at Stony Brook Eastern Long Island Hospital indicated 89% of patients were screened for food insecurity, with approximately 10.4% screening positive. A project team aims to improve the percentage of inpatients assessed for food insecurity at the time of admission to 90% or greater, with those screening positive provided with a food tote bag at discharge through the Food As Medicine program. In addition, the hospital extends support beyond the hospital walls by connecting patients with community-based resources for ongoing food assistance.