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3A

Equity as a measure of service quality

Equity is considered one of the main measures of quality. (Health Quality Ontario, 2017)

The dynamics between health equity and service improvement consist of a mutualistic relationship: high-quality, equitable services do not mean having a standardized approach for all clients. Not everyone has the same circumstances, needs and preferences, including those related to the social determinants of health (Dzau et al., 2022). Therefore, organizations should plan and monitor quality improvement strategies and approaches with equity in mind (Dzau et al., 2022).

Health equity can be used as a measure of service quality in the health care system.

For example:

The Institute for Healthcare Improvement, in collaboration with several health care organizations, has developed a framework to improve health equity in the communities they serve. They also provide a self-assessment tool for health care organizations to measure their efforts to improve health equity.

    The framework includes five components:

  1. 1

    Make health equity a strategic priority.

  2. 2

    Develop the structure and processes to support health equity work.

  3. 3

    Implement specific strategies to address the multiple determinants of health where health care organizations can have a direct impact.

  4. 4

    Decrease institutional racism within the organization.

  5. 5

    Develop partnerships with community organizations to improve health and equity.

  6. (Wyatt et al., 2016)

Service-level equity is also impacted by racism, especially for newcomers. We will explore this next.