“If you’re all working on the same thing but don’t define it in the same way, what’s the likelihood that you’re going to be successful?” This question, posed by speaker Natalie Burke from CommonHealth ACTION, set the tone for the Learning Collaborative’s fifth in-person meeting, held last week in Scottsdale, Arizona. As the Learning Collaborative closes in on a set of common health workforce metrics, the accuracy of definitions and standardization of data sources emerged as main themes.
The meeting began with an inspirational speech from Natalie Burke, President and CEO of CommonHealth ACTION, a national public health organization that aligns people, strategies, and resources to create community-generated solutions to health and policy challenges. Arguing that “health equity is not optional,” Ms. Burke led the group in an interactive exercise to define equity and brainstorm changes that may occur in health professions education and practice if true health equity is realized. In recognition of the need for broader culture change at the university, the group outlined a business case for equity, for example: attracting the best students with an inclusive campus climate, recruiting and retaining talented faculty from all backgrounds, and positioning graduates for future care delivery models. Showing how equity impacts the university’s bottom line will help the Collaborative achieve “perspective transformation” on their campuses, balancing moral arguments for equity (e.g., “it’s the right thing to do”) with arguments based on outcomes and evidence.
Prior to the meeting, demonstration sites collected local data for 16 health workforce metrics that together represent all dimensions of the metrics framework developed during Phase 2. The National Program Office (NPO) used these data to populate a prototype dashboard comparing outcomes from demonstration sites with national benchmarks (where available). Discussion around the prototype dashboard was intense; by “making it real,” the dashboard helped participants begin to see which metrics needed more clarity and definition, where data should be standardized, and which metrics were most useful to all sites. Teams shared their processes for collecting the data and discussed the challenges associated with obtaining data from different units on campus. The NPO plans to incorporate this feedback into the next iteration of the dashboard.
One of the primary goals of Urban Universities for HEALTH is to disseminate knowledge and ideas that have been generated through collaborative work. The session “Ideas for Impact” was designed to help sites select five projects nearing completion for dissemination via a blog, white paper, peer-reviewed article, or other media source. Site teams met with a professional writer to begin shaping the publications. Selected projects for dissemination included:
- The Healthcare Occupational Knowledge Assessment (HOKA) from CSU/NEOMED
- The University of Cincinnati’s social media campaign to recruit underrepresented local students
- The role of institutional support in diversity initiatives, based on the experience of the University of Missouri-Kansas City
- “Busting through the Residency Cap,” a strategy for increasing state funding of Graduate Medical Education (GME), developed by the University of New Mexico
- A multimedia project to engage local students in considering health careers, developed by SUNY Downstate
Dr. Imam Xierali closed the meeting by sharing an illustrative example of the types of longitudinal data available from AAMC for medical students – from application to workforce participation. Data were limited to Cuyahoga County, Ohio, the Geographic Scope of Impact (GSI) for CSU/NEOMED, although similar data are available for other counties. The presentation helped the Collaborative think more strategically about data collection, in particular how to leverage existing sources so that institutions do not need to collect all the data themselves. However, it remains to be seen how these longitudinal datasets can be collected for all health professions, as the AAMC datasets are limited to medicine.
One of the biggest highlights of the meeting for participants was the opportunity to network with their peers. Urban Universities for HEALTH shared the meeting space with two other learning collaboratives funded by the Bill and Melinda Gates Foundation: Completion by Design (CBD), and the USU Transformational Planning Grant (TPG). The three groups interacted around shared goals related to student access and success through informal networking during break times as well as two formal joint sessions: an opening plenary and small-group session to discuss common challenges.
By the end of the meeting, participants agreed that each demonstration site is at a different point in the process of developing metrics, and that some health professions have better data sources than others. Moving forward, the Collaborative will seek to identify datasets relevant to each site’s geographic area, as well as data that are already available and collected by others. In developing metrics, sites plan to include all primary care providers in metrics for primary care (not just physicians), clarify each metric’s parameters so that we are comparing “apples to apples,” and think critically about different metrics that can address the same intent.