The pandemic has hit low-income communities and communities of color in an inequitable way. Yet, having an equity framework prepared Chicago-based Rush University Medical Center for the detrimental effect it would have on homeless populations, workforce shortages and the Chicago community.
When David Ansell, MD, joined Rush as its chief medical officer in 2005, Rush already had decades of programs focusing on healthcare equity that he could build on and formalize. In 2014, he became Rush's senior vice president for community health equity.
In 2016, he worked with Rush's CEO and other healthcare executives to formally create five pillars of health equity to address a 14-year life expectancy gap between Chicago's low-income and affluent communities.
Early on in the pandemic, this framework would help the hospital in helping Chicago's most vulnerable communities.
"We went into homeless shelters and began to test people for COVID-19," Dr. Ansell told Becker's. "Early in the pandemic, we discovered, before the CDC, that it was being asymptomatically spread, and we created a respite center for homeless people with COVID, which is still running a year-plus after it opened in April 2020."
The respite center has since taken care of more than 700 homeless patients who would otherwise have been spreading COVID-19 on the streets or in homeless shelters, he said.
Rush's equity strategy encouraged them to open its doors to COVID-19 patients who were currently receiving care at safety-net hospitals, something Dr. Ansell said no hospital was doing at the time.
"We took patients who were transferred on ventilators, they were going to die at the other hospitals," he said. "They did just as well as people on ventilators who came into our front door of our hospital."
For Dr. Ansell, this is a direct correlation to how an equity strategy saves lives in the community.
COVID-19 also highlighted the need for healthcare workers for hospitals to help patients as many hospitals faced massive staffing shortages. Dr. Ansell said they noted that many jobs in his hospital did not have opportunities to move up the ladder, from a job to a career.
Rush launched a series of internships, apprenticeships and career pathway programs to put low-wage workers into well-paying entry-level jobs that were in short supply. Rush launched programs for patient care technicians, medical assistants and healthcare IT because they only require a certificate.
In one example, a Rush employee who used to work in guest relations at the front desk of the hospital was transitioning into a medical assistant position. For Dr. Ansell, stories like these make his position really rewarding.
Dr. Ansell believes that what Rush is doing for equity can be repeated by other hospitals. However, he emphasized that building an equity framework is not done overnight. It took decades for Rush to build the foundations and programs it currently has in place today.
"We think that these are the right steps to take and if we all take these together, we will have an impact ultimately on health and life expectancy," he said.