National Quality Standards Will Improve Social Determinants of Health

December 17, 2020 - A lack of national standards for social determinants of health quality metrics impedes progress, but a plan for setting nationwide guidelines could be the first step to nationally addressing these non-clinical factors impacting patient health.

Shantanu Agrawal, MD, MPhil, president and CEO of the National Quality Forum called for comprehensive policies and standards to address social determinants of health effectively in a recent episode of Healthcare Strategies, an Xtelligent Healthcare Media podcast.

“One of the roles we can play as an organization is making sure that evidence-based practices, that data is being brought forward so that it is clear what does work in addressing social determinants and disparities,” said Agrawal. “Then there can be wider adoption.”

But focusing too much on the perfect data can slow meaningful change.

“Where the evidence exists, we have to get out of this mindset of more data is better. We need to start implementing widely and broadly,” Agrawal argued. “The evidence is there not just on improved life outcomes and clinical outcomes for patients, obviously those are really important things, but also actual ROI production for organizations. Organizations rightly want to know that if they invest in an area, the investment is going to be sustainable.”

A comprehensive social determinants of health strategy needs nationwide standards that local agencies can use as guides — moving the industry away from proving that social determinants must be addressed to actually addressing them. Local organizations can take the standards and adapt them to fit the specific needs of their populations.

“Balance is critical. There need to be national policies and national standards that we can align around so that we know that all populations will benefit from this work,” Agrawal furthered.

In areas like housing, food insecurity, and transportation, there is already mounds of evidence to support the funding of these initiatives. Studies have repeatedly linked efforts in these areas to improved patient outcomes. So momentum should transition away from furthering this evidence-base to supporting local, community efforts.

“This is about organizations really adopting their communities, trying to get very granular and understanding what the needs of those communities are and then leveraging that national infrastructure and those nationally emerging best practices to apply them locally, changing them where they have to in order to make them more germane to local needs,” continued Agrawal.

To support this work, NQF recently published The Care We Need report. It highlights the need for national policies and standards that can align with all populations and be adjusted to local, community goals.

“A basic thrust of The Care We Need is that this needs to be a priority. It needs to be part of the culture of healthcare that we address disparities and social determinants of health,” Agrawal highlighted.

Addressing social determinants of health is no longer up for debate. Evidence upon evidence has reiterated how these factors impact patient health. So the next step to meaningful work is establishing communities can use as a model.  

“There needs to be enough of a national dialogue and enough of a national infrastructure so that we’re all marching together,” Agrawal concluded.

Listen to the full podcast to hear more details. And don’t forget to subscribe on iTunes, Spotify, or Google Podcasts.