Bassett Medical Center, Cooperstown, NY
Partnerships for Developing Strategy and Curriculum in Disparities

Background: Bassett’s first CLER visit in February 2015 demonstrated that while we had a number of programs dedicated to helping underserved segments of our population in rural, upstate New York, we did not have an overall strategy to assess healthcare delivery to diverse parts of our population. We also did not have an educational program to expose resident physicians to the diverse parts of our population. Our project goals were to develop an institutional strategy for understanding and addressing the diverse population Bassett serves and to develop a curriculum in disparities for our GME programs.

Methods: A steering committee was convened in September 2015 that included leaders from clinical areas in both the Bassett and the private practice community, as well as leaders from public health, administration, research, quality improvement, outreach, mental health, and medical education. The CEO of Bassett was a frequent participant in the steering committee. The committee met every 6 weeks to monitor progress and to give input to work groups focused on institutional strategy and curriculum development.

Results: An institutional strategy was developed that calls for the following: tie the elimination of healthcare disparities to Bassett’s mission/vision/values; use IT and research to better understand the demographics of our region; create dashboards for our disparate populations for preventive care, cancer, and heart care; provide cultural competency training across the institution; achieve a high Health Equity Index; target interventions understanding cost and impact; continue and enhance collaboration with the community; and engage leadership at the board level. An internal medicine disparities curriculum was created that includes experiential blocks at the Gender Wellness Center and the independent, grant-funded free clinic. Didactic curriculum supports the experiential learning. In partnership with the Delivery System Reform Incentive Payment program (a New York state program designed to reduce healthcare disparities among Medicaid enrollees) and Leatherstocking Collaborative Health Partners, a curriculum in cultural competency was developed with the intention of rolling it out to the entire organization and its partners.

Conclusion: The partnership of internal and external stakeholders at Bassett and its surrounding communities has successfully developed a draft of an institutional strategy for addressing healthcare disparities in our region. A residency program has been initiated in the internal medicine residency. A curriculum in cultural competency has begun for the entire organization and its partners. Multiple research opportunities have been created because of the development of these curricula.