Measuring Health Equity:

Collecting Patient Demographic Information

Training Session at [Insert Hospital Name Here]

[Insert Date Here]
 Agenda
• Introduction & Ground Rules
• Health Equity Statistics Exercise
• Demographic Data Collection:
– What we know
– How to ask and answer questions
– Data collection at [Insert hospital name here]
• Videos and Practice Session
• Your questions
• Next Steps & Evaluation

Your chance to participate!

 Learning Outcomes

At the end of today’s session you’ll be able to:

• Define health equity
• Tell patients why hospitals need to collect demographic data
• Explain the 8 questions
• Administer the questionnaire in a sensitive, respectful way
 Principles of group work
• Listen carefully while others are speaking
• Speak from one’s own experience- e.g. “I think” rather than “everyone knows”
• No personal attacks- challenge the perspective, not the individual
• Try not to blame- look for solutions that group members can act on
• Discuss issues that are raised in the training in the training
• Ask for clarification from group members or the facilitators, when needed
• Put devices on silent function. Use respectful etiquette
 Statistics Activity

Learning about health inequities…

• Please walk around the room, read the statistics on the wall, and then
stand beside the group of statistics that most affects, surprises or
interests you…
• We will then spend a few minutes sharing…
 Background:
“Measuring Health Equity in the TC LHIN”

• As part of its Health Equity focus, the Toronto Central LHIN

mandated that all TC LHIN should start collecting patient
demographic information
• Hospital Service Accountability Agreement 2013-4:
5. Continue to actively support TC LHIN health equity initiatives
with the expectation that HSPs participate in the
implementation of related initiatives, including collection of
socio-demographic data.
 What is health equity?

• Equity in health care refers to ensuring quality care and

best outcomes regardless of race, religion, language,
income or any other individual characteristic.

Safe
• Quality care
Effective
Patient-centered
Timely
Efficient
Equitable
 Commitment to Health Equity
• Best practices in health equity:
– Collect patient-level demographic data
– Use patient data to address patient needs
– Identify and report inequities in care
– Implement solutions to reduce inequities
 Asking patients for information…
• Be mindful of barriers around language and literacy
• Some patients are likely to have experienced discrimination and
harassment and may be reluctant to answer questions
• State that answering the questions is entirely voluntary and that
they can say ‘prefer not to answer’ or ‘do not know’ for all items
• Explain all patients are being asked these questions, and that like all
health care information, answers will remain confidential
• All this is research and evidence-based. Share that!
What do we know about demographic data
collection in Toronto
 About patients:
 Patients are willing to share this information
 Two most frequent questions are: “Why are collecting this
information?” And “Who can see this information?”
 About staff:
 Staff comfort increases with practice
 Increased familiarity with questions decreases time needed to
collect demographic information
 Best practice: Face-to-face interaction in data collection
 Quick Guide to Collecting
Demographic Data

• Introduce yourself
• Explain the purpose of the demographic data collection*
• Explain what will happen to the data:
– Who is this visible to?
– This information may also be used by researchers, only it will be grouped
with information from other patients with no name or personal identifiers.
(i.e. it can’t be traced back to a single individual)

Our hospital has started

collecting patient information
to help us for services and
provide quality care * Use available resources (brochure, poster, …)
 Quick Guide to Collecting
Demographic Data
Suggested message to patient:

These questions This will take a few

will tell us who minutes It’s completely
our patients are voluntary, so you can
choose ‘prefer not to
answer’ to any of
questions.
Data Collection: Purpose in 3 steps
It’s all about ‘quality care’

“Find out who our patients are”

“Plan and deliver tailored care”

“Ensure best outcomes for all”

 8 TC LHIN Items:
What they mean, why they’re important
LANGUAGE

Uses in care  To provide appropriate care delivery as required by

the Charter of Rights and Freedoms
 To acquire informed consent
Uses in planning  To improve access to care for those who do not
speak/ready English or French
Impact on quality  Use of interpreters and translators has direct impact
on quality and safety
 BORN IN CANADA

Uses in care  To address barriers and stress associated with migration and
settlement
Uses in planning  To understand the types of supports or services needed
Impact on quality  Improve access to care for newcomers to Canada
 RACIAL/ETHNIC GROUP

Uses in care  To provide targeted care and supports (e.g. Middle Eastern
populations & thalassemia, …)
Uses in planning  To improve outreach to vulnerable groups who do not seek
care at the same level as other groups
 To address access challenges
Impact on quality  Outreach improves preventative care and reduces admissions
 DISABILITY

Uses in care  To fulfill hospital responsibilities around providing accommodation

 Address histories of traumatic interactions
Uses in planning  To carry out accommodation planning
 To work on preventing recurrence of exclusion
Impact on quality  Better accommodation leads to more efficient and effective care
 GENDER

Uses in care  Both sex and gender are relevant to room assignment and
other essential medical testing
 To accommodate the unique needs related to patients’ gender identity
Uses in planning  To improve outreach to vulnerable groups who do not access
care at the same level as other groups
Impact on quality  Outreach better planning improves preventative care and
health outcomes
 SEXUAL ORIENTATION

Uses in care  To understand the needs of patients (e.g. living with

discrimination)
Uses in planning  To create welcoming environments for LGB community
members
 To identify LGB friendly community partners
Impact on quality  Providing a welcoming environment improves access and
patient experiences
 INCOME

person(s)

Uses in care  Relevant for discharge planning

 Relevant for medical prescriptions
Uses in planning  To ameliorate the impact of income on access to primary and
preventative health-care
Impact on quality  Improved health-care for all
 Training Manual & Support
• Glossary (p. 30)
• Responding to Patients’ Questions (p. 25)
• Quick Answers to Frequently Asked Questions (p. 28)
 Best Practices in
Demographic Data Collection
 Question-based video clips
• What did you see
• Disability happening?

• Gender Identity • How do you evaluate the

admitting clerk’s interaction
• Race & Religion with the patient?
• Income • What did the interviewer
specifically say or do that
encouraged the patient to
answer the questions?
 Practice session
• Form groups of 3: Patient, Staff, Observer
• Review practice exercise

Questions:
• How well does the staff person explain the questions?
• What was done well?
• Can anything be improved?
• What advice do you have for the staff member?
 Wrap-up

Your input, Evaluation, Questions?