1. How to Submit Application

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100% of survey complete.

Please answer the following questions to describe your organization's efforts related to equity of care; and limit your response to each question to 300 words. You can also submit supplemental materials with your application, such as dashboards, score cards, reports, etc. Any supplements that you may have should be emailed to equityofcare@aha.org. All applications MUST be submitted using this online application.

Hospital size recognized:
New in 2017, the committee recognizes that the work of health equity is being done by all hospitals, no matter how big or small, urban or rural. Consequently, award submissions will be categorized by number of beds, so please make sure to answer the first question in the application related to hospital size.  

Factors to consider when completing your application:
As you complete your application, it is important to highlight the following:
1) The quantifiable impact your health equity work has made in the communities served
2) The types of partnerships formed within the community during the implementation of this work (for example, community based organizations, the public health department, etc.)
3) Whether the work in health equity has been incorporated into your organization’s business imperative
Special Note: In addition to areas of your health equity work, the committee will consider the three points above when identifying the leading candidates.

Submission Deadline
Please submit the online application and optional supplements by 11:45 p.m. CT on Wednesday, March 15, 2017.

Thank you,
2017 Equity of Care Awards Committee
American Hospital Association,
Institute for Diversity in Health Management

* 1. Please provide the name and location of your organization.

* 2. The size of each applicant’s organization will be determined by number of beds. Please select the bed size of your organization.

* 3. Describe your organization’s results on collecting and using race, ethnicity and language preference (REaL) data and other socio-demographic characteristics. How has REaL data been used to address health care disparities, especially as it relates to understanding the problem, improving outcomes, assessing success and planning strategies? (10 points)

* 4. Describe your organization’s results (goals, evolution, barriers and successes) related to building leadership diversity. (Worth 10 points)

* 5. Describe your organization’s results (goals, evolution, barriers and successes) to become culturally competent. Please include all scorecards, dashboards and results as evidence of your effort. (Worth 10 points)

* 6. Describe your organization’s results (goals, evolution, barriers and successes) related to building board diversity. (Worth 10 points)

* 7. Describe how your organization engages with the local community on equity of care including community representation and innovative engagement approaches. (Worth 10 points)

* 8. Please describe actions you have taken and progress you have made in the last 12 months toward achieving the three priority goals of the #123forEquity pledge campaign. (Worth 10 points)

* 9. Please describe actions you have taken and progress you have made in the last 12 months toward achieving progress in health equity outside of the three goals outlined in the #123forEquity pledge campaign. (Worth 10 points)

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