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Communicable diseases
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1.
DPH-funded, community partnerships for pop-up screening clinics in the community designed to provide rapid testing and counseling regarding treatment initiation for HIV, hepatitis C, and STIs.
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2.
DPH-funded, community partnerships for pop-up vaccination clinics in the community designed to provide testing, vaccination, and transmission-mitigation education in the community.
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3.
Self-guided education and peer education about the increased risk for severe COVID-19 and other respiratory and diarrheal morbidity and mortality among ethnic and racially diverse populations.
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4.
Empower patients with a thorough understanding of communicable diseases, including natural course of illness, methods of transmission, transmission prevention, and reasons for returning; discharge counseling techniques may include discharge nursing teach-back or read-back of instructions.
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5.
DPH-medical-community partnerships designed to focus efforts in areas of high transmission risk when planning resource distribution of testing, treatment, and vaccination supplies related to COVID-19 and other pandemic-related illnesses.
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Non-communicable conditions
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1.
Educate EPs about long-standing racial and ethnic gaps in ED-based care and health outcomes; and promote opportunities for implicit bias training.
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2.
Develop equity metrics, monitor clinical performance data on quality measures, identify inequities in clinical and research, and implement process and policy changes to close disparity gaps.
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3.
Support health equity initiatives at the individual, departmental, and organizational levels that aim to educate patients about certain medical conditions (eg, hypertension, diabetes), early warning signs of serious complications (eg, acute coronary syndrome, renal failure), and available treatment options; educational strategies may involve smart documents and waiting room video educational modules.
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4.
Support and partner with existing patient care navigator and community health worker programs to engage patients beyond the index ED visit and ensure medication and treatment plan adherence, outpatient follow-up scheduling, and regular assessments of any barriers to disease control.
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5.
Partner with local community organizations designed to promote healthy lifestyle (eg, smoking cessation, nutritional food planning, local farm food collaborative, reduced-fee gym memberships, etc).
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Injuries
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1.
Consider the potential environmental determinants of lung inflammation and injury in BIPOC patients with difficult-to-control asthma symptoms; educate patients about PM and its relationship to asthma and counsel them on preventative measures and importance of maintenance medication adherence.
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2.
Support and advocate for state and federal legislation and policy aimed at prevention of toxic waste dumping, containment efforts, periodic testing of soil and water supplies, increased testing for environmental exposures among communities living in high-risk exposure areas, and investment in industrial waste decontamination, safer housing, and quality medical care for affected communities.
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3.
Self-guided education and peer education about the signs and symptoms of toxicity due to common hazardous waste contaminants, and the available treatments.
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4.
Provide opioid analgesia for acute severe pain in the ED based on likely diagnosis, objective measures of pain, and optimal pain reduction (at least a 2-level reduction in pain score for initial treatment).
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5.
Support epidemiologic and narrative research of firearm violence, both nonfatal injuries and deaths, to better understand risk and protective factors as the basis for intervention.
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6.
Use the results of epidemiologic and narrative research to partner with communities to develop and implement effective interventions especially targeted at high-risk youth and young adults of color.
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7.
Partner with existing programs and personnel that have operated trauma center resources for community and firearm violence to extend their inpatient work to reach a greater proportion of those in need by developing and implementing ED protocols to identify, counsel, and refer at-risk populations.
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8.
Educate EPs on the effective counseling of populations at disproportionate risk for community and firearm violence and incorporate smart discharge phrases into the electronic health record system.
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9.
Develop strong collaborations with community groups and social services to whom the ED could transition primary and secondary prevention; incorporate these referrals into discharge materials.
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10.
Encourage state and federal legislation and policy aimed at decreasing firearm homicides and nonfatal injuries (eg, decrease access to illegal firearms, increase federal funding for research on firearm violence, decrease the production of violent video games and media and replace them with games in which the protagonist must save lives rather than kill to win).
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