Quality Improvement as a Tool for Health Equity: Perspectives From North Carolina

Share lessons learned from using quality improvement (QI) and data-informed decision making to advance health equity in North Carolina.

Thirteen safety net dental practices implemented community-informed QI initiatives from 2022 to 2024. They identified community needs, aligned goals and resources, made practice-level improvements, and used data to measure progress. Collective learnings were used to advocate for policy changes supporting health equity.

QI initiatives engaged 87,000 patients across 47 counties. Practice-level care delivery improvements included telehealth, minimally invasive care, addressing social drivers of health, and bolstering care coordination and referral processes. Understanding community needs, organizational support, funding, QI tools, and data-informed decision-making drove success. Barriers included data collection and staffing challenges, as well as workforce and reimbursement policies. The QI processes generated evidence for collective action around policy changes to improve care access and health equity in the state.

The QI process generated evidence that ultimately drove advocacy efforts aimed at improving health equity through systems change.