Key Takeaways
- Race, ethnicity, and language (REAL) data support critical functions in health care, such as understanding population health, ensuring equitable access to care, and enhancing clinical quality of care.
- The case studies presented in this publication describe how seven California acute care hospitals and health systems use REAL data to improve quality of care for Californians.
- The profiled health care organizations are characterized as having “advanced, system-wide approaches to equity”; “building and strengthening equity” in their approaches; or being “experienced with California’s Quality Incentive Pool.”
All Californians deserve to have what they need to be and stay healthy. CHCF’s vision is a health care system sophisticated enough to respond to each person’s unique needs rather than providing identical care to everyone. The collection, analysis, and use of race, ethnicity, and language (REAL) data is essential for achieving this vision.
Pursuing Excellent Care: Seven California Case Studies on Using REAL Data for Quality Improvement provides an in-depth look at how health care organizations across the state are using REAL data to understand the needs of their patients, target medical resources more effectively, and ultimately improve quality of care. Case studies include:
- A safety-net hospital system that maintains a 100% REAL data reporting goal for all departments and has built REAL data reports into daily huddles and Plan, Do, Study, Act cycles.
- A county-owned acute care hospital that identified meaningful maternal health disparities and made targeted improvements in care after analyzing data by mother’s race, ethnicity, and place of birth.
- An academic medical center whose participation in California’s Quality Incentive Pool helped it make the case for creating a new pathway for Black patients on Medi-Cal to use previously inaccessible imaging centers to screen for breast cancer.
This set of case studies serves as a critical resource for health care leaders and policymakers who are committed to identifying and addressing health disparities across California’s diverse communities. When we make our health care system smarter and more responsive to patient needs, we all have a clearer path to health and prosperity.

Pursuing Excellent Care: Seven California Case Studies on Using REAL Data for Quality Improvement
Authors & Contributors
Marsha Regenstein, PhD
Professor, George Washington University
Linda Cummings, PhD
Health Services Research Consultant





