Toward Improving Patient Equity in a Pediatric Emergency Department: A Framework for Implementation.

Autor: Hartford EA; University of Washington, Department Pediatrics, Division of Emergency Medicine, Seattle, WA, USA. Electronic address: Emily.hartford@seattlechildrens.org., Thomas AA; University of Washington, Department Pediatrics, Division of Emergency Medicine, Seattle, WA, USA., Kerwin O; Seattle Children's Hospital Emergency Department, Seattle, WA, USA., Usoro E; Seattle Children's Hospital Emergency Department, Seattle, WA, USA., Yoshida H; University of Washington, Department Pediatrics, Division of Emergency Medicine, Seattle, WA, USA., Burns B; Seattle Children's Hospital Emergency Department, Seattle, WA, USA., Rutman LE; University of Washington, Department Pediatrics, Division of Emergency Medicine, Seattle, WA, USA., Migita R; University of Washington, Department Pediatrics, Division of Emergency Medicine, Seattle, WA, USA., Bradford M; Seattle Children's Research Institute, Seattle, WA, USA., Akhter S; University of Washington, Department Pediatrics, Division of Emergency Medicine, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: Annals of emergency medicine [Ann Emerg Med] 2023 Apr; Vol. 81 (4), pp. 385-392. Date of Electronic Publication: 2023 Jan 18.
DOI: 10.1016/j.annemergmed.2022.11.015
Abstrakt: Disparities in health care delivery and health outcomes for patients in the emergency department (ED) by race, ethnicity, and language for care (REaL) are common and well documented. Addressing inequities from structural racism, implicit bias, and language barriers can be challenging, and there is a lack of data on effective interventions. We describe the implementation of a multifaceted equity improvement strategy in a pediatric ED using Kotter's model for change as a framework to identify the key drivers. The main elements included a data dashboard with quality metrics stratified by patient self-reported REaL to visualize disparities, a staff workshop on implicit bias and microaggressions, and several clinical and operational tools that highlight equity. Our next steps include refining and repeating interventions and tracking important patient outcomes, including timely pain treatment, triage assessment, diagnostic evaluations, and interpreter use, with the overall goal of improving patient equity by REaL over time. This article presents a roadmap for a disparity reduction intervention, which can be part of a multifaceted approach to address health equity in EDs.
(Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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