Equity in Healthcare Delivery
Disparities in healthcare can be understood within the broader context of historical inequities and how they collectively influence institutions, policies and access. To effectively address healthcare disparities at the systemic level, we need improved data to disentangle the circumstances that contribute to inequalities. And we need new initiatives so that medical professionals understand systemic-level challenges, and empower providers to mitigate the effects one patient at a time.
To effectively address healthcare disparities at the systemic level, we need improved data to disentangle the circumstances that contribute to inequalities.
Projects
Bias Recognition and Mitigation: An educational program for clinicians*
For this program, we developed and tested a communications skill-building initiative informed by community engagement. The goal was to mitigate the impact of implicit bias and improve providers’ communication skills with patients from marginalized populations.
Our approach focused on three things: (1) improving clinicians’ understanding of systemic racism and its impacts on patients and on healthcare delivery; (2) creating awareness of their own biases, and (3) fostering communications skills that mitigate both bias and institutional disparities. This program was supported by NIH MD R01MD011532 “CONSULT-BP (COmmuNity-engaged SimULation Training for Blood Pressure Control).”
**** New Project *** Equitable Caregiver Engagement in Serious Illness Care
We know that family caregiver engagement is a key marker for better outcomes for patients with serious illness. Engaged caregivers are the extra eyes, ears, question-askers and advocates for patients. They take care of their family members in all those times when there are no trained clinicians present -- at home, in the hospital room, and in between. It’s critical that caregivers are connected to and engaged with the trained medical team.
We are conducting a mixed-methods study to identify, quantify, stratify and disentangle the multiple barriers to family caregiver engagement for patients with serious illness. Our study will examine how COMMUNITY-level resources intersect with HOSPITAL-level practices to affect caregiver engagement when someone with serious illness is hospitalized.
Our research is asking:
- How are INDIVIDUAL OUTCOMES in serious illness affected by SOCIETY-level factors -- like access to healthcare, neighborhood resources, housing and education?
- How much are these contextual factors DIFFERENTIAL by race and ethnicity?
- How does all of this interact with on-the-ground PRACTICES in hospitals and health care systems?