Effectiveness of the uChicago Health Inequity Classification System on surgical morbidity and mortality conference: A pilot study.

Education Explicit bias Health disparities Implicit bias Surgical complications

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
06 Jul 2024
Historique:
received: 31 03 2024
revised: 16 06 2024
accepted: 06 07 2024
medline: 12 7 2024
pubmed: 12 7 2024
entrez: 11 7 2024
Statut: aheadofprint

Résumé

Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors. We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys. Access and bias were related to surgical complications in 14 ​% of cases. 97 ​% reported enhanced M&M presentations with the grading system, and 47 ​% reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues. Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.

Sections du résumé

BACKGROUND BACKGROUND
Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors.
METHODS METHODS
We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys.
RESULTS RESULTS
Access and bias were related to surgical complications in 14 ​% of cases. 97 ​% reported enhanced M&M presentations with the grading system, and 47 ​% reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues.
CONCLUSIONS CONCLUSIONS
Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.

Identifiants

pubmed: 38991911
pii: S0002-9610(24)00386-6
doi: 10.1016/j.amjsurg.2024.115834
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

115834

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest I declare that the manuscript is original, has not been published before, and is not currently being considered for publication elsewhere and will not be sent to another journal until a decision is made concerning publication by The American Journal of Surgery. The authors have no relevant financial disclosures or conflict of interests. All authors have seen and approved the final version of this manuscript as well as fulfill the COPE (Committee on Publication Ethics) requirements for authorship.

Auteurs

Janani Vigneswaran (J)

Department of Surgery, University of Chicago Medicine, 5841 S. Maryland Ave, Chicago, IL, USA. Electronic address: https://twitter.com/JenVigneswaran.

Simi Ogunnowo (S)

University of Chicago Pritzker School of Medicine, 924 E. 57th St, Chicago, IL, USA.

J Michael Millis (JM)

Department of Surgery, University of Chicago Medicine, 5841 S. Maryland Ave, Chicago, IL, USA.

Kevin K Roggin (KK)

Department of Surgery, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC, USA.

Mitchell C Posner (MC)

Department of Surgery, University of Chicago Medicine, 5841 S. Maryland Ave, Chicago, IL, USA.

Jeffrey B Matthews (JB)

Department of Surgery, University of Chicago Medicine, 5841 S. Maryland Ave, Chicago, IL, USA. Electronic address: https://twitter.com/JBMatthews.

Chelsea Dorsey (C)

Department of Surgery, University of Chicago Medicine, 5841 S. Maryland Ave, Chicago, IL, USA; University of Chicago Pritzker School of Medicine, 924 E. 57th St, Chicago, IL, USA. Electronic address: dei@bsd.uchicago.edu.

Classifications MeSH