Related Experiment Video
Updated: Jul 9, 2025

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
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Equity and Performance Improvement: A Novel Toolkit That Makes Using an Equity Lens the Default
Joint Commission Journal on Quality and Patient Safety
|December 7, 2023
Summary
A new quality improvement (QI) toolkit integrates diversity, equity, inclusion (DEI), and social determinants of health (SDOH) into healthcare projects. This approach significantly increased the incorporation of DEI and SDOH considerations in QI initiatives.
Area of Science:
- Healthcare Quality Improvement
- Health Equity Research
Background:
- Current performance improvement methodologies lack structures to analyze bias, inequity, and social determinants of health (SDOH) impacts on outcomes.
- Integrating diversity, equity, and inclusion (DEI) with SDOH is crucial for comprehensive healthcare improvement.
Purpose of the Study:
- To develop and evaluate a novel quality improvement (QI) toolkit that embeds DEI and SDOH considerations into existing QI frameworks.
- To assess the impact of the DEI and SDOH-integrated QI toolkit on project practices.
Main Methods:
- Developed a QI toolkit incorporating DEI and SDOH into standard QI tools (charter, fishbone diagram, PDSA worksheet).
- Conducted a pre-post analysis of QI projects by fellows before and after toolkit implementation.
- Quantified the integration of DEI/SDOH in QI projects using project data.
Main Results:
- Prior to the toolkit, only 22.9% of QI projects (2016-2021) included DEI/SDOH.
- After toolkit implementation in 2022, 88.9% of QI projects incorporated DEI/SDOH.
- Demonstrated a significant increase in the systematic consideration of DEI and SDOH in QI.
Conclusions:
- The novel QI toolkit effectively integrates DEI and SDOH into healthcare improvement projects.
- This toolkit provides a practical method to "hardwire" DEI and SDOH considerations into QI processes.
- The findings highlight the potential for widespread adoption to advance health equity through QI.
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