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Effectiveness of the uChicago Health Inequity Classification System on surgical morbidity and mortality conference: A
Janani Vigneswaran1, Simi Ogunnowo2, J Michael Millis3
1Department of Surgery, University of Chicago Medicine, 5841 S. Maryland Ave, Chicago, IL, USA. Electronic address: https://twitter.com/JenVigneswaran.
Background:
Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors.
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:
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:
Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.
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