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Equity Landscape in Healthcare Quality: A Mixed-Methods Study of Efforts Within Surgical Quality Programs.

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Healthcare equity efforts exist but lack essential infrastructure. Hospitals need better resources, organization, and processes to effectively address health inequities and improve population health outcomes.

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Area of Science:

  • Healthcare Management
  • Health Equity Research
  • Quality Improvement

Background:

  • Addressing healthcare inequities is crucial for improving population health.
  • Foundational resources, organization, and processes are necessary for health equity initiatives.
  • The current support landscape for health equity efforts in hospitals is largely unknown.

Purpose of the Study:

  • To evaluate the presence of frontline resources, organization, and processes supporting health equity efforts.
  • To assess hospitals participating in American College of Surgeons' (ACS) quality programs.

Main Methods:

  • A mixed-methods design combining online surveys and semi-structured interviews.
  • Descriptive analytics for survey data and inductive coding for interview transcripts.
  • Triangulation of data from surveys and interviews for comprehensive findings.

Main Results:

  • 36% of invited programs completed the survey; 5 program leaders were interviewed.
  • All leaders reported institutional strategies and processes for reporting discrimination.
  • Surveys revealed deficiencies in workforce capacity, engagement, and organization impacting equity efforts.

Conclusions:

  • Existing health equity efforts lack the necessary infrastructure for effective frontline practice.
  • Barriers include superficial institutional implementation, lack of prioritization, and insufficient data.
  • Opportunities involve enhancing leadership buy-in, increasing resources, and developing clear strategies.