Six Steps to Improving Health Equity Using Quality Improvement and Patient Safety Tools

Health equity is a foundational principle for providing high-quality care. The COVID-19 pandemic has increased the urgency of health systems and regulatory agencies to address longstanding health disparities. Imaging disparities have been documented in the imaging literature for decades, but there is paucity of published interventions to successfully reduce disparities in imaging. Quality and safety approaches can be successfully employed to catalyze and rigorously evaluate interventions to reduce imaging disparities. Emerging from the Toyota Production System, the lean management framework focuses on continuous quality improvement to improve efficiency and reduce waste. Lean approaches have been successfully adopted by quality and safety experts in health care for problem-solving and process improvement. This article provides readers with step-by-step guidance on how to address health equity issues by adapting selected lean tools for quality improvement and patient safety. Core steps include (a) problem identification, (b) team building, (c) creation of a data infrastructure, (d) problem analysis, (e) development and testing of solutions, and (f) change management strategies to help organizations sustain successful health equity initiatives. Readers can use these six core steps to catalyze data-driven quality improvement initiatives to reduce imaging disparities within their health systems.