Maximizing Data Capture for Race and Ethnicity of Children Admitted to Critical Care Units
Patricia A Hickey1, Jean A Connor2, Cheryl Toole3
1Patricia A. Hickey is a senior vice president and associate chief nurse, cardiovascular, critical care, and perioperative services, Boston Children's Hospital, and an assistant professor of pediatrics, Harvard Medical School, Boston, Massachusetts.
Insights
Improving sociodemographic data collection in intensive care units (ICUs) is crucial for addressing health inequities. A new process increased race and ethnicity documentation rates to 100% for pediatric ICU patients.
Area of Science:
- Healthcare equity
- Health informatics
- Pediatric critical care
Background:
- Complete sociodemographic data in electronic health records (EHRs) is vital for identifying and addressing health inequities.
- Incomplete sociodemographic data (race, ethnicity) was identified in a significant number of pediatric intensive care unit (ICU) patients.
Purpose of the Study:
- To understand current sociodemographic data ascertainment processes for pediatric ICU patients.
- To demonstrate interprofessional team collaboration in developing solutions for vulnerable patient populations.
- To provide actionable steps for hospitals to reduce missing sociodemographic data and promote equitable care.
Main Methods:
- A Plan-Do-Study-Act (PDSA) framework guided the initiative over four cycles.
- The study focused on evaluating care vulnerabilities and implementing tests of change.
- The primary goal was to capture sociodemographic data within 72 hours of patient admission.
Main Results:
- A novel process was implemented for patient experience representatives to accurately collect, enter, and track sociodemographic data.
- Through targeted education and script utilization, documentation rates for race and ethnicity data improved significantly, reaching 80% to 100%.
Conclusions:
- Overcoming EHR barriers and establishing new workflows facilitated sociodemographic data collection for pediatric ICU admissions.
- The active engagement and recognition of interprofessional teams were key to the success of this initiative in laying the groundwork for equitable care.
Background:
Access to complete patient sociodemographic data in a hospital's electronic health record is important for identifying and understanding health inequities and designing interventions to close health care gaps. Through participation in a national safety collaborative, this team identified many patients in intensive care units (ICUs) for whom sociodemographic data (race and ethnicity) were incomplete or missing.
Objectives:
To describe the processes the team used to understand how sociodemographic data were being ascertained for children admitted to hospital ICUs; demonstrate how interprofessional care teams can collaborate to create solutions for vulnerable patients; and provide steps that can be used at other hospitals to decrease missing sociodemographic data and deliver equitable care.
Methods:
A plan-do-study-act framework guided this initiative to improve collection of data on the race and ethnicity of ICU patients. Via 4 plan-do-study-act cycles, care vulnerabilities and implemented tests of change were evaluated to achieve the goal of capturing sociodemographic data within 72 hours of patient admission.
Results:
A new process was developed for patient experience representatives to collect, enter, and track sociodemographic data accurately. Through education and use of a script, documentation rates reached 80% to 100%.
Conclusions:
Overcoming barriers in the electronic health record and creating new processes supported the collection of sociodemographic data for children admitted to ICUs. Engaging and acknowledging the value of interprofessional teams was important in this successful groundwork to help deliver equitable care.
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