A Systems-Based Framework for Integrating Health Equity and Patient Safety

Area of Science:

• Health Services Research
• Patient Safety
• Health Equity

Background:

• Patient safety equity measurement is underdeveloped, despite documented disparities in healthcare access and quality.
• Minority patients, including Black patients, experience higher rates of preventable harm, such as hospital-acquired infections and medication errors.
• Existing health disparity tools are insufficient for evaluating patient safety events and processes.

Purpose of the Study:

• To identify health system-level measures for patient safety equity.
• To develop a preliminary maturity framework for health systems to assess and integrate patient safety equity.
• To address the critical gap in measuring and addressing safety disparities.

Main Methods:

• Literature review conducted from January 2023 to December 2023.
• Expert panel engagement with eight subject matter experts.
• Development of a preliminary maturity framework based on literature and expert feedback.

Main Results:

• Several tools exist for broader health equity measurement, but few specifically target patient safety.
• A preliminary maturity framework with three levels (fundamental, intermediate, advanced) and six domains was developed.
• The framework domains include data collection, validation, analysis, communication, addressing equity gaps, and organizational culture.

Conclusions:

• A structured approach is needed to systematically measure and improve patient safety equity.
• The proposed framework provides a stepwise guide for health systems to advance their patient safety equity initiatives.
• Further development and validation of the framework are necessary to support health systems in reducing preventable harm for all patient populations.