The Health Equity Network: Using Quality Improvement Methodology In A Learning Network To Improve Equity In The Care Of Trauma Patients
*Meera Kotagal, *Allison Bailey, *Erin Butt, Nora Buzek, Dawne Gardner, Robert Kahn, Dimitrios Makrozahopoulos, *Suzanne Moody, Carley Riley, *Kaaren Shebesta, Ndidi Unaka, *Richard A. Falcone, Jr., Andrew F. Beck
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
Purpose: Pediatric health inequities have been longstanding; however, system improvement efforts to eliminate equity gaps are limited. With that focus, our global aim was to “ensure every family has an equitable transition of care from hospital to home” after injury.
Methods: Through a learning health system focused on equity, we collaborated across clinical teams, with community partners, to use quality improvement methodology to address inequities for patients/families following pediatric injuries. Teams had monthly meetings and discussed common drivers of inequities and potential shared solutions. Teams also identified project-specific learnings and cross-cutting systems issues warranting collective action. The trauma team’s initial focus was on elevating the “voice of the customer” to guide improvement strategies through semi-structured interviews with families.
Results: To date, we have conducted 6 semi-structured interviews, identifying the following themes: feeling rushed/overwhelmed around discharge, challenges of multiple follow-up appointments, lack of clarity of how to care for child at home, and concerns around safe housing and transportation. We are using this feedback to create, and refine, interventions across the transition from hospital-to-home, evaluating effectiveness using family experience scores, unplanned follow-up visits, and patient acute stress scores (Figure 1).
Conclusions: Learning network and quality improvement methodology can effectively be used to focus on tangible steps to narrow equity gaps across a complex system. Targeting patient/family stress around transition to home may improve post-discharge care and reduce contributions to community stress.
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