Effectiveness of the uChicago Health Inequity Classification System on surgical morbidity and mortality conference: A pilot study

Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors. We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classificati...

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Bibliographic Details
Published in:The American journal of surgery 2024-10, Vol.236, p.115834, Article 115834
Main Authors: Vigneswaran, Janani, Ogunnowo, Simi, Millis, J. Michael, Roggin, Kevin K., Posner, Mitchell C., Matthews, Jeffrey B., Dorsey, Chelsea
Format: Article
Language:English
Subjects:
Bias
Classification
Clinical outcomes
Decision making
Education
Explicit bias
Health care access
Health care policy
Health disparities
Implicit bias
Minority & ethnic groups
Morbidity
Mortality
Patients
Response rates
Self report
Stereotypes
Surgeons
Surgical complications
Surgical outcomes
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Summary:Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors. We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys. Access and bias were related to surgical complications in 14 ​% of cases. 97 ​% reported enhanced M&M presentations with the grading system, and 47 ​% reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues. Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities. •Marginalized individuals experience worse postoperative outcomes.•Innovation is needed to augment conversations around health disparities in surgery.•Patient care may improve when discussions around access to care and bias are augmented.
ISSN:0002-9610
1879-1883
1879-1883
DOI:10.1016/j.amjsurg.2024.115834