Development of a Multi-Hospital Collaborative Focused on Child Health Equity

Introduction

Compared with adults, differences in clinical treatment or patient/family experiences related to characteristics such as race, ethnicity, gender, gender identity, sexual orientation, ability status, language, weight status, and income gradient are rarely studied and addressed in the care of children. The objective of this study was to develop a quality collaborative among the three largest children's hospitals in Michigan to rigorously assess potential care inequities and test strategies for improvement.

Methods

All hospital Chief Executives agreed to participate in the collaborative. The coordinating center provides partner hospitals with expertise on research design and methods for assessing inequities. At each hospital, staff work with the coordinating center to retrieve and analyze data. Performance data are shared among the hospitals and strategies for improvement are developed. Each hospital will implement quality improvement strategies targeted to their specific context, including collecting and evaluating data. The partner hospitals will share results to facilitate joint learning, adjust strategies and improve equity in care delivery across the collaborative.

Results

With the assistance of the coordinating center, each hospital conducted >10 focus groups with nurses, physicians, child life specialists, social workers, and others to suggest potential inequities to assess. Jointly, the hospitals assessed the overlap of hypothesized inequities among the institutions and prioritized areas for action which included exploring differences in emergency department wait times and use of restraints.

Conclusions/Implications

Work from this innovative collaborative will help improve patient and family experiences, lead to more equitable pediatric care, foster greater patient trust, and improve employee morale.