An evidence-based healthcare disparities colloquium: A model for practice improvement

“Health disparities” refers to population-specific differences in the presence of disease, health outcomes, quality of healthcare, and access to healthcare services that exist across racial, ethnic and socio-economic groups. Disparities can represent a lack of efficiency within a health care system that results in unnecessary costs and/or reduced health outcomes for an at-risk population. Lankenau Medical Center postulated that studies performed in our own hospital and culminating in a candid public presentation of results would sensitize staff and administration to disparities problems and potentially result in institution-wide improvements.

This study explored an intersection of two hypotheses: (1) Occult disparities in care can be uncovered by evidence-based studies within the local environment; (2) When such disparities are uncovered, top management will sponsor multidisciplinary solutions.

Four projects were designed by separate multidisciplinary teams of residents, nurses and faculty. The studies designed pertained to (1) access to screening mammography; (2) access to screening colonoscopy; (3) length of time from diagnosis to treatment for patients with cancer diagnoses; and (4) automated implantable cardiac defibrillator referrals for high risk cardiology patients. Each study sought to determine if disparities in patient care existed based on race, ethnicity, and/or socioeconomic status between patients treated in the Lankenau Clinical Care Center (LCCC, serving the underinsured population) compared to a similar cohort of patients treated in local private practices.

All studies identified a relatively small scope of disparity between patients treated in the LCCC compared to patients in private practices. The disparities identified in each of the four studies were based on insurance coverage, age, and gender, not race or ethnicity. The findings were presented to the hospital staff at a “Healthcare Disparities Colloquium” in May 2012 in the presence of the hospital President and system CEO. The ultimate results of this project were: (1) heightened staff awareness and interest in disparities issues and (2) leadership's commitment to expanded scope of “study and report” including all hospitals in the health system for the 2nd Annual Healthcare Disparities Colloquium in June 2013.

An Evidence-Based Healthcare Disparities Colloquium is a format which will engage hospital staff, heighten awareness, and lead to improvements in care. We consider this a powerful model for practice improvement.