P3C177: Multidisciplinary Health Equity Rounds: A Springboard on the Journey to Best Outcomes for All Children

Background: Evidence shows that bias and systemic inequities impact patient-provider communication, access to care, patient trust in the healthcare system, treatment adherence, clinical decision making, and patient outcomes. Numerous studies show biases exacerbate health disparities in pediatrics. The American Academy of Pediatrics states to achieve child health equity we must both foster a culture of diversity and inclusion and address bias and discrimination. Nationwide Children’s Hospital (NCH) has made statistically significant improvements in diversifying our workforce. To promote equity, we must next address the systems allowing for bias to impact disparate outcomes in otherwise similar patient presentations.

Methods: A longitudinal Health Equity Rounds (HER) lecture series was created at NCH within a larger Diversity, Equity, and Inclusion curriculum for pediatric residents. Objectives were adapted from similar curricula. Real cases were presented in parallel to highlight the duality within the system. Sessions were hybrid in format and resident led. To create a safe learning space and allow for anonymous audience engagement, QR code questions were utilized and focused on perspective-taking. An interprofessional panel provided multiple viewpoints. Takeaway points included process changes at the individual and system level to promote equitable healthcare delivery. Feasibility and acceptability were assessed after presentations through an anonymous 5-point Likert scale survey.

Results: Approximately 150 people attended the lecture with 70 (47%) completing the survey. Participants were mostly resident and faculty physicians (46% and 34%, respectively). Following the session, 99% of participants could identify effects of structural and implicit bias in clinical scenarios, 91% could use newly learned strategies to improve equitable care delivery, and 84% said the session would impact their practice (Figure 1).

After participating in sessions, pediatric trainees have requested more HER be offered with resident volunteers for sessions over the upcoming 18 months. The planning team has received consultation queries from other departments, divisions, and disciplines on best practices to emulate HER.

Conclusion: This longitudinal HER lecture series has been integrated within the pediatrics residency program to educate and train future pediatricians on child health equity at a large, free-standing quaternary care institution. This lecture series provides a scaffolding for trainees and faculty alike to not only recognize the structural and systemic biases that create or reinforce disparities, but it also provides the time and space for reflection, anonymous participation, and multidisciplinary discussion to provide feedback to the system and reduce preventable harm. Furthermore, residents conduct HER and are empowered to teach not only their peers but faculty, administration, and the hospital community. This pilot series has been recognized by the Graduate Medical Education office who support trainees presenting these cases, and the group has received approval for professional development accreditation.