A Quality Framework to Address Racial and Ethnic Disparities in Emergency Department Care

Hazar Khidir, National Clinician Scholars Program, Yale University School of Medicine, New Haven, CT; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Rama Salhi, National Clinician Scholars Program, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
Amber K. Sabbatini, Department of Emergency Medicine, University of Washington School of Medicine, Seattle, WA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA.
Nicole M. Franks, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
Andrea Green, University Medical Center Northeast, El Paso, TX.
Lynne D. Richardson, Institute for Health Equity Research, Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Emergency Medicine and Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY.
Aisha Terry, Department of Emergency Medicine, George Washington University School of Medicine, Washington, DC; Department of Health Policy, Milken Institute of Public Health, George Washington University, Washington, DC.
Nicholas Vasquez, Envision Healthcare and Vitalyst Health Foundation, Phoenix, AZ.
Pawan Goyal, American College of Emergency Physicians, Irving, TX.
Keith Kocher, Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
Arjun K. Venkatesh, National Clinician Scholars Program, Yale University School of Medicine, New Haven, CT; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT; Yale New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, CT.
Michelle P. Lin, Department of Emergency Medicine at Stanford University School of Medicine, Palo Alto, CA. Electronic address: mplin@stanford.edu.

Document Type

Journal Article

Publication Date

10-15-2022

Journal

Annals of emergency medicine

DOI

10.1016/j.annemergmed.2022.08.010

Abstract

The emergency department serves as a vital source of health care for residents in the United States, including as a safety net. However, patients from minoritized racial and ethnic groups have historically experienced disproportionate barriers to accessing health care services and lower quality of services than White patients. Quality measures and their application to quality improvement initiatives represent a critical opportunity to incentivize health care systems to advance health equity and reduce health disparities. Currently, there are no nationally recognized quality measures that track the quality of emergency care delivery by race and ethnicity and no published frameworks to guide the development and prioritization of quality measures to reduce health disparities in emergency care. To address these gaps, the American College of Emergency Physicians (ACEP) convened a working group of experts in quality measurement, health disparities, and health equity to develop guidance on establishing quality measures to address racial and ethnic disparities in the provision of emergency care. Based on iterative discussion over 3 working group meetings, we present a summary of existing emergency medicine quality measures that should be adapted to track racial and ethnic disparities, as well as a framework for developing new measures that focus on disparities in access to emergency care, care delivery, and transitions of care.

Department

Emergency Medicine

Link to Full Text

Share

COinS