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

Am J Surg. 2024 Oct:236:115834. doi: 10.1016/j.amjsurg.2024.115834. Epub 2024 Jul 6.

Abstract

Background: Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors.

Methods: 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.

Results: 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.

Conclusions: Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.

Keywords: Education; Explicit bias; Health disparities; Implicit bias; Surgical complications.

MeSH terms

  • Adult
  • Female
  • Health Services Accessibility
  • Healthcare Disparities* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Postoperative Complications* / classification
  • Postoperative Complications* / epidemiology
  • Surgical Procedures, Operative