A new research report conducted by the Urban Institute and funded by the Robert Wood Johnson Foundation has found that Black adult patients experience significantly higher rates of hospital acquired infections and injuries than white adult patients of the same age group, gender, with similar insurance coverage — within the same hospital.
The report is an important addition to existing research outlining the disturbing effects of structural racism in America. Health care associated infections (HAIs) and injuries are among the top causes of unnecessary illness and death in the United States. These are harms that patients incur while in the hospital or other facility. Reducing HAIs is a priority for the New Jersey Department of Health and health systems through the state.
Through the Quality Institute’s work with patient safety organizations, including The Leapfrog Group and the National Quality Forum, patient safety and quality is core to our mission. We, and you, our members and partners, cannot accept patient safety infection and injury rates within the same facility that are higher for Black patients than white patients. I urge you to read and share this important research report.
The research found that Black patients experienced significantly worse patient safety in six out of 11 patient safety indicators, including four out of seven indicators related to surgery, such as hemorrhage, pressure ulcers, pulmonary blood clots, and serious blood infections. The report examines 2017 hospital discharge data from 26 states, including New Jersey.
The data are from three years after the implementation of the Affordable Care Act. The Act was a milestone for coverage and access. This report, however, highlights the uncomfortable truth that having an insurance card does not guarantee equitable care and treatment.
For example, data can show where facilities or practices are outliers in following clinical protocols and then provide training to address the problems. Facilities can also identify where they need to hire a more diverse workforce to better serve their patients. Implicit bias and shared decision-making trainings can be targeted to certain facilities or departments where the data point to issues of concern.
Finally, the data could be used to support payment reform and create purchaser pressure to ensure the focus on eliminating racial disparities is continuous and prioritized. Suggestions such as these are outlined within the report. The state has already started to create and require various implicit bias training programs, an important step. But with data like these, facilities, purchasers, and regulators can dig deeper into troubling disparities and identify solutions that can be shared within and across health care systems and practices.
We all must make equity a priority. We all have biases – especially during stressful moments when we revert to instinct. Malice is rarely the issue. That’s why data are so important. The data will tell the story and provide the roadmap. I encourage you to read and share the report with colleagues and I look forward to working with you toward eradicating these racial disparities.