Advocate Trinity Hospital

Presentation Notes

Quality Improvement poster presented at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.


Background/Introduction: Racial disparities exist in obstetric care. Black women in Illinois are three-times more likely to die from obstetric complications than white women. The cesarean section rates of black women are also higher. A 2016 study found that white medical students and residents often believed myths about racial differences in patients. NPR and ProPublica collected over 200 stories of Black women who shared feelings of being dismissed, devalued, and disrespected by providers.

Local problem: The Cesarean Section rates for Black women across our healthcare system are 4.8% higher than for white women. Black women make up 69% of the births at our hospital. Patient satisfaction rounds revealed stories of black women who have not felt respected and heard.

Method: Our measures to reduce disparities include reviewing health quality data by race, ethnicity, and Medicaid status. We have created a multidisciplinary birth equity team that includes a patient advocate. A patient handout was created to share respectful care practices. Patients are surveyed on their experiences. Standardized safety education is given. Education is ongoing for all OB team members on implicit bias, birth equity and cultural competency. Strategies to reduce the Nulliparous Term Singleton Vertex (NTSV) cesarean section rate have been ongoing.

Results/Conclusions: Our hospital has implemented 90% of the key strategies, setting expectations for safe, respectful maternity care. Implicit bias education has been completed by all team members. During rounding, patients report that team members listen carefully to them. Patient Satisfaction surveys (HCAHPS) reveal during February to April 2022 nurses and providers listened carefully to the patient 100% of the time. In 2021 our system had a 24.72% NTSV rate. Our hospital achieved a rate of 22.28%.

Implications for Practice: These efforts can reduce the racial disparities for obstetric patients. This work can be sustained by continuing to work together with a willingness to address racial inequities.

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