Strategies to reduce bias and improve the patient experience

Healthcare disparities remain a primary focus for healthcare organizations across the U.S. Evidence suggests that these disparities negatively impact patient safety and quality of care as racial and ethnic minority groups are less likely to receive routine care, placing them at a higher risk of morbidity and mortality than non-minorities.

Health-related social needs (HRSN) are frequent root causes of disparities in health outcomes. Social determinants of health prevent many racial and ethnic minority groups from having fair opportunities for economic, physical, and emotional health. Examples may include a healthcare provider making inaccurate assumptions or neglecting requests based solely on characteristics such as a patient’s race, ethnicity, or social class.

To address these disparities, healthcare professionals should understand how attitudes and behaviors can impede communication, trust, and patient engagements. Organizations need established leaders and standardized structures and processes in place to detect and address healthcare disparities effectively.

Impact of bias on quality outcomes

One in four Black and Latinx/Hispanic U.S. adults 60 and older report unfair healthcare treatment. Additionally, Black women face pregnancy-related maternal mortality rates over three times higher compared to white women.

Most healthcare professionals enter their respective disciplines seeking to promote the welfare and well-being of others. They possess a strong desire to care for patients in a manner consistent with this idealism. Through this lens, healthcare professionals must recognize and mitigate bias.

Every physician and nurse can impact a patient’s experience.The way in which healthcare workers communicate and listen directly impacts the care experience and ultimately, patient outcomes. Failing to understand individual preferences and patient populations can lead to missing components in the treatment plan.

In addition, lack of awareness regarding communication styles, such as intonation, as well as being impatient with questions, can undermine a culture of safety and compromise trust. Effective strategies to address bias should include the six aims of healthcare quality as outlined by the Institute of Medicine (IOM), now the National Academy of Medicine (NAM): safe, effective, patient-centered, timely, efficient, and equitable.

Healthcare leaders should consider embedding the following four strategies to address healthcare disparities and deliver equitable care regardless of gender, ethnicity, geographic location, and socioeconomic status:

Embracing workforce diversity

As patients’ backgrounds can impact both their health and likelihood in pursuing or receiving adequate care, the healthcare workforce should represent the diverse local communities they serve to help them best understand their needs. In fact, studies have shown that patients prefer physicians of the same race, ethnicity, or gender, rating their experience with these providers higher.

Currently, healthcare providers largely do not reflect the diversity of the communities they serve. Despite 14.4% of the population identifying as Black, only 5.7% of doctors are Black. However, one study found that for every 10% increase of Black primary care physicians, the life expectancy among Black patients within those communities increased by one month. Diversifying the workforce can bring a wider variety of perspectives, even improving outcomes.

Highlighting awareness and staff education

While diversifying the workforce can add new perspectives, training is still needed to educate workers on self-awareness, including tendencies, common biases, and recognizing disparities. Organizational needs assessments can also be used to yield system training opportunities based on key findings. Staff must understand and recognize common biases to ensure they are providing excellent care to yield the best outcomes.

Improving patient education

Involving the patient by providing proper explanation of diagnoses or treatment plans in a way they can understand is a critical component of high-quality care. This includes recognition of the language barriers in patient populations.

One study noted that out of the 15.7% of patients who need an interpreter, only 17.1% actually receive one. Adequate patient resources, including medical interpreters and translated educational materials, can ensure every patient has access to the same medical information. Education can even empower patients to engage as active partners in their own care, advocate for themselves and their medical needs, and take control of the decisions impacting their health.

Investing in local community health centers
With hospital closures sweeping the nation, many patients in rural America find it increasingly hard to access quality healthcare services. Patients in rural areas are often elderly, disabled, veterans, uninsured, or Medicaid recipients.

Community Health Centers (CHCs) serve one in 11 Americans and provide care to at-risk populations, decreasing hospitalization rates and emergency department visits. One study found that within three years of opening CHCs, local communities experienced almost 40% less uninsured visits to local emergency departments. Among patients seeking care at these centers, 90% live in low-income households, and 64% are members of racial or ethnic minorities, receiving care that might otherwise be unobtainable.

As part of their continuous process improvement journey, healthcare organizations should integrate these meaningful bias reduction strategies to improve care quality and reduce inequities.

Felicia Sadler, MJ, BSN, RN, CPHQ, LSSBB is Vice President of Quality at Relias.