Skip to content

Pursuing and Practicing Health Equity in OB/GYN Care

In This Video

  • The Department of Obstetrics and Gynecology at Massachusetts General Hospital works to ensure equity is a part of quality assurance work
  • Providers complete an implicit association test to better understanding their own implicit biases and how that can show up in patient care
  • During adverse event reviewing, they present demographics up front so that as they review the case they can understand if there are opportunities to do better in terms of clinical care and is that informed by who the patient is
  • Future advancements and innovation in patient care need to be applied equitably, across populations of patients

In this video, Allison S. Bryant, MD, MPH, vice chair of quality, equity and safety, and specialist in the Maternal-Fetal Medicine Program in the Department of Obstetrics and Gynecology at Massachusetts General Hospital, discusses how the department is integrating practices and training to increase health equity in patient care—locally and on a regional and national level.

Transcript

I'm the Vice-Chair for Quality, Equity and Safety here at Massachusetts General Hospital in the Department of OB/GYN. That's a role that I sort of crafted a little bit because there are many departments that have Quality Chairs, but I really wanted to make sure that for our department, equity did not get left behind. So, it's really important to me that people sort of always see health equity as a part of quality.

The work that we do here Mass General regarding racial and ethnic disparities or inequities in the care is really aimed at making sure providers and patients understand the differences and that patients from different communities face in terms of their outcomes and of the care that is provided to them so that we can help to mitigate that through awareness. We certainly know that inequities arise at the level of the providers, so how we take care of our patients is really critical and we know that there are many, many differences in the way we take care of patients based on who the provider is and who the patient is, and so we've done a lot of work in terms of understanding our own implicit biases.

We have asked all of our providers to do an implicit association test, for example, and that's part of the onboarding process, but it really doesn't end there. We've done other unconscious bias training. We've done department town halls where we spend time talking about race, ethnicity, and how those might play out in the clinical space. And then we actually do adverse event reviewing, which is a central part of my job as the Quality Chair of the department, where what we ask everyone to do as they present patients, is to present their demographics upfront, so let us know what's the patient's race, what is their language preference, what is their insurance status, so as we review the case we can understand, were there opportunities that we might have done better in terms of clinical care and was any of that informed by who the patient is.

I think we also think about inequities that arise at the level of the health care system, and so sometimes that feels like things that we as providers can't fix, but we can influence them at a level of advocacy, so how we pay for health care, how we think about QA within the health care system, how patients are able to or not able to access our care.

And then lastly, we know that the structural factors that influence their health that we, again, feel like we are not connected to, but we can have a role in, so things like housing insecurity or food insecurity or structural racism, I think it's very important for all of our providers to understand how each of these things contributes to their OB/GYN outcomes and understand how we can influence them.

In terms of future advancements in patient care, what I hope really, is that anything that is designed to improve the health of our populations is applied equitably and I feel like that's my role, is to understand what's coming down the pipeline and how are patients going to be able to access that? And are all of our patients going to be able to access that equitably?

One of our favorite collaborators is the Disparity Solution Center and so the work that we do on the annual report on Equity in Healthcare Quality really works with that center to understand what are the underlying inequities in the care that we are providing, and how do we then sort of, intervene on them, and so we've been really grateful to have that group as partners.

We also are able to be outward-focused, and so I think a lot of folks here in our department spend a lot of time both in regional, state, and national platforms to bring back the best practices that we are working on here and sort of, pay those forward. So I have the honor of being the Chair of the Massachusetts Maternal Mortality Review Committee and so that work, I think, is incredibly powerful to understand the causes of death of the women in this state that we then sort of roll up to a national level to understand how we can make change.

Learn more about the Department of Obstetrics & Gynecology

Refer a patient to the Department of Obstetrics and Gynecology

Related topics

Related

The Mass General OB/GYN department has begun a three-year plan addressing diversity, equity and inclusion issues affecting work environment and patient care.

Related

In this video, Katherine Rushfirth, CNM, MSN, associate chief of the Midwifery Service in the Department of Obstetrics and Gynecology at Massachusetts General Hospital, discusses the department's approach to community health, incorporating social determinants of health into the care of their patients.