Patient perspectives of the climate of diversity, equity, and inclusion in the emergency department

Abstract

Objective Assessing the diversity, equity, and inclusion (DEI) climate of emergency departments (EDs) can inform organizational change to provide equitable, inclusive, and high‐quality care to their diverse patient populations. The purpose of this project was to investigate patient perspectives on the climate of DEI in an urban ED. Methods This was a cross‐sectional survey study conducted in a large‐volume, urban ED in Detroit, MI, from November 2018 to January 2019. The survey was developed by an experienced ED DEI committee via an iterative process and broad consensus. Results During their care in the ED, 849 patients completed an anonymous survey about their perspectives and experiences of DEI in that ED. Overall, the responses were favorable as most respondents reported that the ED staff treated patients from all races equally (75.8%) and made patients feel accepted (86%). However, some respondents felt that the ED staff's treatment of populations with greater complexity, such as patients who are mentally ill (16.8%) or lower income (14.3%), needs the most improvement. Conclusions This DEI climate assessment survey of ED patients’ perspectives revealed important insights that could guide strategic initiatives to advance DEI in the ED. This assessment may serve as a model for continuous evaluation of DEI over time and in multiple healthcare settings to help guide organizational change efforts.

Identifying the prevalence and characteristics of diversity, equity, and inclusion leaders in academic emergency medicine

“…20 In a recent study interviewing patients in the ED, patients viewed DEI work positively. 21 As academic EM DEI leaders emerge, we sought to understand the characteristics of these leaders-how they for many years; however, many do not have a titled position and most do not have protected or funded effort. The nascency of their position likely contributed to the fact that the majority have no job description.…”

Invited Editorial: Patient perspectives of the climate of diversity, equity, and inclusion in the emergency department

“…As the "safety net" for US healthcare, emergency departments (EDs) provide critical healthcare access to a diverse group of patients regardless of insurance coverage or ability to pay. 1 Yet, ED clinicians' implicit biases, which are similar to the levels in the general population, can influence their clinical decision making and the patients' perception of care. 2 Because perception is reality, a patient's perception of their healthcare professional has a direct effect on medication compliance, willingness to communicate, and treatment adherence.…”

“…As the “safety net” for US healthcare, emergency departments (EDs) provide critical healthcare access to a diverse group of patients regardless of insurance coverage or ability to pay. 1 Yet, ED clinicians’ implicit biases, which are similar to the levels in the general population, can influence their clinical decision making and the patients’ perception of care. 2 …”

“…The cross‐sectional survey by Davuluri et al describes patients’ perspectives of the climate of DEI in the ED. 1 The survey was developed by an interdisciplinary group of physicians, nurses, social workers, and so on. The survey consisted of 41 questions, largely organized into matrices and divided into the following 4 sections: care for specific patient populations, patient's care experiences and values, ED compared to other hospital system clinics and departments, and demographics.…”

“…The cross‐sectional survey by Davuluri et al describes patients’ perspectives of the climate of DEI in the ED 1 . The survey was developed by an interdisciplinary group of physicians, nurses, social workers, and so on.…”