Variability in Collection and Use of Race/Ethnicity and Language Data in 93 Pediatric Hospitals
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Variability in Collection and Use of Race/Ethnicity and Language Data in 93 Pediatric Hospitals John D. Cowden 1 & Gabriela Flores 1 & Tiffany Chow 1 & Patricia Rodriguez 2 & Tracy Chamblee 2 & Megan Mackey 3 & Anne Lyren 4 & Michael F. Gutzeit 5 Received: 23 August 2019 / Revised: 15 January 2020 / Accepted: 2 February 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract Objective To describe how pediatric hospitals across the USA and Canada collect race/ethnicity and language preference (REaL) data and how they stratify quality and safety metrics using such data. Methods Pediatric hospitals from the Solutions for Patient Safety network (125 US, 6 Canadian) were surveyed between January and March 2018 on collection and use of patient/family race/ethnicity data and patient/family language preference data. The study team created the survey using a formal process including pretesting. Responses were analyzed using descriptive statistics. Results Ninety-three of 131 (71%) hospitals completed the survey (87/125 [70%] US, 6/6 [100%] Canadian). Patient race/ ethnicity was collected by 95%, parent/guardian race/ethnicity was collected by 31%, and 5/6 Canadian hospitals collected neither. Minimum government race/ethnicity categories were used without modification/addition by 68% of US hospitals. Eleven hospitals (13%) offered a multiracial/multiethnic option. Most hospitals reported collecting language preferences of parent/ guardian (81%) and/or patient (87%). A majority provided formal training on data collection for race/ethnicity (70%) and language preferences (70%); fewer had a written policy (41%, 51%). Few hospitals stratified hospital quality and safety measures by race/ethnicity (20% readmissions, 20% patient/family experience, 16% other) or language preference (21% readmissions, 21% patient/family experience, 8% other). Conclusions The variability of REaL data collection practices among pediatric hospitals highlights the importance of examining the validity and reliability of such data, especially when combined from multiple hospitals. Nevertheless, while improvements in data accuracy and standardization are sought, efforts to identify and eliminate disparities should be developed concurrently using existing data. Keywords Race/ethnicity . Language . Safety . Quality improvement . Pediatrics
Abbreviations REaL Race/ethnicity and language SPS Solutions for Patient Safety
OMB IOM HHS
* John D. Cowden [email protected]
Introduction
1
Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA
2
Children’s Medical Center Dallas, 1935 Medical District Drive, Mailstop K4.01, Dallas, TX 75235, USA
3
Central Connecticut State University, 1615 Stanley St, New Britain, CT 06053, USA
4
UH Rainbow Babies and Children’s Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA
5
Children’s Hospital of Wisconsin, 8915 W. Connell Court, Milwaukee, WI 53226, USA
Office of Management and Budget Institute of Medicine Health and Human Services
Disparities related to race, ethnicity, and language
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