Linking equitability to quality: the development of a pediatric nursing e-quality measure.
Over the past decade, many initiatives have been directed toward eliminating racial and ethnic disparities in healthcare. Despite these efforts, the 2007 National Healthcare Disparities Report revealed that overall disparities in healthcare quality and access have not decreased. Although the disparities described vary in magnitude by category and population, they were identified in almost every aspect of healthcare. Improving the quality of care may not reduce disparities; therefore, ensuring the collection of better patient reported race and ethnicity data, whereas linking it to clinical performance may be one of the first challenges to overcome. Eliminating disparities in healthcare is particularly important in the provision of pediatric care because children of immigrant families are the fastest growing sector of the pediatric population in the United States. This article describes an approach to the stratification of nursing-sensitive measures by race, ethnicity, and insurance group, which integrally links cultural competence to quality of care, identifies disparities in patient outcomes related to nursing care, and informs the development of tailored interventions to meet the needs of diverse patients and their families.
Berger
Anne M
AM
Nursing Patient Care Services, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA. anne.berger@childrens.harvard.edu
Branowicki
Patricia A
PA
D002648:Child; D054624:Health Status Disparities; D006801:Humans; D009732:Nursing Care / Q000379:methods / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D010371:Pediatric Nursing / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States