Bridge the Gap: Reducing Inequity in Hospital Readmissions for African American Patients with Heart Failure Through Quality Improvement Initiatives

Carolina Ornelas; Raj P Fadadu; Morrise A Richardson; Omonivie H Agboghidi; Jonathan D Davis

doi:10.1089/heq.2020.0082

Bridge the Gap: Reducing Inequity in Hospital Readmissions for African American Patients with Heart Failure Through Quality Improvement Initiatives

Health Equity. 2021 Jan 25;5(1):30-34. doi: 10.1089/heq.2020.0082. eCollection 2021.

Authors

Carolina Ornelas^{1

2}, Raj P Fadadu^{1

2}, Morrise A Richardson¹, Omonivie H Agboghidi¹, Jonathan D Davis³

Affiliations

¹ School of Public Health, University of California, Berkeley, Berkeley, California, USA.
² School of Medicine, University of California, San Francisco, San Francisco, California, USA.
³ Department of Cardiology, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Abstract

Purpose: Heart failure (HF) disproportionately impacts African Americans. We evaluated existing quality improvement (QI) initiatives and patient and provider perceptions of barriers to HF care to develop equity-centered QI recommendations. Methods: We performed a literature review, interviewed providers and patients (N=11), and conducted a root cause analysis at a safety net hospital in San Francisco, California. Results: We have identified four elements to foster a more equitable HF care model: screening for social determinants of health, technological innovation, optimization of space, and implicit bias training. Conclusion: QI initiatives for HF should integrate health equity elements in their design and implementation.

Keywords: health equity; heart failure; quality improvement.