RAND Corporation and MedStar researchers examined the intersection of patient safety and racism, focusing on patient safety and health equity from clinician leaders’ perspectives. An overarching emphasis of the work concerned the impact of racism and other related factors (i.e., bias) on patient safety events and potential interventions or changes (such as creating a culture of speaking up about racism in care) that can help prevent such events.
The authors conducted an environmental scan of peer-reviewed studies and gray literature to understand established linkages between patient safety events and racism. They also interviewed 14 subject-matter experts (clinicians with patient safety and/or health equity expertise) to understand their perspectives on factors that contribute to patient safety events, factors that influence formal and informal reporting of such events, and the impact of racism on patient safety events. Recommendations are to implement an equity approach to patient safety data collection, improve the user experience in formal reporting systems, and create a culture for speaking up on racism in patient safety.
- The environmental scan revealed that while patient safety events, overall, were characterized by racial and ethnic disparities, methodological challenges—primarily related to data availability—limited in-depth analysis of this finding.
- The environmental scan also indicated that racism and its impact on patient safety events was more often discussed in editorials than in peer-reviewed and gray literature.
- Subject-matter expert interviews indicated that various levels of racism ranging from internalized and interpersonal to institutional and systemic directly impact the risk of patient safety events and highlighted the interplay between racism and social determinants of health.
- The authors also identified patient, provider, and systems factors that contribute to disparities in patient safety events.
- Research Report: Identifying and Understanding Ways to Address the Impact of Racism on Patient Safety in Health Care Settings. RAND Corporation. August 8 2022