Achieving Equity in Emergency Medicine Quality Measures Requires a Sex and Gender Lens
Quality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and ge...
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| Published in | The Journal of emergency medicine Vol. 65; no. 1; pp. e60 - e65 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.07.2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0736-4679 |
| DOI | 10.1016/j.jemermed.2023.03.063 |
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| Abstract | Quality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all.
The aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example.
Current quality measures related to AMI, such as time-to-electrocardiogram and door-to-balloon time in percutaneous coronary intervention, may have important and modifiable disparities when stratified by sex. Even when presenting with signs and symptoms of AMI, women experience delayed time to diagnosis and treatment. Few studies have considered interventions to mitigate these differences. However, the data available suggest that sex-based disparities can be minimized by implementation of strategies such as a quality control checklist.
Quality measures were created to deliver high-quality, evidence-based, and standardized care, but without the inclusion of sex and gender metrics, they may not advance care to an equitable level. |
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| AbstractList | Quality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all.
The aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example.
Current quality measures related to AMI, such as time-to-electrocardiogram and door-to-balloon time in percutaneous coronary intervention, may have important and modifiable disparities when stratified by sex. Even when presenting with signs and symptoms of AMI, women experience delayed time to diagnosis and treatment. Few studies have considered interventions to mitigate these differences. However, the data available suggest that sex-based disparities can be minimized by implementation of strategies such as a quality control checklist.
Quality measures were created to deliver high-quality, evidence-based, and standardized care, but without the inclusion of sex and gender metrics, they may not advance care to an equitable level. Quality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all.BACKGROUNDQuality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all.The aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example.OBJECTIVEThe aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example.Current quality measures related to AMI, such as time-to-electrocardiogram and door-to-balloon time in percutaneous coronary intervention, may have important and modifiable disparities when stratified by sex. Even when presenting with signs and symptoms of AMI, women experience delayed time to diagnosis and treatment. Few studies have considered interventions to mitigate these differences. However, the data available suggest that sex-based disparities can be minimized by implementation of strategies such as a quality control checklist.DISCUSSIONCurrent quality measures related to AMI, such as time-to-electrocardiogram and door-to-balloon time in percutaneous coronary intervention, may have important and modifiable disparities when stratified by sex. Even when presenting with signs and symptoms of AMI, women experience delayed time to diagnosis and treatment. Few studies have considered interventions to mitigate these differences. However, the data available suggest that sex-based disparities can be minimized by implementation of strategies such as a quality control checklist.Quality measures were created to deliver high-quality, evidence-based, and standardized care, but without the inclusion of sex and gender metrics, they may not advance care to an equitable level.CONCLUSIONSQuality measures were created to deliver high-quality, evidence-based, and standardized care, but without the inclusion of sex and gender metrics, they may not advance care to an equitable level. AbstractBackgroundQuality measures within Emergency Medicine (EM) were developed to standardize and improve care. Their development has been limited by lack of consideration of sex- and gender-based differences. Research has suggested that sex and gender can impact clinical care and treatment. Inclusion of sex and gender differences is needed to create EM quality measures that are equitable to all. ObjectiveThe aim of the review is to provide a brief history of EM quality measures and the value of considering sex- and gender-based evidence in their development to ensure equity, using acute myocardial infarction (AMI) as an example. DiscussionCurrent quality measures related to AMI, such as time-to-electrocardiogram and door-to-balloon time in percutaneous coronary intervention, may have important and modifiable disparities when stratified by sex. Even when presenting with signs and symptoms of AMI, women experience delayed time to diagnosis and treatment. Few studies have considered interventions to mitigate these differences. However, the data available suggest that sex-based disparities can be minimized by implementation of strategies such as a quality control checklist. ConclusionsQuality measures were created to deliver high-quality, evidence-based, and standardized care, but without the inclusion of sex and gender metrics, they may not advance care to an equitable level. |
| Author | Buehler, Greg B. Jarman, Angela F. McGregor, Alyson J. Andrabi, Sara Faynshtayn, Nina G. Thomas, Ynhi T. |
| AuthorAffiliation | c Undergraduate College, Brown University, Providence, Rhode Island 02912, USA a Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, 1504 Ben Taub Loop, Houston, Texas 77030, USA d Department of Emergency Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, South Carolina 29605, USA b Department of Emergency Medicine, University of California-Davis, 4150 Y St, St 2100, Sacramento, California 95817, USA |
| AuthorAffiliation_xml | – name: b Department of Emergency Medicine, University of California-Davis, 4150 Y St, St 2100, Sacramento, California 95817, USA – name: a Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, 1504 Ben Taub Loop, Houston, Texas 77030, USA – name: c Undergraduate College, Brown University, Providence, Rhode Island 02912, USA – name: d Department of Emergency Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, South Carolina 29605, USA |
| Author_xml | – sequence: 1 givenname: Ynhi T. orcidid: 0000-0003-3120-6397 surname: Thomas fullname: Thomas, Ynhi T. email: ythomas@bcm.edu organization: Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas – sequence: 2 givenname: Angela F. surname: Jarman fullname: Jarman, Angela F. organization: Department of Emergency Medicine, University of California-Davis, Sacramento, California – sequence: 3 givenname: Nina G. surname: Faynshtayn fullname: Faynshtayn, Nina G. organization: Undergraduate College, Brown University, Providence, Rhode Island – sequence: 4 givenname: Greg B. surname: Buehler fullname: Buehler, Greg B. organization: Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas – sequence: 5 givenname: Sara surname: Andrabi fullname: Andrabi, Sara organization: Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas – sequence: 6 givenname: Alyson J. surname: McGregor fullname: McGregor, Alyson J. organization: Department of Emergency Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville, South Carolina |
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| Keywords | health equity quality measures sex and gender medicine acute myocardial infarction |
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| SubjectTerms | acute myocardial infarction Emergency Female health equity Humans Male Myocardial Infarction - diagnosis Myocardial Infarction - therapy Percutaneous Coronary Intervention Quality Indicators, Health Care quality measures sex and gender medicine Sex Factors |
| Title | Achieving Equity in Emergency Medicine Quality Measures Requires a Sex and Gender Lens |
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