The Forgotten Aim: Investigating Inequities in Clinical Systems
Abstract: Racial/ethnic disparities in health outcomes are associated with premature death and disability, billions of dollars in excess medical costs, and lost productivity. Decades of research have documented racial/ethnic disparities in the leading causes of death, in the diagnosis and treatment of a range of illnesses, and in the use of health services. Current health equity efforts focus on population level approaches to address disparities in overall health; however, emerging evidence suggests that hospitals are plagued by systemic design biases that contribute to variations in care and subsequently in health outcomes. Research is needed to uncover factors contributing to these disparate outcomes and how to redesign clinical systems to support safe, equitable care. Our work seeks to help identify and address inequities that result in adverse outcomes by integrating equity as a cross-cutting feature across the dimensions of sociotechnical systems analysis. The research presented illustrate our ongoing efforts to uncover inequities in clinical environments using systems analysis, patient journey mapping, and machine learning. Our future research will expand on these efforts to provide a comprehensive assessment of inequities in the delivery of care and offer guidance to help reduce disparities in health outcomes and improve the quality of care provided to all patients served by the hospital.
Biography: Dr. Myrtede Alfred is an Assistant Professor in the Mechanical & Industrial Engineering Department at the University of Toronto. She directs the Safety, Equity, & Design (SĒD) lab which examines vulnerabilities that contribute to patient harm and embedded inequities which result in racial/ethnic disparities in health outcomes. Her team also supports quality improvement initiatives at local hospitals and she holds appointments at Unity Health Toronto and Michael Garron Hospital (ON, Canada). Dr. Alfred has published over 40 peer-reviewed articles, and her research has been funded by the Agency for Healthcare Research and Quality, Natural Sciences and Engineering Research Council, Canadian Foundation for Innovation, and Canadian Institutes of Health Research. She serves as the co-chair of the HFES DEI committee and on the editorial of several HF/E journals. Dr. Alfred obtained her PhD in industrial engineering from Clemson University (2017).