Display options
Cite
Reisinger-Kindle K, Dethier D, Wang V, et al. Health Equity Morbidity and Mortality Conferences in Obstetrics and Gynecology. Obstet Gynecol. 2021;138(6):918-923doi: 10.1097/AOG.0000000000004575.
Reisinger-Kindle, K., Dethier, D., Wang, V., Nandi, P., Bradley, E. T., Evans, M. L., Ireland, L. D., Dhanraj, D., & Bryant, A. S. (2021). Health Equity Morbidity and Mortality Conferences in Obstetrics and Gynecology. Obstetrics and gynecology, 138(6), 918-923. https://doi.org/10.1097/AOG.0000000000004575
Reisinger-Kindle, Keith, et al. "Health Equity Morbidity and Mortality Conferences in Obstetrics and Gynecology." Obstetrics and gynecology vol. 138,6 (2021): 918-923. doi: https://doi.org/10.1097/AOG.0000000000004575
Reisinger-Kindle K, Dethier D, Wang V, Nandi P, Bradley ET, Evans ML, Ireland LD, Dhanraj D, Bryant AS. Health Equity Morbidity and Mortality Conferences in Obstetrics and Gynecology. Obstet Gynecol. 2021 Dec 01;138(6):918-923. doi: 10.1097/AOG.0000000000004575. PMID: 34735374.
Copy Download .nbib Format: NLM
Share it on

Obstet Gynecol. 2021 Dec 01;138(6):918-923. doi: 10.1097/AOG.0000000000004575.

Health Equity Morbidity and Mortality Conferences in Obstetrics and Gynecology.

Obstetrics and gynecology

Keith Reisinger-Kindle, Divya Dethier, Victoria Wang, Preetha Nandi, Erin Tracy Bradley, Megan L Evans, Luu Doan Ireland, David Dhanraj, Allison S Bryant

Affiliations

  1. Departments of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, and Massachusetts General Hospital, Brigham and Women's Hospital, and Tufts Medical Center, Tufts University School of Medicine, Boston, and UMass Memorial Medical Center, UMass Medical School, Worcester, Massachusetts.

PMID: 34735374 DOI: 10.1097/AOG.0000000000004575

Abstract

Maternal mortality and morbidity continue to occur at unacceptably high levels in the United States, with communities of color experiencing significantly higher rates than their White counterparts, even after adjustment for confounding factors such as socioeconomic status. Many obstetrics and gynecology departments across the country have begun to incorporate routine discussion and analysis of health equity into peer review and educational processes, including grand rounds and morbidity and mortality conferences. Despite the desire and drive, there is little published guidance on best practices for incorporation of an equity component into these conferences. This document outlines the current processes at four academic institutions to highlight the variety of ways in which health equity and social justice can be incorporated when analyzing patient experiences and health outcomes. This commentary also provides a list of specific recommendations based on the combined experiences at these institutions so that others across the country can incorporate principles of health equity into their peer-review processes.

Copyright © 2021 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

Financial Disclosure The authors did not report any potential conflicts of interest.

References

  1. Gregor A, Taylor D. Morbidity and mortality conference: its purpose reclaimed and grounded in theory. Teach Learn Med 2016;28:439–47. doi: 10.1080/10401334.2016.1189335 - PubMed
  2. Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. National Academies Press (US); 2000. - PubMed
  3. Marx D. Patient safety and the Just culture. Obstet Gynecol Clin North Am 2019;46:239–45. doi: 10.1016/j.ogc.2019.01.003 - PubMed
  4. Gonzalo JD, Yang JJ, Huang GC. Systems-based content in medical morbidity and mortality conferences: a decade of change. J Grad Med Educ 2012;4:438–44. doi: 10.4300/JGME-D-12-00016.1 - PubMed
  5. Kravet SJ, Howell E, Wright SM. Morbidity and mortality conference, grand rounds, and the ACGME's core competencies. J Gen Intern Med 2006;21:1192–4. doi: 10.1111/j.1525-1497.2006.00523.x - PubMed
  6. Accreditation Council for Graduate Medical Education. ACGME common program requirements (residency). ACGME; 2020. - PubMed
  7. Orlander JD, Barber TW, Fincke BG. The morbidity and mortality conference: the delicate nature of learning from error. Acad Med 2002;77:1001–6. doi: 10.1097/00001888-200210000-00011 - PubMed
  8. Campbell WB. Surgical morbidity and mortality meetings. Ann R Coll Surg Engl 1988;70:363–5. - PubMed
  9. Racial and ethnic disparities in obstetrics and gynecology. Committee Opinion No. 649. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e130–4. doi: 10.1097/AOG.0000000000001213 - PubMed
  10. Grobman WA, Bailit JL, Rice MM, Wapner RJ, Reddy UM, Varner MW, et al. Racial and ethnic disparities in maternal morbidity and obstetric care. Obstet Gynecol 2015;125:1460–7. doi: 10.1097/AOG.0000000000000735 - PubMed
  11. Howell EA, Egorova N, Balbierz A, Zeitlin J, Hebert PL. Black-White differences in severe maternal morbidity and site of care. Am J Obstet Gynecol 2016;214:122–7. doi: 10.1016/j.ajog.2015.08.019 - PubMed
  12. Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:980–1004. doi: 10.1016/S0140-6736(14)60696-6 - PubMed
  13. Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 2010;375:1609–23. doi: 10.1016/S0140-6736(10)60518-1 - PubMed
  14. Creanga AA. Maternal mortality in the United States: a review of contemporary data and their limitations. Clin Obstet Gynecol 2018;61:296–306. doi: 10.1097/GRF.0000000000000362 - PubMed
  15. Wong PC, Kitsantas P. A review of maternal mortality and quality of care in the USA. J Matern Fetal Neonatal Med 2020;33:3355–67. doi: 10.1080/14767058.2019.1571032 - PubMed
  16. Troiano NH, Witcher PM. Maternal mortality and morbidity in the United States: classification, causes, preventability, and critical care obstetric implications. J Perinat Neonatal Nurs 2018;32:222–31. doi: 10.1097/JPN.0000000000000349 - PubMed
  17. Anachebe NF. Racial and ethnic disparities in infant and maternal mortality. Ethn Dis 2006;16:S3–6. - PubMed
  18. Ali D. Safe spaces and brave spaces: historical context and recommendations for student affairs professionals. NASPA; 2017. - PubMed
  19. To err is helpful. Cultural complications curriculum: leveraging morbidity & mortality conference to advance culture. Accessed May 15, 2021. https://www.culturalcomplications.com - PubMed
  20. Perdomo J, Tolliver D, Hsu H, He Y, Nash KA, Donatelli S, et al. Health equity rounds: an interdisciplinary case conference to address implicit bias and structural racism for faculty and trainees. MedEdPORTAL 2019;15:10858. doi: 10.15766/mep_2374-8265.10858 - PubMed
  21. Gurin P, Nagda B, Ratnesh A, Zuniga X. Dialogue across difference: practice, theory, and research on intergroup dialogue. Russell Sage Foundation; 2013 - PubMed
  22. MedEdPORTAL. Structural competency: curriculum for medical students, residents, and interprofessional teams on the structural factors that produce health disparities. Accessed May 15, 2021. https://www.mededportal.org/doi/10.15766/mep_2374-8265.10888 - PubMed
  23. The Center for Nonviolent Communication. Accessed May 15, 2021. https://www.cnvc.org/ - PubMed
  24. Hollaback! Bystander intervention training. Accessed May 15, 2021. https://www.ihollaback.org/bystander-resources/ - PubMed
  25. Boysen PG. Just culture: a foundation for balanced accountability and patient safety. Ochsner J 2013;13:400–6. - PubMed
  26. Gopaldas A. Intersectionality 101. J Public Policy Marketing 2013;32:90–4. doi: 10.1509/jppm.12.044 - PubMed

Publication Types