Equitability: Equitable Nursing Care
Why is this measure important?
One third of all Americans currently identify themselves as members of a racial or ethnic minority, and children of immigrant families are the fastest growing sector of the pediatric patient population in the U.S. today. At the same time, studies have shown that racial and ethnic minorities, and those who receive their health insurance through the government, do not always receive the highest quality care.
Because nurses play such an important role in providing care to our patients, we look at measures of nursing quality (such as intravenous care and skin care) to ensure that all of our patients receive the same high quality of care.
How do we track this measure?
We have collected comprehensive information on the quality of our nursing care since 2000. In 2006, we received a grant from the Boston Public Health Commission to collect information by race, ethnicity, language and educational background using standards established by the Commission’s Center for Health Equity & Social Justice. We also collect insurance information from all patients at the time of admission.
By comparing this information twice a year, we are able to determine whether patients from racial and ethnic minorities and those who either have no insurance or receive their health insurance from the government are receiving the same high quality of nursing care as other patients.
How do we compare to other hospitals?
Since other children’s hospitals do not collect and analyze this information in the same way, it is impossible to compare our performance with that of other children’s hospitals on this measure. Instead, we evaluate ourselves based on how well we care for all patients, regardless of their ethnic or racial background or their health insurance.
Since we began collecting and comparing this information in 2006, we have found no statistically significant differences in the percentage of patients from racial and ethnic minorities receiving high quality care or experiencing a problem with nursing care at our hospital compared to other patients.
The chart below summarizes the results. Differences within the hatched areas are differences that could be expected based on chance alone, and are not therefore considered meaningful.
Similarly, there were no significant differences in problems experienced by patients with public health insurance compared to patients with private health insurance.
What are we doing to maintain our excellence?
The quality of nursing care provided to children from racial and ethnic minorities and to those who either have no insurance or receive their health insurance from the government is reviewed twice a year by the hospital’s Nursing Executive Committee for Quality and our Nursing Practice, Quality and Outcomes Committees.
In addition, a three-person team from Children’s Hospital Boston has completed a year-long disparities leadership training program, which will allow us to play a leadership role in providing equal health care to all children.