Improving Cardiovascular Care for Women through Implicit Bias Awareness as a Quality Improvement Process
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Abstract
Background: Female patients with a cardiovascular crisis are at risk of facing care disparity due to implicit bias by clinical providers in the emergency department (ED). Aims: To (1) evaluate and compare the effects of implicit bias training on clinical practice change in the cardiac care of men verses women 30 days after educational intervention (2) evaluate and compare the attitudes and perceptions of implicit bias training (measured before and after intervention) with a 10-item measurable survey (3) receive feedback on the educational intervention for future use. Methods: The Plan Do Study Act method of quality improvement was used for this project. Assessment included a baseline review compared to post intervention data. Likert scale-based surveys were administered to the staff to determine change in nursing knowledge. Results: The Wilcoxon singed-rank test demonstrated significant increases in staff knowledge post intervention. Pearson chi square tests used to evaluate interventions effects for (younger under 50 years of age) before and after intervention showed for younger female patients; evidence of pre/post difference in frequency of EKG tests and Troponin lab assessments were in the desired direction. Pre intervention, evidence of gender differences for all but the distribution of EKG and Troponin labs for older patients existed. Post intervention, there was evidence of gender differences in medications used for younger patients. Conclusions: Education on implicit bias creates awareness potentially altering cardiovascular care positively.