Advancing Equitable Healthcare Access and Delivery: Lessons Learned from a Novel Healthcare Equity Consult Service

Dismantling healthcare disparities will require health systems respond acutely to concerns of bias, racism, and inequities. A novel Healthcare Equity Consult Service (HECS) provides social justice expertise and consultation with interdisciplinary professionals in real time. Preliminary evaluation of this unique, innovative health system intervention assessed experiences and impact.

Consistent and accurate definitions and high-reliability-based response protocols were designed for HECS, and the team received training in strategies to intervene in complex interactions. Thirty-nine consults were completed August 2022 through February 2023 and reviewed for demographic characteristics and health equity issue(s). A majority (27) of patients for whom consults were requested were Black/African-American. The most common equity issue was concern for bias due to racism, reflected in stigmatizing language, treatment for pain, involvement of security or protective services and other issues. Consults also reflected problems with gender identification, stigma related to mental illness, disability and intersectionality.

Three of eight clinicians, 10 of 18 advisory committee members and eight of 13 consult team members responded to surveys with open- and closed-ended questions. Nearly all reported favorably about their experiences and supported continuing the service; many suggested expansion to outpatient settings. One clinician and one advisory committee member raised concerns about negative consequences for patients or clinical teams.

Conclusions: Early experience with an innovative HECS suggests this type of intervention provides a practical framework for addressing bias and structural inequities at the front lines of inpatient care. Future work should examine the impact on patients and families, and on institutional policies and practices.

David Brown – Associate Vice President and Associate Dean for Health Equity and Inclusion, Otorhinolaryngology, University of Michigan Medical School; Adrianne Haggins – Emergency Medicine – University of Michigan Medical School; Erin Khang – Social Work – Michigan Medicine; Okeoma Mmeje – Associate Chief Clinical Officer for Health Equity, Obstetrics and Gynecology, University of Michigan; Erika Newman – Pediatric Surgery – University of Michigan Medical School; Christina Wright – Spiritual Care – Michigan Medicine