American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

NIH-ACS Symposium Findings Summary

Health care disparities—differential access, care, and outcomes owing to factors such as race or ethnicity—are widely established. Compared with other groups, African American individuals have an increased mortality risk across multiple surgical procedures. Gender, sexual orientation, age, and geographic disparities are also well documented. Further research is needed to mitigate these inequities. To do so, the American College of Surgeons and the National Institutes of Health National Institute of Minority Health and Disparities convened a research summit to develop a national surgical disparities research agenda and funding priorities. Sixty leading researchers and clinicians gathered in May 2015 for a two-day summit.

Symposium Themes

Surgical Disparities Research Themes (Click to enlarge)First, literature on surgical disparities was presented within five themes:

  • Clinician
  • Patient
  • Systemic/access
  • Clinical quality
  • Postoperative care and rehabilitation-related factors

These themes were identified via an exhaustive preconference literature review and guided the summit and its interactive consensus-building exercises. After individual thematic presentations, attendees contributed research priorities for each theme. Suggestions were collated, refined, and prioritized during the latter half of the summit. Breakout sessions yielded three to five top research priorities by theme.

Surgical Research Priorities Identified

Surgical Disparities Research Priorities (Click to enlarge)Overall priorities, regardless of theme, included:

  1. Improving patient-clinician communication by helping clinicians deliver culturally dexterous, competent care and measuring its effect on the elimination of disparities.
  2. Fostering engagement and community outreach by using technology to optimize patient education, health literacy, and shared decision making in a culturally relevant way; disseminating these technologies; and evaluating their effect on reducing surgical disparities.
  3. Improving care at facilities with a higher proportion of minority surgical and trauma patients. This includes evaluation of regionalization of care versus strengthening of safety-net hospitals within the context of differential access and surgical disparities.
  4. Evaluating the long-term effect of acute interventions and rehabilitation support within the critical period of injury or illness on functional outcomes and patient-defined perceptions of quality of care.
  5. Improving patient centeredness by identifying expectations for postoperative and post-injury recovery. This includes adhering to patient values regarding advanced health care planning and palliative care needs.

Next Steps

The National Institutes of Health and American College of Surgeons Summit on Surgical Disparities Research succeeded in identifying a comprehensive research agenda. Future research and funding priorities should prioritize patients’ care perspectives, workforce diversification and training, and systematic evaluation of health technologies to reduce surgical disparities.

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