Using Online Provider Reviews to Tackle Discrimination, Patient Safety
By Sara Heath
A recent study shows how online provider reviews can help identify discrimination in healthcare. The researchers, who published their findings in JAMA Network Open, observed: "Traditional health care performance metrics, such as Hospital Compare, do not report on discrimination or health inequities." However, online provider review websites — which allow patients to leave comments about a healthcare encounter — are both timely and capture factors not always noted in other patient experience surveys, according to the study authors. The researchers' examination of more than 10,000 online provider reviews identified almost 3,000 that included words often linked to discriminatory situations, and 182 were ultimately found to describe instances of discrimination. Nearly 50% of those reviews involved discrimination that occurred within clinical spaces while patients were actively receiving care or waiting for care. The research also found that 36.3% of the reviews involved discrimination committed by the consumer and directed to the healthcare provider, while 29.1% included examples of institutional racism and about 14% were categorized as discrimination occurring in non-clinical spaces. The online provider reviews highlighted six key themes of discrimination: acts of commission or explicit bias, acts of omission or denial or delay of certain necessities, unprofessionalism, disrespect, stereotyping, and dehumanization. "We report these 6 manifestations to serve as a conceptual framework for subsequent programs designed to reduce discrimination in health care," the researchers said. They noted that each of the manifestations of discrimination "have been previously (and independently) described as separate individual drivers of medical errors and lapses in patient safety. Consequently, it stands to reason that these manifestations of discrimination might result in harm to individuals and lead to inequities in care." By approaching the acts of discrimination as forms of patient harm, the researchers suggest, "organizations can adopt more traditional patient safety strategies, like the Plan-Do-Study-Act cycle, to improve the patient experience."
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