Using rising tides to lift all boats: Equity-focused quality improvement as a tool to reduce neonatal health disparities.
Using rising tides to lift all boats: Equity-focused quality improvement as a tool to reduce neonatal health disparities.
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利用水涨船高：以公平为中心的质量改进作为减少新生儿健康差距的工具。
DOI：
10.1016/j.siny.2021.101198
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发表时间：
2021-03
影响因子：
3
通讯作者：
Peña MM
中科院分区：
文献类型：
--
作者：
Reichman V;Brachio SS;Madu CR;Montoya-Williams D;Peña MM
有大量证据表明，新生儿的健康状况存在差异。虽然质量改进（QI）的方法往往被建议作为一种工具，以促进健康公平，QI倡议的差异的影响是可变的。QI工作可能会减轻、恶化或延续现有的差异。如果在设计QI项目时没有有意将重点放在促进公平上，可能会助长干预措施所产生的不平等，使弱势群体进一步处于不利地位。本文综述了围产期和新生儿护理的差异，QI对健康差异的影响，以及“以公平为中心的质量改进”（EF-QI）的概念。EF-QI不同于带有股权透镜的QI，因为它是以行动为导向的，并以股权为中心。EF-QI倡议有目的地将公平纳入整个项目的结构，是突出和解决弱势群体需求的包容性合作努力。EF-QI原则适用于项目构思、执行、分析和传播的每个阶段，并可能为减少新生儿护理中的差异提供机会。
Evidence of health disparities affecting newborns abounds. Although quality improvement (QI) methodology is often suggested as a tool to advance health equity, the impact of QI initiatives on disparities is variable. QI work may mitigate, worsen, or perpetuate existing disparities. QI projects designed without an intentional focus on equity promotion may foster intervention-generated inequalities that further disadvantage vulnerable groups. This article reviews disparities in perinatal and neonatal care, the impact of QI on health disparities, and the concept of “Equity-Focused Quality Improvement” (EF-QI). EF-QI differs from QI with an equity lens in that it is action-oriented and centered around equity. EF-QI initiatives purposely integrate equity throughout the fabric of the project and are inclusive, collaborative efforts that foreground and address the needs of disadvantaged populations. EF-QI principles are applicable at every stage of project conception, execution, analysis, and dissemination, and may provide opportunities for reducing disparities in neonatal care.
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