Addressing cancer health disparities with a quality dashboard.

Abstract

171 Background: Equity is lacking in cancer care. In 2021, the cancer center at our academic medical center established a quality dashboard with relevant performance measures. We aimed to evaluate our care in various domains of healthcare quality; however, no measures of equity were displayed. In 2023, we stratified our performance measures according to various population groups and evaluated group differences. In the next phase of this quality improvement cycle, we added the stratified results to the quality dashboard to display these group differences and prioritize equity. Methods: We identified performance measures that could be stratified by population groups, such as race, ethnicity, insurance type, and primary spoken language. Three measures, mortality index (MI), length of stay (LOS) index, and 30-day readmission rate, were calculated using a third-party program for the fiscal year 2022. Additionally, we stratified 2021 and 2022 data on patient satisfaction, assessed by the proportion of patients selecting the top answer to the likelihood of recommending the practice, by race and language. Each performance measure was color-coded in a quality dashboard according to the institution-set benchmarks (goals) and thresholds (satisfactory performance). Values better than or equal to the benchmark were displayed in green, between the benchmark and threshold in yellow, and worse than the threshold in red. Values worse than the benchmark were considered opportunities for improvement. Results: Population group differences are now captured on our quality dashboard. For the stratified MI results, white and Asian patient populations met the threshold, while the black patient population did not. Latinx patients did not meet the MI threshold, while the non-Latinx patient population did. Patients with Medicaid did not meet the MI, LOS, or readmission thresholds. Regarding patient satisfaction, the white patient population and those whose primary language was English met the benchmark, while the non-white patient population and the non-English speaking group did not. Conclusions: The quality dashboard, with the addition of measures stratified by sociodemographic factors, highlights signs of cancer health disparities at our institution. Leadership can use this tool to target resources to specific areas where disparities exist. The next steps include understanding contributing factors and setting appropriate benchmarks for future quality improvement work. Finally, we must understand the needs of other population groups facing cancer health disparities but not represented in the data, including the sexual and gender minority population.