122 - Health Equity Rounds in the NICU: A Novel Multidisciplinary Educational Conference

Poster Number: 122

Amanda J. Kim, Oregon Health & Science University, Portland, OR, United States; Devlynne S. Ondusko, Oregon Health & Science University School of Medicine, Portland, OR, United States; Kaitlyn Sacotte, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States; Ladawna Gievers, Doernbecher Children's Hospital at Oregon Health & Science University, Portland, OR, United States

Background: Despite improving pregnancy-related morbidity and mortality in other high-income countries, birthing people and infants in the United States have disparate and worsening outcomes. Infant outcomes are influenced by structural, political, and moral determinants of health. As clinicians in the neonatal intensive care unit (NICU) we are professionally obligated to enact structural and individual changes to mitigate disparities.  Therefore, recognizing and understanding how structural determinants of health (SDoH) affect our patients is paramount.

Objective: We developed a multidisciplinary case-based education conference for NICU staff of all disciplines. The objectives are for participants to name and recognize SDoH, understand how SDoH affect our patients and their families, and to shape a multidisciplinary NICU team committed to a workplace culture that promotes diversity, equity, inclusion and justice.

Design/Methods: The authors developed the objectives above with a plan to hold quarterly conferences named Health Equity in the NICU Rounds (HENR). Each HENR centers on the social and structural aspects of a particular patient case. Cases highlight structural racism, inadequate healthcare access, immigration concerns, custody, substance use disorder, poverty, incarceration and law enforcement involvement, spiritual or religious diversity, limited English proficiency, and/or literacy. We develop specific objectives and introduce terminology and concepts for shared learning and communication. We invite experts from various fields to broaden our understanding. Opportunities for personal reflection and group discussion are built into each conference. References and additional articles, books, podcasts, and/or documentaries are provided after each HENR for self-directed learning.

Results: In five conferences to date, a wide array of cases and SDoH were discussed [Table 1]. We have created a reflective space in which clinicians from various disciplines have voluntarily shared their perspectives and identified areas for personal and collective growth.Conclusion(s): Patient-centered, trauma informed care is essential in the NICU for the healing of neonates and their families. Encouraging an empathic staff that is well informed about SDoH is a step toward addressing disparities in pregnancy and neonatal outcomes. While education alone will not resolve inequities, we have successfully implemented a case-based curriculum to inform multidisciplinary clinicians about structural factors affecting our patients as one part of a multifaceted approach to health equity in our NICU.
Table 1. Summary of Health Equity in the NICU RoundsEach row summarizes one HENR. CHD- congenital heart disease; ELBW- extremely low birth weight; CDC- Center for Disease Control; LEP- limited English proficiency.