123 - Improving diversity, equity and inclusion content in Pediatric Grand Rounds

Poster Number: 123
Publication Number: 123.216

Desiree Leverette, Yale-New Haven Children's Hospital, New Haven, CT, United States; adam berkwitt, Yale Pediatrics Residency Program, Yale School of Medicine, Department of Pediatrics, New Haven, CT, United States; Matthew Grossman, Yale School of Medicine, New Haven, CT, United States; Channelle Carr, Yale-New Haven Children's Hospital, New Haven, CT, United States; Faith D. Crittenden, Yale-New Haven Children's Hospital, West Haven, CT, United States; Pnina Weiss, Yale School of Medicine, New Haven, CT, United States; Sharon Ostfeld-Johns, Yale New Haven Hospital, New Haven, CT, United States; Andrew Taylor, Yale School of Medicine, West Haven, CT, United States; Karina Amaya, Yale School of Medicine, West Hartford, CT, United States; Jessica Malcolm, Yale-New Haven Children's Hospital, New Haven, CT, United States; Brittney Dioneda, Yale-New Haven Children's Hospital, New Haven, CT, United States

Background: Addressing racism and structural inequality within medical education is critical to developing equitable care. Development of presentations that consistently and specifically address aspects of diversity, equity, and inclusion (DEI) is also essential to sustainably reaching this goal. Grand Rounds (GR) serves as a cornerstone of academic departments and increasing DEI content has great potential for addressing the hidden curriculum and enhancing the educational climate.

Objective: We aimed to consistently increase content addressing DEI in our institution’s Pediatric GR. Specifically, using a novel tool (Figure 1) to evaluate DEI content, we sought to increase the average presentation’s score to ≥ 4 within 2 years.

Design/Methods: We implemented quality improvement methodology, following the Model for Improvement to reach our aim of a shift in practice with 6 consecutive scores ≥ 4. We formed a multidisciplinary team including pediatric residents and members of the Offices of Education, DEI and Quality Improvement. We retrospectively applied our novel scoring tool to previous GR presentations to determine a baseline period and then prospectively scored presentations weekly at GR. We subsequently developed key drivers and 5 interventions (Figure 2), which included 1) creating 4 GR per year dedicated specifically to DEI topics, 2) revising our GR mission statement to include DEI objectives, 3) sharing goals and expectations to include DEI content with upcoming speakers, 4) seeking feedback from GR speakers, and 5) providing resource materials to them to enhance their ability to address DEI. We performed PDSA cycles on these interventions, incorporating feedback from speakers and our team to adopt, adapt or abandon interventions. We tracked outcome data using a statistical process control chart and compared average scores between the baseline and post-intervention periods using a two-tailed t-test.

Results: Our control chart does not yet demonstrate a shift, but there have been 11 points above the control limits after beginning interventions (Figure 3). The average score of DEI content increased from 1.2 (CI95 0.7-1.7) at baseline to 3.8 after intervention (CI95 2.2-5.4, p = < 0.001). Feedback from speakers demonstrated the importance of providing resources to increase DEI content.Conclusion(s): By using a QI approach, we were able to increase the DEI content of Pediatric GR with interventions aimed at providing clear goals, expectations and resource materials to speakers. Given the wide GR audience, our strategy has the potential to enhance our department’s educational environment.
Figure 1: Scoring Tool
Figure 2: Key Driver's Diagram