Aiming beyond equality to reach equity: the promise and challenge of quality improvement

Abstract

Quality improvement must move beyond only measuring average quality and change and focus on equity to support achieving the quality needed for effective universal health coverage, argue Lisa Hirschhorn and colleagues• We suggest five key areas where strategies for quality improvement need to tackle inequity: stakeholder engagement, measurement, design, improvement work, and learning

Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

“…For example, MRI should be used instead of CT imaging for stroke management. This outcome supports the idea suggested in a recent BMJ article [26]. This state of poor quality of patient care could contribute to more mortality rates than the lack of access to services.…”

“…The aim of this study is to examine the characteristics of patients undergoing diagnostic neuroimaging across the U.K., including race, socio-economic status and disease severity, to determine whether there is a significant inequality in access to the required neuroimaging technology. As quality of health care varies across subpopulations in the U.K., we intend to identify where targeted interventions could be implemented to improve the inequities as well inequalities faced by minority populations [26,27]. This qualitative study follows the Population, Interest, Context (PICo) format (Table 3).…”

“…Service provided for each area is dependent on the demand, which means that access to specialised services varies across the U.K. Therefore, the outcomes of this study will allow for targeted interventions to improve health systems for subpopulations [26].…”

“…This evidence proves that it would be more cost-effective to provide patients with a form of neuroimaging to prevent further damage and cost despite the fact that it is not accessible. A study conducted on CT access within hospitals in relation to minor head injury reported that only 3.4% (6/174) of hospitals in their survey did not have unrestricted access to CT technology; however, most patient admissions required approval by a senior or specialist doctor (119/174; 68.3%) [26].…”

Covid-19: The UK’s political gamble that bodes ill for health and the health service

“…9 Many of those who can work are burnt out (doi:10.1136/bmj.n1823)10; there is no end, no Dr Robotnik big boss finale (doi:10.1136/bmj.n1813). 11 When staff are under pressure, the virtues of quiet listening, of so much benefit to patients (doi:10.1136/bmj.n1757),12 are lost; hope of delivering quality of care that is equitable (doi:10.1136/bmj.n939),13 of levelling up, becomes more distant.…”