Health Equity Morbidity and Mortality Conferences in Obstetrics and Gynecology

Abstract

Maternal mortality and morbidity continue to occur at unacceptably high levels in the United States, with communities of color experiencing significantly higher rates than their White counterparts, even after adjustment for confounding factors such as socioeconomic status. Many obstetrics and gynecology departments across the country have begun to incorporate routine discussion and analysis of health equity into peer review and educational processes, including grand rounds and morbidity and mortality conferences. Despite the desire and drive, there is little published guidance on best practices for incorporation of an equity component into these conferences. This document outlines the current processes at four academic institutions to highlight the variety of ways in which health equity and social justice can be incorporated when analyzing patient experiences and health outcomes. This commentary also provides a list of specific recommendations based on the combined experiences at these institutions so that others across the country can incorporate principles of health equity into their peer-review processes.

The Disparity Morbidity and Mortality Conference

“…The value of the program has been underscored by the regular attendance of residents, faculty within the department, health system executives, and various leaders of the medical school. Since the inaugural Surgical Disparity M&M, the program has been adopted by other departments within the institution, including cardiology, neurosurgery, and gastroenterology, and is in the process of being implemented at other institutions across the country 10. The widespread adoption of Disparity M&M by other departments and at other institutions further demonstrates the importance of integrating social determinants of health into the discussion of adverse patient outcomes.…”

“…Since the inaugural Surgical Disparity M&M, the program has been adopted by other departments within the institution, including cardiology, neurosurgery, and gastroenterology, and is in the process of being implemented at other institutions across the country. 10 The widespread adoption of Disparity M&M by other departments and at other institutions further demonstrates the importance of integrating social determinants of health into the discussion of adverse patient outcomes. Furthermore, involvement of members from the state legislature has prompted policy change on a state-wide scale and has generated systemsbased change to minimize health care disparity for patients from all socioeconomic backgrounds.…”

Strategies to Promote Maternal Health Equity

“…This education can also be integrated into traditional departmental education, such as continuing education series, trainee curriculum, morbidity and mortality rounds, and grand rounds. 36 , 52 In 2021, Arrington et al 34 reported an increase in health care professional attribution as a measure of readiness to address health inequities, after engaging 65% of the labor and delivery staff in events to raise awareness of health inequities and bias through social events, grand rounds, and synchronous and asynchronous learning.…”