The CLE's Role in Preparing New Clinicians to Engage in Quality Improvement Efforts to Eliminate Health Care Disparities

Abstract

Across the United States, inequities in health care persist. Differences in the quality of health care, or health care disparities, occur across numerous dimensions including race, ethnicity, sex, geographic location, socioeconomic status, sexual orientation, gender identity, and many others. 1,2 These disparities are complex and likely a result of numerous factors. As a result, meaningful change will require action at all levels of the health care system. For health care organizations, action to eliminate health care disparities includes systems-based approaches to identify and address inherent biases, misguided processes, and missed opportunities to deliver optimal care to all patient populations. Such approaches start with data collection and analysis to inform focused, culturally appropriate quality improvement (QI) initiatives. Engaging new clinicians is a key element of any systems-based approach, as new clinicians will shape the future of health care delivery. Clinical learning environments (CLEs), or the hospitals, medical centers, and ambulatory care clinics where new clinicians train, have an important role in this process. The transition from undergraduate or preprofessional training to clinical care is the optimal time to engage new clinicians as they are just beginning to develop practices that will likely be with them for decades. 3 By helping new clinicians continually monitor for equity as they care for patients and by giving them the skills to address disparities in care, CLEs have the potential to change organizational culture and shape a workforce that is prepared to engage with and treat every patient according to their needs. The National Collaborative for Improving the Clinical Learning Environment (NCICLE) developed this document as a guide for CLEs in engaging new clinicians in QI efforts to eliminate health care disparities. As co-chairs of the work group that authored the document, we were privileged to work with an interprofessional team that brought diverse perspectives to the common goal of envisioning a set of expectations for engaging new clinicians in addressing health care disparities. Our hope is that this document will inspire and guide CLE leaders across the country as they develop and implement strategic initiatives to ensure health care equity now and into the future.

Adaptability, Agency, and Association to Influence Change: The Report of the 2020-21 AACP Argus Commission

“…A report published in 2019 reflects the work of a committee that makes recommendations related to the timely topic of preparing new clinicians to engage in quality improvement efforts to eliminate health care disparities. 37 Health equity and social determinants of health represent important areas for interprofessional learning and practice.…”