Improving Capture of Race and Ethnicity Data in a Regional Neonatal Intensive Care Unit.

Abstract

Addressing disparities and improving outcomes for patients in a neonatal intensive care unit (NICU) requires accurate and reliable reporting of race and ethnicity. We sought to increase the percentage of infants with caregiver-reported race and ethnicity at NICU discharge to greater than 90% using quality improvement (QI) methods. We first identified drivers including standardization, increasing reliability, and addressing gaps in education and health literacy. Tests of change included revising forms to enhance clarity and support equity, addressing barriers to the reliable processing of paper forms, real-time auditing and clinical decision support in the electronic health record, and development of a patient portal prebirth electronic form. Statistical process control charts were used to track the outcome measure, the percentage of patients in a NICU who had caregiver-reported race and ethnicity documented at discharge, and the process measure of the percentage of infants whose forms were received within 7 days of admission. The average percentage of patients with caregiver-reported race and ethnicity documented at NICU discharge increased from 38% to 94%. The percentage of forms received within 7 days of admission increased from 81% to 96%. Improvements have been sustained for more than 18 months. We improved the documentation of caregiver-reported race and ethnicity among patients discharged from our NICU through rigorous QI methods. Accurate and reliable capture of race and ethnicity data should help identify and address disparities and improve care for all infants.