Improving Race and Ethnicity Data Collection in an Academic Neonatal Intensive Care Unit.

Abstract

There are significant racial and ethnic inequities in neonatal care and outcomes. Accurate race and ethnicity demographic information is the cornerstone of equity-focused quality improvement. The collection of accurate race and ethnicity demographic information is complex for neonates that cannot self-report and do not yet have personal identity formation. In a large, academic, level III neonatal intensive care unit (NICU), we implemented a quality improvement initiative aimed at increasing the completeness and accuracy of race and ethnicity demographic information in patient records. We conducted a quality improvement initiative using data from January 2021 to June 2025 among patients admitted to a large, academic, level III NICU. The primary goal was to reduce the percentage of missing or unknown racial and ethnic demographic information. Our study included a preintervention data quality assessment period followed by 3 plan-do-study-act (PDSA) cycles focused on patient registration and cross-departmental collaborations with the birth registry and the Department of Obstetrics and Gynecology. During the preintervention data quality assessment, we demonstrated a steady state with 30% of patients admitted to the NICU having missing or unknown race and ethnicity demographic information. We observed 3 shifts associated with PDSA cycles. During the last PDSA cycle, the missing or unknown demographic information was 10%. We decreased the proportion of missing or unknown demographic data in a large, academic, level III NICU through a multidisciplinary hospital-wide collaboration. This initiative serves as the first step to implement equity-focused quality improvement.