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Learning Objectives: To deliver evidence-based health equity education in resident and faculty conference using case-based content to highlight examples of inequity in emergency medicine practice.Background: While GME requires formal education on health disparities, there is a lack of standardized education in emergency medicine (EM) residency curricula on these topics. Educational Objectives: 1. To evaluate health disparities in an evidence-based manner using anonymized ED-specific case examples 2. To increase structural competency regarding the systems that perpetuate these disparities 3. To equip EM providers with actionable steps to mitigate these disparities 4. To develop a curriculum that can be replicated by other programs. Curricular Design: The Health Equity Curriculum (HEC) was developed using Kern’s curricular design framework. A consensus group of residents and faculty members met over 4 months to identify curriculum gaps. Patient and provider-centered topics were identified through informal needs assessment of the trainees with the plan to deliver them over two years. To maximize reach, the 30-minute HEC lectures were integrated into the monthly morbidity and mortality (M&M) conference stressing how healthcare disparities lead to measurable adverse outcomes. This approach was modeled after a surgical M&M series at the University of Michigan with proven success. Interested residents prepared lectures for each topic using a standard format. Faculty experts were recruited to mentor each resident. The concept was introduced at faculty meetings and residency conference with the support of departmental and residency leadership. Monthly lectures were launched in February 2021, with topics presented in a stepwise fashion to allow each lecture to build upon previous ones. Feedback was collected after 6 months via anonymous surveys sent by email. Impact/Effectiveness: Our HEC contributes to GME by providing an evidence-based series of lectures generalizable to all EDs. Our 6-month survey respondents expressed an overall satisfaction with the curriculum in increasing their understanding of health disparities.

ObjectiveGiven the variability in crisis standards of care (CSC) guidelines during the COVID-19 pandemic, we investigated the racial and ethnic differences in prioritization between 3 different CSC triage policies (New York, Massachusetts, USA), as well as a first come, first served (FCFS) approach, using a single patient population.MethodsWe performed a retrospective cohort study of patients with intensive care unit (ICU) needs at a tertiary hospital on its peak COVID-19 ICU census day. We used medical record data to calculate a CSC score under 3 criteria: New York, Massachusetts with full comorbidity list (Massachusetts1), and MA with a modified comorbidity list (Massachusetts2). The CSC scores, as well as FCFS, determined which patients were eligible to receive critical care under 2 scarcity scenarios: 50 versus 100 ICU bed capacity. We assessed the association between race/ethnicity and eligibility for critical care with logistic regression.ResultsOf 211 patients, 139 (66%) were male, 95 (45%) were Hispanic, 23 (11%) were non-Hispanic Black, and 69 (33%) were non-Hispanic White. Hispanic patients had the fewest comorbidities. Assuming a 50 ICU bed capacity, Hispanic patients had significantly higher odds of receiving critical care services across all CSC guidelines, except FCFS. However, assuming a 100 ICU bed capacity, Hispanic patients had greater odds of receiving critical care services under only the Massachusetts2 guidelines (odds ratio, 2.05; 95% CI, 1.09 to 3.85).ConclusionVarying CSC guidelines differentially affect racial and ethnic minority groups with regard to risk stratification. The equity implications of CSC guidelines require thorough investigation before CSC guidelines are implemented.