Effectiveness of the uChicago Health Inequity Classification System on surgical morbidity and mortality conference: A pilot study.

Background: Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors.
Methods: We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys.
Results: Access and bias were related to surgical complications in 14 ​% of cases. 97 ​% reported enhanced M&M presentations with the grading system, and 47 ​% reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues.
Conclusions: Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.
Competing Interests: Declaration of competing interest I declare that the manuscript is original, has not been published before, and is not currently being considered for publication elsewhere and will not be sent to another journal until a decision is made concerning publication by The American Journal of Surgery. The authors have no relevant financial disclosures or conflict of interests. All authors have seen and approved the final version of this manuscript as well as fulfill the COPE (Committee on Publication Ethics) requirements for authorship.
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