Use of health equity tools in patient safety incident analyses: a scoping review
Bibliographic record
Abstract
OBJECTIVES: The aim of this study is to investigate the use and effectiveness of equity tools in current practices of patient safety incident analyses via a scoping review of the literature. DESIGN: Scoping review of the literature using the two main search term concepts "health equity" AND "safety review". The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was used to report in this paper. DATA SOURCES: Databases including but not limited to MEDLINE, Embase and PubMed were searched from inception to 16 January 2023. ELIGIBILITY CRITERIA: Studies that included an equity tool in patient safety reviews were included. There were no restrictions on language or setting for included studies. Review articles were excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search and screen included articles. Data from included studies was extracted and compiled. RESULTS: Five studies out of 5026 screened studies were included in the final analysis, 4 were conducted in the USA and 1 in Norway. While all studies identified equity domains to guide their approach to the provision of more equitable care, only three proposed change ideas and one implemented their framework to evaluate the role of social determinants and bias in adverse events. Communication was the most common theme found across four of the five studies. Access to healthcare services and bias were included as equity domains in two of the five studies. Implicit bias training was one of the identified change ideas. Other change ideas included improving access and communication, for example, through increasing the use and availability of interpreter services. One of the studies piloted the implementation of their equity checklist and found adverse event causes rooted in equity in 50% of the cases. CONCLUSIONS: This scoping review demonstrates that there is a gap in current patient safety incident analyses, specifically lacking the consideration of equity domains. The development of a comprehensive health equity tool is necessary to promote equitable and safe care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.254 | 0.487 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.007 | 0.012 |
| Bibliometrics | 0.042 | 0.026 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.011 | 0.015 |
| Open science | 0.004 | 0.008 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".