Improving Equity in Healthcare Through Hospital Safety Monitoring Systems

Canadian Patient Safety Week (CPSW)  October 28-November 1, 2024

Canadian Patient Safety week is encouraging us to think more deeply about the categories of safety incidents (e.g., demeaning or dehumanizing incidents, culturally unsafe care) and the people receiving and delivering healthcare that can experience harm (e.g., patients, community members, clinical and non-clinical staff). Aligned with this focus, a CQuIPS led research project funded by the Canadian Institutes of Health Research (CIHR), is examining how an equity lens can be incorporated into two hospital safety monitoring systems – incident reporting and patient concerns. This 3-year interdisciplinary and intersectoral project, launched in summer 2024, engages essential collaborators, including patient/public members, from Ontario, British Columbia, Alberta, and Quebec.  

The integration of an equity lens into hospital safety monitoring systems has been largely overlooked until now. Through interviews, consensus-building activities, and a national survey, we will develop the first comprehensive guide on how hospitals can address inequities within their safety monitoring processes. This guide will include an online pan-Canadian equity integration assessment survey and tailored recommendations, ensuring that hospitals can systematically understand and act upon equity considerations in relation to the ‘work system’ and its interacting elements defined as person, tasks, tools/technologies, environment, and organization. This is the first initiative of its kind to provide hospitals with a framework and tools to transform their safety monitoring systems to better serve all populations, moving beyond generic safety protocols to those that recognize and address specific equity-related harms. 

 It is anticipated that this project will have a transformative impact on how hospitals across Canada, and potentially internationally, monitor and address equity in patient safety.  We hope to see widespread engagement of our equity integration assessment and recommendations guide, with hospitals improving incident reporting and patient concern systems, and creating new approaches, to identify, understand, learn from and make changes in relation to equity-related safety threats. This work also has the potential to inform national and international patient safety frameworks, ensuring that equity is embedded into all levels of safety monitoring, from frontline care to policy-making. Our ultimate aim is to create a healthcare system that is more equitable, safer, and responsive to the needs of all patients.