| Vision Statement | The ultimate goal of this project is to build a resident-led healthcare disparities initiative that will enhance resident, faculty, and organizational knowledge of the healthcare disparities affecting the patients we serve, thereby allowing Our Lady of the Lake (OLOL) to better address its patients’ healthcare disparities in the future. |
| Team Objectives | OLOL is the sponsoring institution for a pediatric residency program and serves as the primary clinical site for 4 Louisiana State University residency programs. OLOL has an opportunity to better engage its residents in identifying and addressing the healthcare disparities that exist within our patient population. Effective population health interventions must be grounded in the specific needs of the communities being served. The purpose of our project was to explore the effects of educational and behavioral interventions on the willingness of resident physicians to engage their patients in discussions of socioeconomic determinants of health, as well as residents’ knowledge regarding their patient population’s health disparities. Our project focused on residents from programs that have significant outpatient and ED contact with patients: internal medicine, emergency medicine, pediatrics, psychiatry, ENT, and surgery. |
| Success Factors | The most successful part of our work was the buy-in and participation from faculty and resident champions, highlighting the importance of the topic to medical education. Resident champions took ownership of the project and motivated their peers to participate in the education and intervention phases. Faculty members were essential in disseminating information vital to the project implementation. While both interventions showed at least some gain in resident knowledge or change in resident attitude, the didactic session appeared to be more effective. We were inspired by the level of motivation from the resident champions as well as participating residents. The education and intervention led residents to engage in quality interventions and research projects outside the scope of this project that focused on healthcare disparities. This motivation to further pursue projects that address issues within their patient population is an attestation of what the project accomplished. |
| Barriers | The largest barrier encountered was that there was no way to be sure each resident added the residency-specific dot phrase to their note templates. Residents reported willingness but often forgetfulness in asking the specific question. This could be a reason the didactic session had a stronger impact on resident knowledge and behavior compared to the intervention phase. We worked to overcome this challenge by asking the residents to self-report if they did ask the questions/use the dot phrase. There is bias in self-reporting, but results showed that the residents who asked their patients the questions more frequently reported a higher increase in subjective importance after the intervention phase. |
| Lessons Learned | The single most important piece of advice to provide another team embarking on a similar initiative is to plan a slower, more thorough rollout of the behavioral intervention to ensure the successful adoption of a dot phrase or z-codes so that the intervention is more effective in getting the residents in the habit of asking their patients about barriers to healthcare. |