In this episode, we are going to discuss the impact of diagnostic errors on health equity. For patients of color, the unequal medical care and quality of the diagnosis received isn’t due to just location, education, or income. It’s also at times due to healthcare professionals’ cognitive biases, along with decades of clinical studies that examined only white, male bodies, and a lack of understanding about the social determinants of biological illnesses.
The causes of poor quality diagnosis for people of color is multifactorial and is not just related to explicit or implicit racial bias, however -- lack of trust, missing data, and reduced data at the point-of-care are just a few of the other contributing factors. Although health inequities within communities of color have persisted for hundreds of years, many are just now waking up to the problem.  There is now an elevated sense of awareness of health inequities in our country due to the exacerbated health outcomes triggered by COVID-19 and preexisting disparities that have been magnified under the microscope of the pandemic.
If one studies history, you can easily find preexisting health inequities that took form long before COVID. It is widely accepted that the first kidnapped Africans to reach European colonies in the Americas for the purposes of slavery did so in 1619 – meaning Black health was ignored from or country’s beginning with health disparities persisting through the next 400+ years. The very foundation of the transatlantic slave trade is false medical theories of black inferiority and physical differences between blacks and whites.
To better how the patient safety movement aligns with health equity, healthcare professionals should listen to Dr. Ronald Wyatt.  Dr. Wyatt is one of the most renowned patient safety experts and health equity champions in this country.  He is Vice-President and Patient Safety Officer at MCIC Vermont, a risk-retention group, where he leads multiple patient safety initiatives for several leading academic health systems. He is an internationally known equity, safety and quality improvement/implementation expert. Dr. Wyatt was the first co-chair of the Institute for Healthcare Improvement (IHI) Equity Advisory Group and is faculty for the IHI Pursuing Equity Initiative. After serving as the Medical Director for the US Defense Health Agency/Military Health System Patient Safety Analysis Center, he became the first medical director of The Joint Commission (TJC) Office or Quality and Patient Safety and the first patient safety officer for The Joint Commission. While at TJC, Dr. Wyatt led the team that wrote the Patient Safety Systems Chapter, contributed to Sentinel Event Alerts and created the Quick Safety publication. He served as technical advisor on the RCA2 document that has been widely adopted as a guide to completing a root cause analysis.
Dr. Wyatt is a member of the ACGME Clinical Learning Environment Review committee, as well as faculty on the ACGME Disparity Collaborative. He also serves on several boards including the IHI Certified Professional in Patient Safety, the Society to Prevent Diagnostic Error and the Consumers Advocating for Patient Safety. Currently, he is faculty/advisor/coach on multiple health equity collaboratives including BCBS Massachusetts/IHI, ACGME BCBS Illinois Equity Matters, KC Learning Action Network and the Providence health system equity collaboratives. Dr. Wyatt has written and published many articles, blog pieces and chapters on patient safety, health equity/disparity and process improvement.

Episode Bookmarks:
01:30 Introduction to Dr. Ron Wyatt
04:30 The human cost of diagnostic error (patient deaths due to a diagnostic error are estimated at 40,000-80,000 per year!)
06:00 “To make the right diagnosis in a timely manner is a core quality component.”
06:30 Dr. Wyatt discusses how correct diagnoses are the link between patient safety and healthcare quality.

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