From quality improvement to equality improvement projects: A scoping review and framework

Increasing awareness of health disparities has led to proposals for a pay-for-equity scheme. Implementing such proposals requires systematic methods of collecting and reporting health outcomes for targeted de-mographics over time. This lays the foundation for a shift from quality improvement projects (QIPs) to equality improvement projects (EQIPs) that could evaluate adherence to standards and progress toward health equity. We performed a scoping review on EQIPs to inform a new framework for quality improvement through a health equity lens. Forty studies implemented an intervention after identifying a disparity compared to 149 others which merely identified group differences. Most evaluated race-based differences and were conducted at the institutional level, with representation in both the inpatient and outpatient settings. EQIPs that improved equity leveraged multidisciplinary expertise, healthcare staff education, and devel-oped tools to track health outcomes continuously. EQIPs can help bridge the inequality gap and form part of an incentivized systematic equality improvement framework.

Automated summary

Increasing awareness of health disparities has led to proposals for a pay-for-equity scheme. Implementing these proposals requires systematic methods of collecting and reporting health outcomes. A scoping review on EQIPs found that most interventions focused on race-based differences at the institutional level, utilizing multidisciplinary expertise and tools for continuous tracking of health outcomes. EQIPs can help bridge the inequality gap and form part of an incentivized systematic equality improvement framework.