Trinity Health
Novi, Mich.

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Equity in Care was initiated by Trinity Health in 2009 as the Circuit Breaker project — a system-wide effort for the community benefit departments in all Trinity Health System hospitals. Its purpose was to collect self-identified patient information on race, ethnicity and language preference. An internal team was assembled by Mercy Health Partners to train all registration staff on how to obtain this information from patients at registration.

Following completion of the project in May 2009, it became the Equity in Care Initiative, as part of an Equity Quality Improvement Collaborative funded by a Robert Wood Johnson Foundation grant. The combined Equity in Care project was expanded to include identifying potential disparities in cardiac care in a patient population stratified by race, ethnicity and primary language; overall management was through George Washington University.

Beginning in July 2009, all inpatient and emergency department registrations across our member hospitals were stratified by patient-identified race, ethnicity, and primary language with that information entered into our electronic medical record systems. Staff and patient education was carried out with subsequent surveys of both groups demonstrating wide acceptance of the new registration process and questions. Quality review supported the position that the data was indeed patient-identified, and collected on virtually every registration in the mentioned areas.

Data reports were first obtained in August of 2009, and submitted to George Washington University on a monthly basis through December of 2010. Although grant support for the project ended at that point, data collection continues. Our progress and results were reviewed at two national meetings in Washington, D.C., and Orlando, Fla.; to date no statistically significant difference in outcomes by race, ethnicity or primary language has been identified.