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Thursday, August 23, 2018

Implicit Bias in Patient Care: An Endemic Blight on Quality Care

JoAnn Grif Alspach
Critical Care Nurse
August 2018 vol. 38 no. 4 12-16

Here is an excerpt:

How Implicit Bias Is Manifested

A systematic review by Hall and colleagues revealed that implicit bias is manifested in 4 key areas: patient-provider interactions, treatment decisions, treatment adherence, and patient health outcomes. How a physician communicates, including verbal cues, body language, and nonverbal behavior (physical proximity, frequency of eye contact) may manifest subconscious bias.7,10 Several investigators found evidence that providers interact more effectively with white than nonwhite patients. Bias may affect the nature and extent of diagnostic assessments and the range and scope of therapies considered. Nonwhite patients receive fewer cardiovascular interventions and kidney transplants. One meta-analysis found that 20 of 25 assumption method studies demonstrated bias either in the diagnosis, treatment recommendations, number of questions asked, or tests ordered. Women are 3 times less likely than men to receive knee arthroplasty despite comparable indications. Bias can detrimentally affect whether patients seek or return for care, follow treatment protocols, and, perhaps cumulatively, can influence outcomes of care. Numerous research studies offer evidence that implicit bias is associated with higher complication rates, greater morbidity, and higher patient mortality.

The info is here.