The Impact of Racial and Gender Bias on Patient Safety in Hospital and Surgical Settings

Although racial and gender biases have a longstanding history in medicine, and society as a whole, COVID-19 brought these issues to the forefront of medicine. Mounting evidence now indicates how these biases impact patient safety and health outcomes, and physicians and healthcare providers should be aware of the potential risk created by racial and gender bias in clinical settings.

We found a couple of recent articles that discuss what’s at stake for both patients and physicians in hospitals and operating rooms:

• A recent report published by the Urban Institute explores racial disparities in health outcomes, specifically differences in Black and white patients’ safety during hospitalization. Using discharge records and data on 11 key safety indicators – like pressure ulcer rate, in-hospital fall hip fracture rates, postoperative respiratory failure rate and postoperative sepsis – researchers found that Black patients experienced “significantly worse” safety outcomes compared to white patients of the same age and gender. Black patients also experienced higher rates of hospital acquired illness or injury during or shortly after surgical procedures.

• Gender bias can also impact patent safety, as noted by Kelly Wright, MD, in a Medpage Today opinion piece that describes a memorable personal experience in the operating room. “Toxicity and delays in the OR are an important patient safety issue,” she writes. “Psychological safety has a significant impact on whether a team member will speak up in a high stakes work environment. Microaggressions and bullying erode psychological safety, making a team more prone to errors.” Wright emphasizes the need for more data on how gender discrimination affects patient outcomes in the operating room and advocates for microaggressions and team conflicts to be reported like other safety issues: “They should be reviewed on a regular basis similar to a morbidity and mortality conference, with the goal of implementing process improvements and systemic change.”

According to an article published by The Joint Commission, organizational support, skills training and cognitive resources can help prevent bias from affecting care quality. The article suggests that these resources can help reduce bias by building helpful skills like empathy, emotional regulation and partnership building with patients. (See more recommendations from The Joint Commission here.)

Raising awareness of racial and gender bias in clinical settings is critical. MLMIC encourages physicians to be proactive in addressing gaps and disparities related to screening, detection, treatment and access to care.