Critical care clinics
-
Critical care clinics · Oct 2024
ReviewRacial, Ethnic, and Socioeconomic Differences in Critical Care Near the End of Life: A Narrative Review.
Patients from groups that are racially/ethnically minoritized or of low socioeconomic status receive more intensive care near the end of life, endorse preferences for more life-sustaining treatments, experience lower quality communication from clinicians, and report worse quality of dying than other patients. There are many contributory factors, including system (eg, lack of intensive outpatient symptom management resources), clinician (eg, low-quality serious illness communication), and patient (eg, cultural norms) factors. System and clinician factors contribute to disparities and ought to be remedied, while patient factors simply reflect differences in care and may not be appropriate targets for intervention.
-
Critical care clinics · Oct 2024
ReviewDisparities in Access, Management and Outcomes of Critically Ill Adult Patients with Trauma.
Despite legal protections guaranteeing care for patients with trauma, disparities exist in patient outcomes. We review disparities in patient management and outcomes related to insurance status, race and ethnicity, and gender for patients with trauma in the preadmission, in-hospital, and postdischarge settings. We highlight groups understudied and either underrepresented or unrepresented in national trauma databases-including American Indians/Alaska Natives, non-English preferred patients, and patients with disabilities. We call for more study of these groups and of upstream factors affecting the reviewed demographics to measure and improve outcomes for these vulnerable populations.
-
Critical care clinics · Oct 2024
ReviewCultivating Diversity, Equity, and Inclusion in Pulmonary and Critical Care Training: A Path Toward Health Care Excellence.
Pulmonary and Critical Care Medicine (PCCM) fellowship training faces increasing competition but lacks diversity, hindering health care excellence. Despite a growing interest in the field, programs lack diverse representation. ⋯ Sustainable solutions are vital for achieving diversity, equity, and inclusion in PCCM. Strategies for achieving equity among training programs include adopting inclusive recruitment practices, recognizing differential attainment, addressing bias, fostering an equitable academic climate, and implementing multifaceted strategic processes to enhance diversity in mentorship including recognition and compensation for diversity and equity work.
-
Critical care clinics · Oct 2024
ReviewWorkforce Diversity and Equity Among Critical Care Physicians.
Health disparities persist among minoritized populations. A diverse clinician workforce may help address these disparities and improve patient outcomes; however, diversity in the critical are workforce (particularly among women and those historically underrepresented in medicine (URiM)) is lacking. This review describes factors contributing to low respresentation of women and URiM in critical care medicine, and proposes strategies to overcome those barriers.
-
Critical care clinics · Oct 2024
ReviewRace and Ethnicity Disparities in Management and Outcomes of Critically Ill Adults with Acute Respiratory Failure.
This article reviews the current evidence base for racial and ethnic disparities related to acute respiratory failure. It discusses the prevailing and most studied mechanisms that underlay these disparities, analytical challenges that face the field, and then uses this discussion to frame future directions to outline next steps for developing disparities-mitigating solutions.