Abstract：
BACKGROUND: Across surgery, marginalized individuals experience worse postoperative outcomes. These disparities stem from the interplay between multiple factors.
METHODS: We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys.
RESULTS: Access and bias were related to surgical complications in 14 % of cases. 97 % reported enhanced M&M presentations with the grading system, and 47 % reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues.
CONCLUSIONS: Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.
METHODS: We introduced a novel framework to assess the role of barriers to access and bias in surgical complications (the uChicago Health Inequity Classification System, CHI-CS) in the setting of morbidity and mortality conference and assessed impact through pre and post implementation surveys.
RESULTS: Access and bias were related to surgical complications in 14 % of cases. 97 % reported enhanced M&M presentations with the grading system, and 47 % reported a change in decision-making or practice style. Although post-implementation response rate was low, there were improvements in self-reported confidence and comfort in recognizing and discussing these issues.
CONCLUSIONS: Implementation of the CHI-CS framework to discuss bias and access to care positively impacted the way providers view, discuss, and process health inequities.
摘要：
背景：在整个手术中，边缘化个体术后结局较差。这些差异源于多种因素之间的相互作用。
方法：我们引入了一个新颖的框架来评估进入障碍和偏见在手术并发症中的作用（uChicagoHealthInquityClassificationSystem，CHI-CS）在发病率和死亡率会议的背景下，并通过实施前后的调查评估影响。
结果：在14%的病例中，通路和偏倚与手术并发症有关。97%的人报告说，通过评分系统增强了M&M演示，47%的人报告决策或实践风格发生了变化。尽管实施后的答复率很低，在认识和讨论这些问题时，自我报告的信心和舒适度有所改善。
结论：实施CHI-CS框架以讨论偏见和获得护理的方式对提供者的看法产生了积极影响，讨论,和过程健康不平等。
方法：我们引入了一个新颖的框架来评估进入障碍和偏见在手术并发症中的作用（uChicagoHealthInquityClassificationSystem，CHI-CS）在发病率和死亡率会议的背景下，并通过实施前后的调查评估影响。
结果：在14%的病例中，通路和偏倚与手术并发症有关。97%的人报告说，通过评分系统增强了M&M演示，47%的人报告决策或实践风格发生了变化。尽管实施后的答复率很低，在认识和讨论这些问题时，自我报告的信心和舒适度有所改善。
结论：实施CHI-CS框架以讨论偏见和获得护理的方式对提供者的看法产生了积极影响，讨论,和过程健康不平等。
