Assessment of Bias in Agitation Management: How to elucidate etiology of bias and educate staff to provide the most equitable care in challenging situations

Abstract:
Background/Significance: Bias is present in medicine; it is an unfortunate reality in which we live. However, there is room to improve our healthcare landscape for patients. To do so, we must have a sense of where bias stems from and how that creates differences in care. Available literature shows that black patients are 13-22% more likely to be restrained compared to white patients (Jin, 2021). Other studies have shown that black patients have a 2.2% increased chance of receiving chemical sedation compared to white patients, with this difference remaining constant when controlling for psychiatric admission (Kharti 2022). These studies were performed in the emergency department, but we expect similar findings across hospitals.



Methods: We have a great resource at our disposal within our hospital system: the condition support, a multidisciplinary care team which responds and helps units and primary teams manage people who have behavioral challenges while hospitalized. All these condition supports are reviewed on a biweekly basis to identify opportunities for improvement. We have undergone exploration of racial bias as it pertains to our system’s agitation management via review of our condition supports, reviewing demographic information and interventions performed, iincluding restraints and medication use. Quality Improvement IRB approval was obtained for this review. Data analysis is under way.



Results: Results from analysis are pending.

Discussion/Implications: We expect to find biases in the handling of condition supports, particularly with regards to restraints in black patients but are reviewing with many factors in mind. We hope to use this information to develop targeted educational interventions to promote equitable care in our community