Abstract
OBJECTIVE: There are significant racial and ethnic inequities in neonatal care and outcomes. Accurate race and ethnicity demographic information is the cornerstone of equity-focused quality improvement. The collection of accurate race and ethnicity demographic information is complex for neonates that cannot self-report and do not yet have personal identity formation. In a large, academic, level III neonatal intensive care unit (NICU), we implemented a quality improvement initiative aimed at increasing the completeness and accuracy of race and ethnicity demographic information in patient records.
METHODS: We conducted a quality improvement initiative using data from January 2021 to June 2025 among patients admitted to a large, academic, level III NICU. The primary goal was to reduce the percentage of missing or unknown racial and ethnic demographic information. Our study included a preintervention data quality assessment period followed by 3 plan-do-study-act (PDSA) cycles focused on patient registration and cross-departmental collaborations with the birth registry and the Department of Obstetrics and Gynecology.
RESULTS: During the preintervention data quality assessment, we demonstrated a steady state with 30% of patients admitted to the NICU having missing or unknown race and ethnicity demographic information. We observed 3 shifts associated with PDSA cycles. During the last PDSA cycle, the missing or unknown demographic information was 10%.
CONCLUSION: We decreased the proportion of missing or unknown demographic data in a large, academic, level III NICU through a multidisciplinary hospital-wide collaboration. This initiative serves as the first step to implement equity-focused quality improvement.
