Society for Maternal-Fetal Medicine Special Statement: How to incorporate health equity into quality improvement and patient safety efforts

Optimizing health outcomes among historically marginalized racial and ethnic communities, especially in obstetrics, has tremendous potential to improve the lives of not only patients and their families but also future generations. Understanding potential drivers of health inequities in obstetrics is critical to eliminating them. This Special Statement delivers a comprehensive, action-driven framework that builds on the recommendations in Society for Maternal-Fetal Medicine Consult Series #62: Best Practices in Equitable Care Delivery—Addressing Systemic Racism and Other Social Determinants of Health as Causes of Obstetrical Disparities. We provide strategies to integrate the evaluation of social drivers of health and health disparities into quality and safety case reviews, thereby advancing equity as a fundamental dimension of healthcare excellence. We demonstrate how to incorporate a health equity lens into patient safety events, specifically severe maternal morbidity case reviews and root cause analyses. Through an enhanced case review process that considers health and healthcare inequities as potential contributing factors, hospital quality improvement efforts can target upstream contributors to health outcomes so that adverse outcomes around the time of delivery may be averted.