ABSTRACT
Background
Quality measures within Emergency Medicine (EM) were developed to standardize and
improve care. Their development has been limited by lack of consideration of sex-
and gender-based differences. Research has suggested that sex and gender can impact
clinical care and treatment. Inclusion of sex and gender differences is needed to
create EM quality measures that are equitable to all.
Objective of the Review
The aim of the review is to provide a brief history of EM quality measures and the
value of considering sex- and gender-based evidence in their development to ensure
equity, using acute myocardial infarction (AMI) as an example.
Discussions
Current quality measures related to AMI such as time-to-electrocardiogram and door-to-balloon
time in percutaneous coronary intervention may have important and modifiable disparities
when stratified by sex. Even when presenting with signs and symptoms of AMI, women
experience delayed time to diagnosis and treatment. Few studies have considered interventions
to mitigate these differences. However, the data available suggest that sex-based
disparities can be minimized by implementation of strategies such as a quality control
checklist.
Conclusions
Quality measures were created to deliver high quality, evidence-based, and standardized
care, but without the inclusion of sex and gender metrics, they may not advance care
to an equitable level.
Keywords
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Article info
Publication history
Accepted:
March 11,
2023
Received in revised form:
March 7,
2023
Received:
September 27,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
