Literature Review Finds That Patient Safety May Be Especially Challenging For Marginalized Groups

Patient safety is a key priority for hospitals and other providers. Yet, patient safety may be especially challenging for marginalized groups, according to the authors of an article recently published in the International Journal for Equity in Health, titled Patient Safety in Marginalised Groups: A Narrative Scoping Review.

The authors of this article performed a systematic review of the literature to understand the range of patient safety issues for people considered marginalized. A total of 67 studies were reviewed.  Most of the studies were designed to ascertain whether the characteristics of the marginalized group made an impact on patient safety. 

The review identified 13 different marginalized groups, but the four most commonly addressed in the literature were ethnic minority groups; those residing in care homes; the frail elderly; and those of low socio-economic status. The review also identified 12 separate patient safety issues, though over half of the studies reviewed concerned three major topics: medication safety, adverse outcomes, and near misses.

The review revealed that, in most cases, multiple factors linked to marginalization appeared to  have a negative impact on patient safety. The two largest areas studied involved medication safety and ethnicity; still, the authors noted there was a paucity of patient safety research related to marginalized groups overall.   

The article’s conclusions are not surprising: concerns about the risk to marginalized communities in health care already have influenced public health policy. For example, in 2019, California adopted multiple laws designed to reduce the effects of implicit bias and reduce disparities in health care, including requirements that continuing education courses for certain health care providers include specified instruction on understanding implicit bias in medical treatment, and requirements that certain facilities implement evidence-based implicit bias programs for all health care providers involved in perinatal care within the facility. As a result of the increased understanding of the disparate care risk for marginalized populations, hospitals and other providers might wish to give additional consideration to these issues when planning and preparing patient safety strategies.