Seed Grant Award: Addressing Inequities in Liver Transplant Evaluation-Identifying and Eliminating Health Worker Bias

The Center of Liver Disease and Transplantation at Columbia University Medical Center seeks to address inequities in the liver transplant evaluation of people of color by identifying provider bias and developing solutions to decrease identified biases. To achieve this objective, we will complete the following: (1) perform bias assessment of faculty and staff (2) train staff on the concepts of systemic racism and culturally competent care.  The participants are members of  a large multi-disciplinary group including hepatologists, surgeons, mid-level providers, psychiatrist, social workers, nutritionists and pharmacist that comprise the transplant team. Our hypothesis is: Every healthcare worker has implicit bias and this implicit bias affects management decisions that impact the likelihood that a patient will be listed for liver transplant. Tools used to assess staff bias will be (a)Implicit Association Test (IAT) and (2) Clinical Vignette Assessment. Cultural Diversity training were provided by Breaking the Cycle Consulting Services (BCC). 

Data collected will be analyzed using both quantitative and qualitative assessments. Although bias training increases awareness, our goal is to change behavior and promote equity. All data will be shared with the center staff and the university. If appropriate and approved by the institutional review board, results will be published for community review. 

The project began in November of 2020 with content development. Bias assessment testing began in December of 2020 and continued for 21 days as an online survey. Diversity training workshops began in January of 2021. Matching funds have been requested, and all grant monies rewarded went directly towards paying for consulting services and materials for this grant proposal. 

This project was funded through the Addressing Racism: A Call to Action for Higher Education initiative of the Office of the Vice Provost for Faculty Advancement.