# PAINED: Project Addressing INequities in the Emergency Department

> **NIH NIH R61** · CHILDREN'S RESEARCH INSTITUTE · 2022 · $1,766,145

## Abstract

Project Abstract
Racial and ethnic inequities in health care quality have been described across a broad range of clinical
settings, patient populations, and outcomes. Clinician implicit bias has been implicated in the causal pathway
for health care disparities. It is now imperative that we target the causes and develop interventions to mitigate
and eradicate such inequities. Our overarching goal is to eradicate health care inequities through evidence-
based interventions. In response to the RFA-NS-22-002: HEAL Initiative: Advancing Health Equity in Pain
Management (R61/R33), the objectives of this proposal are to develop and test the impact of two
interventions on overcoming clinician implicit bias and mitigating inequities in the management of pain among
children seeking care in the emergency department for the treatment of appendicitis or long bone fractures.
The scientific premise stems from our prior work which: 1) demonstrated racial and ethnic inequities in the
management of pain for children in the emergency department; 2) examined the role of implicit bias in vignette-
based health outcomes; and 3) used audit and feedback and clinical decision support tools to improve
performance metrics among clinicians. We will build on this foundational work by measuring the impact of
clinician implicit bias among providers and nurses on both process and outcome measures, including the
assessment and reduction of pain. We will use a stakeholder-informed approach to identify quality metrics that
are patient-centric. We will then test whether regular clinician audit and feedback, through the provision of
‘Equity Report Cards,’ as well as provision of real-time, electronic health record-embedded clinical decision
support can serve as useful interventions in mitigating racial/ethnic disparities in clinical outcomes. This
research is significant because both interventions can be inexpensively disseminated and scaled to emergency
departments nationally as well as to other clinical venues and adapted for various clinical conditions. Through
innovative study design and rigorous evaluation, this proposal will provide critical evidence and lay the
foundation for eradicating racial and ethnic inequities in the provision of care and improved child health
outcomes for all.

## Key facts

- **NIH application ID:** 10537743
- **Project number:** 1R61DK135406-01
- **Recipient organization:** CHILDREN'S RESEARCH INSTITUTE
- **Principal Investigator:** Monika Kumari Goyal
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,766,145
- **Award type:** 1
- **Project period:** 2022-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10537743

## Citation

> US National Institutes of Health, RePORTER application 10537743, PAINED: Project Addressing INequities in the Emergency Department (1R61DK135406-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10537743. Licensed CC0.

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