#MEQAPI – Tweetchat Feb 15-2018 3:00ET Amplifying Women’s Voices

Just a reminder, MEQAPI stands for Monitoring & Evaluation, Quality Assurance, and Process Improvement, and you can visit us at http://www.meqapi.org.

It is a fact that women in science and medicine have less voice than men. This manifests in women being interrupted more, being asked for opinion less, being on fewer expert panels, etc. It is seen when a female physician is assumed to be a nurse, the male nurse is assumed to be a physician, and patients, families, and clinicians alike will turn to the male in the discussion to corroborate what the woman says.

These are facts.

In one thin slice of this unfortunate pie, women use social media such as Twitter less than men (47% vs 53%), get retweeted less frequently, have few followers, and are again, often spoken over in conversations.

This is, quite naturally, very irritating and demoralizing to  the women involved, but it shadows a more dangerous threat – it harms quality and safety. Undersampling, ignoring, and failing to engage women’s voices in medicine degrades quality, increases risk, and worsens the health outcomes of patients. Everything runs slower, has more errors, and costs more when we mute the voice of half the healthcare workforce.

This chat will look at several dimensions pertinent to the problem, and ask how to improve the situation.

We will take a QI approach, and discuss the topic using each of the typical arms of the basic Quality Improvement Ishikawa diagram to guide and support discussion. An Ishikawa diagram will be provided ahead of time and during the chat.

Women Voice


  • Policies
    • Facility or work unit policies, practices, rules
    • Specialty-specific policies
    • Human Resource guidelines, policies, etc.
    • Workflow and standard practices
    • Training
  • Work
    • Projects in which women are selected, lead, initiate, etc
    • Consultation of women for input, expert opinion, etc.
    • Recognition for achievement, effort, support, etc.
    • Plagiarism, theft or unattributed use of ideas, work, etc.
    • Sabotage of women’s work
    • Space, physical, time, and mental space to do creative work
    • Built environment, situation of toilets, parking, change rooms, rest areas, etc.
    • Time
  • Social Media
    • Follows
    • Retweets and Likes
    • Online bullying
    • Interruptions
    • Shunning
  • Conferences
    • Selection of speakers, panel members, judges, etc.
    • Seating
    • Interruptions
    • Questions
    • Disruptions
    • Post-conference follow up
  • People
    • Patients
    • Providers/HCP
    • Role Models
    • Sexualization
    • Diminishment
    • Peer support
    • Attitudes and bullying
  • Other
    • Environment
    • Pay
    • Equipment
    • Measurement
    • Recruitment
    • Other


  1. What POLICIES increase or reduce the ability of Women to be Heard in Medicine and Science
  2. What WORK factors increase or reduce the ability of Women to be Heard in Medicine and Science
  3. What SOCIAL MEDIA issues increase or reduce the ability of Women to be Heard in Medicine and Science
  4. What CONFERENCE issues increase or reduce the ability of Women to be Heard in Medicine and Science
  5. What PEOPLE factors increase or reduce the ability of Women to be Heard in Medicine and Science
  6. What OTHER factors increase or reduce the ability of Women to be Heard in Medicine and Science


MEQAPI focuses on healthcare improvement, and in the spirit of shameless borrowing (and efficiency), takes existing perspectives from the IHI, AHRQ, and others.

To quote the IHI on what the Triple Aim encompasses:

The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. It is IHI’s belief that new designs must be developed to simultaneously pursue three dimensions, which we call the “Triple Aim”:

  • Improving the patient experience of care (including quality and satisfaction);
  • Improving the health of populations; and
  • Reducing the per capita cost of health care.

The six domains of care quality (STEEEP) mapped out by the Agency for Healthcare Research and Quality (AHRQ) are foundational to healthcare improvement. All care, and by inference quality measures, should be focused on being Safe, Timely, Effective, Efficient, Equitable, and Patient Centered. We expand this to include Affordability, STEEEPA.

The MEQAPI tweetchat aims to give voice to a broad range of stakeholders in healthcare improvement, and it embraces everyone from administrators to zoologists, and includes physicians, nurses, researchers, bed czars, cleaners, and yes, patients and care-givers.


The Author and Moderator: Matthew is a Principal Analyst at Whitney, Bradley, and Brown Inc. focused on healthcare improvement, and serves on the board of directors of the Blue Faery Liver Cancer Association. Matthew is the founder of the Monitoring & Evaluation, Quality Assurance, and Process Improvement (MEQAPI) organization, and is a KM and quality improvement author, and regularly blogs for Physician’s Weekly. Matthew’s pro bono roles have included support for the Queensland Emergency Medicine Research Foundation and the St. Andrew’s Medical Research Institute. Matthew is active on social media related to healthcare improvement and hosts the weekly #MEQAPI chat. Matthew also trains others in the use of MAXQDA. You can find his contact info in his MAXQDA professional trainer profile




Published by

Matthew Loxton

Healthcare Analyst using Lean Six Sigma, Knowledge Management, & Organizational Learning to improve healthcare http://linkedin.com/in/mloxton

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