A Brief Intervention to Increase Provider and Staff Ability to Create a Welcoming and Affirming Environment for LGBTQ Patients

From the 2021 HVPAA National Conference

Tiffany Wandy (LifeBridge Health), Daniel Durand, Sommer Gray

Background

Studies show that lesbian, gay, bisexual, and transgender populations, in addition to having the same basic health needs as the general population, experience health disparities and barriers related to sexual orientation and/or gender identity expression. Many avoid or delay care, receive inappropriate care, or are given inferior care because of perceived or real discrimination by health care providers and institutions.

Objective

Our motivation for pursuing specific, in-depth training for our Radiology department stemmed from a larger system-wide initiative to achieve designation as an LGBTQ Healthcare Equality Leader from the Human Rights Campaign Foundation.

Methods

The following parameters drove our approach:
Goals:

  • Conduct an initial mandatory one-hour training with at least 80% of the Radiology Department (both staff and providers) by the end of 2018
  • Conduct an initial optional one-hour training with at least 50% of the Radiology Department (both staff and providers) by the end of Q2 2019
  • Improve the Radiology Department’s ability to provide high-quality care for LGBTQ patients by:
  • Increasing knowledge about LGBTQ health/social service needs
  • Increasing LGBTQ-affirming attitudes
  • Increasing LGBTQ-affirming behaviors
  • Develop and refine strategies that enable the Radiology
  • Department to collect and utilize sexual orientation and gender identity data to improve health services and patient outcomes

Objectives

  • By the end of the first training, participants will be able to identify at least three risk factors that contribute to LGBTQ disparities
  • By the end of the second training, participants will be able to enact at least two ways to affirm gender

Results

In order to have a quantifiable way to measure the impact of the training sessions, we implemented a pre/post assessment. The assessments were identical and included a total of five questions, one of which was true/false and four that were open-ended. In the pre-assessment, participants correctly answered an average of 2.5 questions, incorrectly answered an average of 0.5 questions, and left blank an average of 2.0 questions. In the post-assessment, participants correctly answered an average of 4.1 questions (64% increase), incorrectly answered an average of 0.5 questions (no change), and left blank an average of 0.5 questions (75% decrease). Interestingly, the open-ended questions elicited much more comprehensive responses on the post-assessment; the average number of words used to answer the pre-assessment was 12, while the average number of words used to answer the post-assessment was 29 (142% increase).

Conclusions

Overall, our experience shows that a simple educational intervention gave our staff the resources and tools necessary to aid them in creating a welcoming and affirming environment for any LGBTQ patient who walks through our doors.

Clinical Implications

Health care providers can take positive steps to promote the health of their LGBTQ patients by examining their practices, offices, policies, and staff training for ways to improve access to quality health care for the LGBTQ population. Participating in provider and staff training programs can give teams the tools necessary to create a welcoming environment for every patient who walks through the door.