It's Pride Month: How 7 hospitals are improving LGBTQ-centered care and reducing discrimination

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June is Pride Month, and hospital leaders from Rush, Kaiser Permanente and CommonSpirit Health shared how their hospitals and health systems are improving care and mitigating discrimination toward the LGBTQ community.

More than half of patients in the LGBTQ community report having faced discrimination in a healthcare setting. Seventy percent of transgender or gender-nonconforming patients said they have experienced discrimination in a healthcare setting, and 56 percent of lesbian, gay or bisexual patients reported facing discrimination in healthcare, according to the Human Rights Campaign's "Healthcare Equality Index 2020."

Here's what seven hospitals are doing to combat LGBTQ-patient discrimination and improve LGBTQ-centered care:

Ronald Copeland, MD. Senior Vice President of National Equity, Inclusion and Diversity Strategy and Chief Equity, Inclusion and Diversity Officer of Kaiser Permanente (Oakland, Calif.): Kaiser Permanente has a long-standing commitment to achieving equitable health outcomes for our LGBTQ members, patients and families. In addition to being recognized for 11 consecutive years as an LGBTQ Healthcare Equality Leader by the Human Rights Campaign, we are consistently vocal about the need for equity across healthcare and beyond for LGBTQ Americans, advocating for workplace protections and standing up for the rights of transgender individuals.

Lloyd Dean. CEO of CommonSpirit Health (Chicago): When HIV/AIDS began to take its tragic, disproportionate toll on the gay community, I remember our hospitals opening their doors widely to care for those in need. When others backed away, we lived out our commitment to compassionate, unbiased care. Four decades later, in Pride Month 2021, I can assure you that our commitment to LGBTQ equity is proud, strong and unwavering.

Scott Ellner, DO. CEO of Billings (Mont.) Clinic: Billings Clinic is committed to ensuring an inclusive, compassionate environment for all. One of the most important things we can do in healthcare is to take care of everybody who comes through our doors, whether they're a patient, a visitor or a co-worker. We also know that it's our responsibility to meet people where they're at in our communities outside of our walls. Everybody deserves care that meets their needs. At Billings Clinic, we regularly review and adjust our work to make sure we are LGBTQ+ inclusive. We have a group that actively works on internal and external policies to make sure we are open and meeting the needs of patients, we provide training opportunities for our staff to better understand and meet LGBTQ+ patient needs, and we have providers who are resources in the community to connect with these patients.

Billings Clinic will not discriminate, and we are on a continuous journey to build diversity, equity, belonging and inclusion both within our organization and in the communities we serve. I am incredibly proud of the work we are doing, but we also know that there is more to be done because being an inclusive organization takes constant commitment. There will always be new opportunities to learn, to adjust and to enhance what we are doing.  

Gina Romero Hernandez. Vice President and Chief Learning Officer at Montefiore Health System (New York City): Montefiore Health System takes a broad approach to LGBTQ healthcare. At a corporate level, we are proud leaders in the LGBTQ Healthcare Equality Index through our participation in the Human Rights Campaign since 2017. This distinction is awarded for our commitment to equitable and knowledgeable healthcare to LGBTQ patients and their families and a safe, inclusive workplace for our associates. Some of the ways in which Montefiore has earned this honor are through the pillars of associate engagement, associate training, patient experience and community engagement. A multidisciplinary committee across Montefiore manages LGBTQ awareness, inclusion, education and community outreach to ensure these pillars are actively engaged throughout the year and celebrated during Pride Month. 

In terms of trainings, Montefiore offers a tremendous variety of LGBTQ training opportunities, beginning with diversity and inclusion onboarding training for all new associates, and clinical offerings, including the Patient Care Act outlining the American Disabilities Act, Affordable Care Act, Patient Bill of Rights and the Civil Rights Act of 1964. Other trainings offered to all associates include Diversity and Inclusion Training, Leading Across Generations (a course aimed at improving relations in a multigenerational environment), Disrupting Everyday Bias, Cultural Competency and Health Literacy, LGBTQ Healthcare for clinicians, and Working with Transgender Patients, plus over 50 additional courses aimed at diversity and inclusion available in the Human Rights Campaign. Since our inception into HEI, education and training has increased over 200 percent to over 25,000 Montefiore associates.

Montefiore has a long history of providing leading-edge LGBTQ care in our hospitals, community healthcare centers and specialty clinics. Montefiore's Adolescent AIDS Program is on the forefront of HIV/AIDS care serving patients 13-24 years old; for those over 16, Montefiore's Oval Center focuses on sexual and mental health for LGBTQ patients. Additionally, Montefiore provides surgical services to the transgender community, a growing practice outlined in our website where a new TransWellness Center has recently launched. 

K. Ranga Rama Krishnan. CEO of Rush University System for Health (Chicago): Equality is and has always been at the heart of Rush's mission, so maintaining a culture of respect, inclusion and equal treatment for patients, visitors, students and employees who are lesbian, gay, bisexual, transgender, queer and/or questioning, and other sexual identities (LGBTQ+) is deeply ingrained in who we are. We understand all too well the healthcare disparities that face the LGBTQ+ community, including access to care and a lack of knowledge and understanding among healthcare providers. To begin to address these disparities, we've formed Affirm: The Rush Center for Gender, Sexuality and Reproductive Health, a comprehensive center that provides safe, accessible, affirming and multidisciplinary, comprehensive care from across the Rush System to those who identify as LGBTQ+. Rush's long-standing commitment to equity of care for the LGBTQ+ community extends beyond the walls of Affirm to all aspects of our institution — from patient care and clinical expertise to employment opportunities, training and employee benefits. We proudly provide extensive resources and welcoming policies to ensure that we continue to support and foster the culture of inclusion and equality that Rush is known for.

Dawson Smith. Vice President of Affiliate Operations and Network Development for UAB Medicine (Birmingham, Ala.): UAB Medicine is proud to once again be designated as a leader in LGBTQ Healthcare Equality by the Healthcare Equality Index for the survey year 2020-21. Since we first started participating in the survey in 2016, we have made significant progress in creating an inclusive and affirming environment for both our LGBTQ patient and employee populations. In order to help patients connect with the right provider, we have updated our provider directory so patients can find providers with training and a focus on the LGBT patient population. 

Our most significant accomplishments to date has been the addition of programs that support our transgender population. We recently launched the Gender Health Clinic, a one-of-a-kind specialty clinic in the Southeast for transgender patients that provides access to care for hormone replacement therapy, gender-affirming surgeries, and access to primary and mental healthcare. We also offer health benefits that cover care specific to our transgender employees. As the only non-VA hospital with the leadership designation in the state of Alabama, we play an important role in caring for this community. While we have accomplished a lot in this space, we know the work is ongoing and are committed to making UAB Medicine a more inclusive and affirming place for all our patients and employees.

Kevin Wang, MD. Medical Director for Swedish's LGBTQI+ Initiative (Seattle): In early 2020, Swedish launched its LGBTQI+ Initiative to identify opportunities to improve care and better meet the health needs of our LGBTQIA+ community. [Editor's note: "I" stands for "intersex" and "A" stands for "asexual."] Members of the initiative team have worked alongside more than a dozen community-based organizations to better understand how to support the LGBTQIA+ community.

Swedish is normalizing using pronouns by distributing pronoun pins (she/her/hers, he/him/his, they/them/theirs) and encouraging caregivers to share their pronouns with patients; using inclusive language in patient materials, including adding sexual orientation and gender identity or expression into nondiscrimination clauses; using inclusive language in signage, including urine collection instructions and gender-inclusive restrooms; adding fields in intake forms, electronic health record and MyChart for name and pronouns used, sexual orientation, gender identity and sex assigned at birth; and developing a Transgender Healthcare Navigation Program.

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