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Disparities Leadership Inspires LGBT Collaborative, Community

November 25, 2013

The University of New Mexico Hospitals (UNMH) fosters an atmosphere of inclusion and equality so both patients and staff receive the care and comfort they deserve. In 2010, Jamie Silva-Steele, then an administrator overseeing the hospital’s ambulatory department, created UNMH’s Office of Diversity, Equity, and Inclusion to help do just that. The office’s work inspired the formation of a separate LGBT Collaborative, which has changed hospital policies, training, and perspective to ensure a safe, caring environment for lesbian, gay, bisexual, and transgender (LGBT) patients and staff.

To commence this work, Silva-Steele took part in the Disparities Leadership Program through the Disparities Solutions Center at Massachusetts General Hospital. The program is designed to help hospital leaders implement practical strategies to eliminate racial and ethnic disparities in health care. As part of the program, Silva-Steele created the initiative’s framework.

During the development phase, Silva-Steele created a 60-page self-assessment, which measured the hospital’s diversity compliance practices against class standards. While UNMH was meeting several of the standards, the hospital was still lacking in several areas. Silva-Steele set forth to address these areas and any disparities in the care patients receive.

Five bodies guide the initiative’s work:

  • The executive diversity, equity, and inclusion steering committee, which focuses on governance, leadership, and systems, and will include two task forces:
    • The competence task force, which plans to focus on language access and services, and staff  cultural competence training and development
    • The care task force, which plans to focus on patient involvement and the creation of culturally and linguistically appropriate care models and processes
  • The compliance task force, which focuses on data collection and analysis, and compliance with national standards
  • The community task force, which focuses on mutually beneficial community engagement and partnerships

Community task force plants a seed

The community task force comprises various community members and agencies, including the LGBT community. In 2011, a few of these members started the LGBT Collaborative to identify how to reduce any disparities – perceived or real – that may impact LGBT patients and families. “At the same time, we were learning about the recommendations coming from the Office of Civil Rights and The Joint Commission regarding a study that assessed the care of LGBT patients in the health care environment,” Silva-Steele says. “The outcomes were not good, and we felt we needed to ensure that we were providing awareness and training on this very important issue.”

Once the collaborative was advertised internally, staff and providers eagerly joined the effort, and UNMH declared it an employee resource group (ERG). The concept of the ERG, which also came from the Disparities Leadership Program, refers to employees joining forces with community members and/or represented people to evaluate how to address disparities found within the particular population.

When the collaborative formed, there was interest in helping the hospital create a more inclusive environment. The group reviewed and suggested revisions to hospital policy concerning visitation; provided valuable suggestions on the patient demographics data collection form, which were adopted on both the intake form and UNMH’s electronic health record; and offered guidance for training on the new intake process. “It was important for us to take an open stance to receiving and acting on input, which helped us form a trust relationship,” says Kristina Sanchez, MBA, executive director of ambulatory business operations.

Monthly collaborative meetings are open to all UNMH staff and community partners, and the group participates in various activities and events throughout the year. Among the collaborative’s recent activities was Albuquerque Pride, the annual LGBT pride festival for the city of Albuquerque. In previous years, UNMH operated a booth at the festival – this year marked the first that UNMH staff and community partners marched in the parade. “Our active participation in the pride parade this year garnered much positive commentary from the crowd,” Sanchez recalls. “One woman said, ‘Well alright, UNM! It’s about time!’; the whole group around her cheered.”

The collaborative also operates Caring for the LGBT Community, an informative, comprehensive, interactive, four-hour workshop that prepares employees to work with LGBT coworkers, patients, and families. The workshop covers terminology, history, and culturally relevant tools to help participants develop the appropriate skills and knowledge for working with the LGBT population. For example, caregivers are trained to ask all patients for their preferred pronoun before referring to them as he or she. A panel of LGBT individuals and allies also share stories with the group and answer questions. “Often we find that people within our organization don’t even know what LGBT stands for,” says Misty Salaz, manager of the Office of Diversity, Equity, and Inclusion. “The course raises awareness among care professionals to empower and enable them to provide more sensitive care for LGBT patients and families.”

Several executive leaders have also taken the course, and according to Salaz, the Office of Diversity, Equity, and Inclusion hopes to make Caring for the LGBT Community mandatory training for management. The office is also exploring offering a follow-up course that delves deeper into questions posed by past participants and potentially compiling an online list of LGBT-friendly health care providers.

UNM also offers Safe Zone training through its Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Resource Center, a student-initiated center that strives to provide a safe environment for people of all gender identities, gender expressions, sexual orientations, sexualities, and other identities. Safe Zone training delves further into being an LGBTQ ally, terminology and different types of hate, negativity, and phobias. After completing this course, participants can display a sticker on their lanyard or office indicating that their space offers a greater sense of safety for members of the LGBTQ community. “Our outpatient clinic midlevel providers (80+ individuals) recently completed their Safe Zone training course, and other clinic groups have requested the training for their entire team,” Sanchez says.

After working together for more than two years, the LGBT Collaborative was ready to seek some recognition for its hard work in making UNMH a more open and inclusive health care environment. “A goal of the collaborative was for UNMH to get recognized as a leader in LGBT health care equality,” Silva-Steele says. “This year, we received recognition through the Human Rights Campaign’s, Healthcare Equality Index as being just that! We are proud of this honor.”

For more information about LGBT initiatives and the Office of Diversity, Equity, and Inclusion, please contact:

Misty Salaz
Office of Diversity, Equity,  and Inclusion
University of New Mexico Hospitals

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