Essential hospitals have long shown a commitment to care for lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) patients, serving on the front lines of caring for individuals with HIV/AIDS in the 1980s. When many providers hesitated to take these patients, essential hospitals provided innovative and compassionate care during the crisis.

While the hospital industry has made great strides in improving access to essential services for members of the LGBTQ community, disparities remain. Research shows that members of the LGBTQ community disproportionately experience poverty and often face discrimination, stigma, and ostracism — all of which can negatively affect their access to health care and their care outcomes. Some LGBTQ individuals also are at an increased risk for certain mental and behavioral health conditions, including depression, anxiety, and substance misuse, and experience higher rates of sexual and physical violence than heterosexual or cisgender individuals.

Since 2010, the Human Rights Campaign has released the Healthcare Equality Index (HEI), an annual report measuring policies and practices designed to support LGBTQ inclusion in health care settings. The voluntary survey scores facilities’ current policies and practices and show gaps where there is room for improvement. Providers that earn a score of 100 on the HEI are designated as LGBTQ Healthcare Equality Leaders.

In 2018, more than 80 essential hospitals participated in the HEI. The annual report highlighted innovative programs at Temple University Health System, in Philadelphia, and The MetroHealth System, in Cleveland.

A Task Force Created from Tragedy

The 2016 mass shooting at Pulse nightclub in Orlando spurred a concerted effort at Temple University Health System, in Philadelphia, to create a more inclusive environment. Following the shooting, Ben Moore, risk manager for the health system, began to wonder what more the health system could do to promote inclusivity at a time when the LGBTQ community felt isolated and afraid.

Informal meetings with coworkers transformed into the Temple Health LGBTQ Alliance Task Force. Comprising more than 170 hospital employees — including clinical staff, ancillary staff, human resources staff, and legal team members — the task force “represents Temple as a whole” and aims to implement changes at all levels of the hospital, Moore says. He emphasizes that the task force aims to create an inclusive environment not only for patients, but also staff and visitors.

Temple surveyed clinicians to gauge their level of comfort in caring for the LGBTQ community, determine their cultural competence, and identify what training might be necessary to improve care. The task force used survey results to develop new policies and procedures, including a new human resources manual to educate staff about transgender issues during routine meetings. The task force also created a frequently asked questions document and terminology guide to ensure staff are equipped to treat LGBTQ patients in a respectful and culturally competent way.

Ben Moore, Heather Clauss, MD, and Robert Bettiker, MD, lead the Temple Health LGBTQ Alliance Task Force.

Moore and the task force also have worked to go beyond the hospital’s walls by conducting community outreach and partnering with a homeless shelter for LGBTQ individuals. They asked individuals about their level of comfort in seeking care at Temple and identified areas for improvement in the hospital. The group now meets regularly to voice their concerns and ask questions. Temple also participated in Philadelphia’s OutFest and Pride Festival to show the community that the health system is a safe and welcoming place to access care.

Since forming the task force, Temple has made great strides toward creating a more inclusive health system. Moore says the health system’s efforts to promote inclusivity are “not just about changing the language, but providing education.” Temple has used the Human Rights Campaign’s HEI training modules to create its own training on LGBTQ care that new and existing staff are required to complete.

Moore recommends that essential hospitals participate in the HEI survey and use it as a resource to improve hospital practices.

A companion association blog post in the coming week will review The MetroHealth System’s innovative Pride Clinic for LGBTQ care — another program highlighted in the 2018 HEI report.