• Article
  • March 8, 2016

Improving the LGBT Patient and Family Care Experience

To ensure it was providing the best experience to every family and patient it serves, Children's Hospital of Philadelphia (CHOP) examined populations they hadn't looked at before. 

"We needed to be sure we were fulfilling our commitment to be inclusive of all families," says Rachel Biblow, senior director, Department of Patient and Family Services. CHOP knew it had LGBT patients and families, but realized it wasn't hearing their voices. "It's all about treating people with respect and dignity, but how do we do that?" Bilbow says. "We took a look at our own policies. If we want to be the best, what do we need to do?"

According to a survey CHOP took of the LGBT community, 29 percent of LGBT parents and 73 percent of transgender parents said they think their child would be treated differently by a health care provider if they were open about their identity. LGBT children and youth often experience negative health outcomes due to harassment, bullying and negative family reactions, and CHOP wants these patients to feel safe talking to providers and parents about their health care needs.

Two years later, CHOP has a mindful, purposeful road map for moving policy into practice. The focused initiative ensures inclusion of and respect for all patients, families and staff members. Here are the strategies the team shared at the 2016 Quality and Safety in Children's Health Conference:

Set policy. This includes an employee nondiscrimination policy on sexual orientation and gender identity; a patient bill of rights and training requirements for staff members.

Get leaders on board. New policies and procedures won't have much clout unless organizational leadership embraces them, so ensure they are on board.

Train staff members. Look at the LGBT competence in your institution. Staff members are generally eager to learn best practices for inclusion. Garner executive leadership support and guidance to address expectations and HR concerns.

Partner with staff diversity experts. Assess feedback methods from LGBT patients and families—are they effective? "If we're not hearing complaints, we're not creating a venue where parents feel safe to tell the truth," says Linda Hawkins, Ph.D., family services specialist. Create a training program to support staff members' best practices, and assess organization needs or pain points.

Review forms and documents. Forms should include more than mom and dad. CHOP's records include up to five options for the people who are active in the child's life. This accounts for aunts, uncles, grandparents and foster parents. Consider marital status and how it's listed and recorded—partners or spouses? Capture preferred names and pronouns and consider how the organization will identify someone who is transgendered in the medical record.

Appreciate limitations. Don't be afraid to explain and apologize. "Our field teaches us how to be great professionals but doesn't always teach us how to say we're sorry and we messed up," Hawkins says.

Build inclusive dialog. Patients and families will feel safe when you say the words first: How is everyone related to the patient? Are there other people who are part of the patient's support team who will be coming to the hospital? Who has legal authority to make health care decisions for the patient? What names and pronouns would you be most comfortable with the team using for each of you? What names does your child use for each of you?

Assess the space. How are LGBT populations included in your organization? Look at the organization's artwork, marketing materials and family examples. Is it inclusive of the patient and family population? Is the organization using examples of LGBT parent systems in training simulations? What options exist for gender-neutral bathrooms? Where are these located? When there's a single restroom, does it need to be delineated as for a man or a woman?

Engage the LGBT community. Participate in community-wide LGBT pride events. Promote the hospital's competence in this area. Encourage medical professionals at the organization to be listed with the Gay and Lesbian Medical Association. Recruit LGBT patients and families for advisory committees.

Build partnerships and communicate. Focus on the organization's strengths, and build partnerships with LGBT patients, families and staff members to open the lines of communication. Let them know it's safe to bring their voices to the table and continually raise the voices of these families every day.