Transgender Patients Have Unique Needs; UVA is Striving to Address Them

Thursday, March 22, 2018

Imagine this: you check in at a doctor’s office and are asked to fill out a personal information form. Moving through the list of questions, you arrive at one that asks if you are male or female. What if neither choice is appropriate for you?

For members of the transgender community, this is a common experience.

At UVA Health System, closing this information gap has become an important goal. Last year, the Medical Center began participating in the Health Equality Index — a nationally recognized benchmarking tool — to gauge our progress in serving the unique needs and expectations of transgender and LGBTQ patients. Our 2017 score — which is a benchmark for ongoing improvement — was 60 out of 100.

Recently announced, our 2018 Health Equality Index score was 95 out of 100.

First Steps
Improvement efforts have been guided by a multi-disciplinary Transgender Advisory Committee. One of its first recommendations was to participate in the 2017 Health Equality Index. Created by the Human Rights Campaign, the nation’s largest LGBTQ civil rights advocacy group and political lobbying organization, the index evaluates how well healthcare facilities are providing equity and inclusion to their LGBTQ patients, visitors and employees.

“Our 2017 score (60 out of 100) showed we had a way to go in providing health equity. Those results helped us focus our improvement efforts,” explains Patient Experience Officer Bush Bell, who is an advisory committee co-chair.

Between 2017 and 2018, the advisory committee recommended that the Medical Center lay a stronger foundation for serving LGBTQ patients by:

  • Revising and better communicating non-discrimination policy
  • Requiring that the most senior leaders in each work area complete a training series, LGBTQ-Centered Care: An Executive Briefing

“This initiative is centered in respect for all patients and staff in the UVA Health System. We want to provide tools and education to make it easy and natural to do the right thing when interacting with our transgender and LGBTQ community members,” says advisory committee co-chair David Repaske, PhD, MD, Division Chief, Pediatric Endocrinology and Acting Chief, Pediatric Nephrology.

2018 Focus — Training and New Epic Tools
“We have a lot of work to do in 2018. Many groups are requesting training and educational workshops. Caregivers are asking for enhanced Epic tools to improve documentation so they can better care for their LBGQT patients,” Bell reports.

Training The advisory committee has established training partnerships with the Center for Affiliated Learning and the National LGBT Health Education Center, both of which offer many online classes. All team members are expected to complete at least one of three recommended classes this year:

  • Providing Quality Care to Lesbian, Gay, Bisexual and Transgender Patients: An Introduction for Staff Training — This is an overview course for all team members.
  • Achieving Health Equity for Lesbian, Gay, Bisexual and Transgender People — This course is designed for clinicians who want to learn more about this patient population.

These courses are now in the LMS (NetLearning). To enroll, please log in to your NetLearning account and search for them under the Learning Opportunities (Enroll) tab.

New Epic Tools — The advisory committee is assessing a new electronic medical record module that captures clinically relevant information such as biological sex, gender identity, gender expression, sexual orientation and a patient’s preferred name. The module is available on our Epic Phase 2 platform, but has not been activated.

“Our current medical records only contain binary — male or female — information about a patient’s sexual profile,” notes Bell. “When we upgraded our Epic system last summer, we opted to delay installation of the new software until clinical and administrative leaders had an opportunity to assess its utility.”

The advisory committee is now supporting leaders in making that assessment.

“As we strive to put patients at the center of all that we do, we often need to step beyond our current approach and processes,” Bell says. “Serving and caring for members of the transgender and LGBTQ communities requires a willingness to act with respect and compassion, to learn and speak their language and to gain a deeper understanding of their unique medical needs. We are proud of the progress we are making and are counting on all team members to help us provide health equity to all of our patients.”

Transgender Advisory Committee Members

  • Bush Bell
  • David Repaske, MD, PhD

Community Members

  • Roxanne Barreto
  • Lou Weakley

Health System Team Members

  • Leah Beard
  • Susanna Brent
  • Dallas Ducar
  • Mary Ann Harkins
  • Rachel Holmes
  • Jamie Hughes
  • April Kimble
  • Georgina King
  • Susan Kirk, MD
  • Kathryn Susanne Laughton
  • Rebecca Lewis
  • Amy Sarah Marshall
  • George Minor
  • Casey Morrison
  • Gary Nimax
  • Mark Pulczinski
  • Colby Rountree
  • Mary Sullivan
  • Cindy Westley