UM BWMC Physician Creates Gender-Inclusive Toolkit to Help Health Care Providers Offer More Equitable Care to Members of the LGBTQ+ Community

Appropriate education, electronic medical record updates and patient and family involvement can minimize discrimination and lead to better experiences and care outcomes

GLEN BURNIE, Md. (Sept. 20, 2023) – Specialized trainings for doctors and nurses, recording preferred names and pronouns in electronic medical records (EMRs), and involving patients and families in care plans are all key factors that can lead to better health care experiences and outcomes for LGBTQ+ individuals, according to research published by a UM BWMC physician in The Lancet Regional Health - Americas this week.

Gagandeep Dhillon, MD, MBA, Associate Medical Director of the Adfinitas inpatient hospital team at UM BWMC, and his coauthors at Banner Health and Sacred Health Hospital, conducted a rigorous examination of medical journals and interviewed patients and providers representing the LGBTQ+ community to understand how health care providers could better meet the care needs of their patients. The team consolidated the insights into resources that could easily be adapted for use at various health care settings, from large academic medical centers to community hospital and local practices. By tackling these important concerns and offering feasible solutions, Dr. Dhillon and his co-authors aim to help more health care settings provide fairer and more equitable care to everyone.

"We wanted to create something that was easy to replicate, evolve and share with other physicians, nurses and care team members," said Dr. Dhillon. "This toolkit outlines vital steps that hospitals and local practices can take to ensure they are providing equitable and compassionate health care to everyone they serve."

The authors' first recommendation is to offer specialized training to medical providers that addresses gaps in health care quality that have disproportionately affected LGBTQ+ individuals. Trainings should address implicit biases and emphasize the importance of using gender-affirming terms and respecting a patient's wishes to be called by their preferred name and pronouns.

"Many physicians and nurses practicing today earned their clinical degrees 10 to 20 years ago, when there was limited or no education or resources on gender-inclusive care," said Dr. Dhillon. "Today, we know it's important to address people by their pronouns as this builds respect and trust between providers and patients."

Equally important is recording a patient's preferred name and pronouns in the electronic medical record so that it can be referenced by other providers and used in future interactions. Many EMR systems offer prebuilt fields to capture preferred pronouns, sex at birth and gender identity, but some health care settings either don't have these features enabled, or haven't trained staff on how to record and/or the importance of including this information in the patient's record.

Research suggests that failing to use, or refusing to acknowledge someone's preferred name or pronouns can have damaging effects on patients.

"When a provider fails to use a patient's preferred name or pronouns, it is not only seen as a sign of discrimination, but it also has long-lasting, harmful effects on a patient's health," said Dr. Dhillon. "Some individuals may be hesitant to seek care from that provider, or any other provider again."

Another key component of the toolkit is encouraging health care providers to include patients and their families and loved ones in care conversations and treatment plans. Several studies have shown that involving patients as well as their families and caregivers in the planning, delivery and evaluation of their health care can lead to safer and higher-quality care experiences.

Many of the initiatives outlined by Dr. Dhillon and his co-authors are being implemented at UM BWMC and across the University of Maryland Medical System, the hospital's parent organization. At UM BWMC, preferred name, pronouns and sex at birth are all collected at the time of their registration. This ensures that any provider that sees the patient has access to this important information. The University of Maryland Medical Center, the System's flagship academic hospital, also has an LGBTQ+ employee resource group, a transgender health program for adult and pediatric patients, and several departments that practice inclusive care.

"It's critically important that our hospitals and care locations ensure that every individual receives comprehensive and appropriate care at every interaction, regardless of their sexual identity or gender orientation," said Neel Vibhakar, MD, MBA, Senior Vice President and Chief Medical Officer at UM BWMC and Associate Chief Clinical Officer at UMMS. "Asking for pronouns and ensuring our team members consistently and appropriately use them not only builds trust between the patients and care team, but also allows our clinicians to learn more about the patient's health care needs, which can further inform clinical decisions and create better outcomes and more positive experiences."

"As health care workers, we have a unique opportunity to lead by example, which requires us to demonstrate our commitment to strengthening our culture of respect, and our appreciation for and understanding of everyone who walks through our doors," said Roderick King, MD, MPH, Senior Vice President and Chief Equity, Diversity and Inclusion Officer at UMMS. "Within our communities and around the world, individuals that identify as LGBTQ+ continue to face disparities in health care. The more we can learn about our patients, and their experiences and needs, the better able we are to relate to and to care for them."

Learn more about UMMS' commitment to equity, diversity and inclusion.

About the University of Maryland Baltimore Washington Medical Center

The University of Maryland Baltimore Washington Medical Center (UM BWMC) is an acute-care facility that is part of the University of Maryland Medical System. It is located in Glen Burnie, Maryland and has 314 beds and more than 3,100 team members. It also has 1,200 medical providers on staff in over 50 specialties. For more information, visit www.umbwmc.org.

About the University of Maryland Medical System

The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org.