The nonprofit hospice made educating its 500 staff and volunteers a core focus of the initiative. It partnered with SAGECare, a New York-based nonprofit that provides LGBTQ+ cultural competency training to long-term care providers in 49 states. Four years ago, the hospice achieved platinum certification, meaning 80% of MJHS leadership and staff had received four hours of onsite and virtual training, with an hour of additional updated training each year.
The training includes an overview of the needs, concerns and unique history of LGBTQ+ patients to help providers better understand the community and improve quality of services.
“We help organizations like MJHS understand how someone is coming into care and what they’ve experienced in getting care,” said Nicholas Watson, SAGECare managing director of social enterprise. “Then, we focus on things that a caregiver might miss or misunderstand if they don’t understand that context.”
For example, the training helped educate MJHS hospice staff as needed on gender identity. It encouraged staff members to display their pronouns on their identification badges to help make patients more comfortable communicating about their gender, which can play a critical role in patient care.
“If we are taking care of a transgender individual, we might need to know the type of catheter we need to deliver,” said Shelby Smith, who heads MJHS business development and co-chairs the LGBTQ+ subcommittee within the hospice’s diversity, equity and inclusion council. “There are times when someone is guarded [about their gender]. It’s not about knowing what type of genitals they have, it’s about knowing which type of equipment is going to fit their body’s needs.”
MJHS Hospice and Palliative Care also adapted its technology, so staff can change a patient’s gender listing in the electronic health record if necessary and work to ensure the information is accurate in other data repositories.
Through the initiative, caregivers are encouraged to connect with patients by wearing rainbow pins as a symbol of LGBTQ+ pride.
Lane Tatman, a registered nurse with MJHS who is gay, said the initiative has boosted care for LGBTQ+ patients. After his rainbow pin prompted a patient to come out to him, he worked to reconcile her with her daughter.
“When this woman died, she was comfortable with herself and with her relationship with her daughter," Tatman said of the experience.
Some of the steps MJHS Hospice and Palliative Care took, including its use of pronouns on badges and its actions to communicate more effectively, were included in recommendations the National Hospice and Palliative Care Organization made to its members when it released its survey results last year.
Weiss said she thinks the initiative has helped increase word-of-mouth referrals to the hospice from the LGBTQ+ community, though the effort has not yet translated into a sizable influx of LGBTQ+ patients. She said she believes an increase will happen in time, however.
"For people who have been discriminated against in any way, trust has be earned," Weiss said. "We're trying to do that."
