Sanford Health is committed to investing in underserved communities by creating equitable and inclusive access to care.
In acknowledging the health disparities present in the LGBTQ+ community across the country, Sanford Health is proactively pursuing progress through investment in Healthcare Equality Index (HEI) accreditation.
HEI is a project created by the Human Rights Campaign to serve as a national LGBTQ+ benchmarking tool that evaluates health care facilities’ policies and practices related to the equity and inclusion of their LGBTQ+ patients, visitors and employees. Sanford Health Fargo was awarded a grant from the Centers for Disease Control and Prevention to support this work in health equity.
How the index ranks equality
Sanford Medical Center Fargo has been named a top performer on the 2022 Healthcare Equality Index. HEI-accredited providers measure their LGBTQ+ inclusion in four areas:
- Non-discrimination and staff training
- Patient services and support
- Employee benefits and policies
- Patient and community engagement
Michael Burson, a senior social worker at the Sanford Roger Maris Cancer Center in Fargo, North Dakota, helped lead the process that led to Sanford Health’s accreditation.
“What we’re seeing is that there is a deep and urgent need in the LGBTQ community,” Burson said. “Essentially, many of the members of this community have lost trust in the medical field and it is having grave impact on their health.”
Shelby Terstriep, M.D., a Sanford Health medical oncologist, was instrumental in landing a CDC grant that would help address existing disparities in health care. The effort originated with Dr. Terstriep’s conversations with several of her lesbian patients about ways providers could do things differently.
“We have an organized department looking at equitable health care now,” Dr. Terstriep said. “We have policies and procedures that focus on issues that we might not have thought about in the past and wording and language that we wouldn’t have noticed before.”
Why measure equality in health care
Surveys involving the LGBTQ+ community suggest there is plenty of room for improvement in how many health systems provide care.
According to national numbers provided by the Healthcare Equality Index 2022:
- 70% of transgender or gender nonconforming patients surveyed have experienced some type of discrimination in health care.
- 56% of lesbian, gay or bisexual patients surveyed have experienced some type of discrimination in health care.
- 73% of transgender respondents believe they would be treated differently by medical personnel because of their LGBTQ status; 29% of lesbian, gay and bisexual respondents believe the same.
- 52% of transgender respondents believe they would be refused medical services because of their LGBTQ status; 9% of lesbian, gay and bisexual respondents believe the same.
“Many times, within the LGBTQ population, patients will tell me they find out which doctors are allies through the underground,” Dr. Terstriep said. “That’s how they find their doctor. It’s not that most doctors are not open and objective but the patients don’t know that so they’re very reluctant to be honest about their sexuality and their gender identity. That affects their care.”
Apprehension regarding needed medical attention can come in many forms, Burson said. He has had conversations with transitioning patients who have dealt with being called the wrong name at the front desk at a clinic, for instance. They have then had to explain in a waiting room setting that they’re transitioning.
It’s the kind of situation that can discourage patients from coming back.
‘We want to be visible in the community’
“Training is a big part of this,” Burson said. “Making sure that all staff are trained appropriately and have good knowledge about not only how to treat LGBTQ patients, but the history behind some of the struggles and concerns. I think obtaining the accreditation was important because it signifies where we’re at. We want to be visible in the community as safe providers.”
Sanford will continue to reach out to LGBTQ+ patients and families, Burson said. Listening, in this case, can be the gateway to better health care.
“I think we need to hear their experiences,” he said. “We want to hear from them because they’re the experts. We can do a significant amount of learning. We want to make sure that everybody who wants to help us in our effort is welcome to do that. We want to hear from them.”
When Dr. Terstriep brought up the idea of HEI accreditation to Sanford physician leadership, the reaction was overwhelmingly positive. It’s something they wanted to see happen.
“I really want the LGBTQ population to know that this is how Sanford physician leadership feels about it,” she said. “Our executive leadership was so supportive in making changes. The biggest thing for us is in knowing that there are things that we may not know. We have to learn from patients and listen to them tell us how we can do better. I know the desire to do better is there.”
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