Culturally sensitive emergency care for sexual and gender minority youth: A quality improvement initiative

• Published in: International emergency nursing 2024-03, Vol.73, p.101425, Article 101425
• Main Authors: Goodall, Kaysi R., Morse, Elizabeth, Howard, Carolyn M.
• Format: Article
• Language: English
• Subjects: Culturally sensitive care; Emergency nursing; LGBTQIA+; Pediatric nursing; Quality improvement; Sexual and gender minority
• ISSN: 1755-599X; 1532-9267
• DOI: 10.1016/j.ienj.2024.101425

•Sexual and gender minority youth face substantial health disparities and often seek care in a pediatric emergency department for mental health crises.•When met with negative healthcare experiences, sexual and gender minority youth avoid healthcare in the future due to anticipated discrimination, which worsens both preventative and emergency health outcomes.•A pilot quality improvement initiative for staff training on sexual and gender minority culturally sensitive care was devised and implemented at a large, urban pediatric hospital in the Southeast U.S.•Staff demonstrated a statistically significant increase in clinical preparedness in caring for sexual and gender minority youth in response to the low-cost, flexible learning intervention. Despite evidence of the impact of provider implicit bias and overt discrimination experienced by sexual and gender minority youth (SGMY), evidence surrounding sexual and gender minority cultural sensitivity training for pediatric emergency health professionals is limited. No targeted training existed to improve the clinical preparedness of healthcare professionals serving SGMY by increasing providers' knowledge and attitudinal awareness in a pediatric emergency department at a large, urban pediatric hospital in the Southeastern United States. The Institute for Healthcare Improvement’s [15] Model for Improvement informed the project and was completed in four Plan-Do-Study-Act cycles. A cross-sectional, pre-test post-test design was used to gather demographic data, administer the LGBT-DOCSS questionnaire, and collect participant feedback on the training session. The LGBT-DOCSS results were analyzed using an independent samples t-test. Evidence-based pedagogical strategies were utilized for a 60-minute staff training session. Staff (n = 25) had six opportunities to attend one of the training sessions over a period of 4 months. Self-selection and voluntary participation contributed to recruiting participants who demonstrated high baseline LGBT-DOCSS scores, particularly on the subscales that measure knowledge and attitudinal awareness. After the sessions, participants showed an increase in LGBT-DOCSS scores with a statistically significant increase in the clinical preparedness subscale. This project was the first at the institution to focus on culturally sensitive emergency care for sexual and gender minority youth. The content was well received by staff, who demonstrated increased clinical preparedness after the training.