Do ask do tell: Improving sexual orientation and gender identity documentation completion within electronic medical records

Background – Lesbian, Gay, Bisexual, Transgender, and other (LGBTQIA+) patients represent a minority group in healthcare settings. This population is underrepresented due to many factors, including lack of sexual orientation and gender identity (SOGI) reporting via electronic medical record (EMR) though it is a federally mandated policy. By not reporting SOGI for patients, underrepresentation of LGBTQIA+ health issues are reported. Increasing documentation of SOGI, patients can have their identities seen and ultimately helps improve health equity for LGBTQIA+ patients. Purpose – Increase documentation in EMR related to patients’ sexual orientation, gender identity, sex assigned at birth, and pronouns in the inpatient setting. Method –Data was compiled on both a monthly and quarterly basis. Quarterly interventions were implemented to all inpatient units including computer reminder cards, leadership access to audits to be shared with team members, pride flag stickers given to staff that could show completion of SOGI documentation on patients, and a SIM was created to help staff ask patient’s their pronouns and correct colleagues when using inappropriate pronouns. Data - Four documentation requirements were audited (sexual orientation, gender identity, sex assigned at birth, and pronouns) the goal was to have a minimum completion rate of 25% from 15 of the inpatient units over a four quarter time span. Gender identity had an increase of average completion by 5% with 11 of 15 units meeting the goal documentation. Sexual Orientation had a total increase of average completion by 7% with 5 of 15 units meeting the goal documentation. Sex assigned at birth had a total increase of average completion by 1% overall with 5 of 15 units meeting the goal documentation. Pronouns had a total increase of average completion by 5% overall with 2 of 15 units meeting the goal of 25% documentation. Conclusion – This project showed an overall increase in completion across all four data points