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Sexual, gender minority patients report greater comfort when SOGI’s collected via nonverbal self-report

Registrar form collection is the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department.

Photo by @rawpixel from Unsplash.com

Sexual or gender minority patients reported greater comfort and improved communication when SOGI was collected via nonverbal self-report.

This is according to “Assessment of Patient-Centered Approaches to Collect Sexual Orientation and Gender Identity Information in the Emergency Department”, a study done by Adil Haider, MD, MPH; Rachel R. Adler, ScD; Eric Schneider, PhD; et al and publisher din JAMA Network Open.

For this study, the researchers wanted to identify the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department (ED).

So they tapped four EDs on the east coast of the US that sequentially tested two different sexual orientation and gender identity (SOGI) collection approaches between February 2016 and March 2017.

A total of 540 enrolled patients were analyzed; the mean age was 36.4 years and 66.5% of those who identified their gender were female.

In particular, two SOGI collection approaches were tested: nurse verbal collection during the clinical encounter vs nonverbal collection during patient registration. The ED physicians, physician assistants, nurses, and registrars received education and training on sexual or gender minority health disparities and terminology prior to and throughout the intervention period.

Multivariable ordered logistic regression was used to assess whether either SOGI collection method was associated with higher patient satisfaction with their ED experience. Eligible adults older than 18 years who identified as a sexual or gender minority (SGM) were enrolled and then matched 1 to 1 by age (aged ≥5 years) and illness severity (Emergency Severity Index score ±1) to patients who identified as heterosexual and cisgender (non-SGM), and to patients whose SOGI information was missing (blank field). Patients who identified as SGM, non-SGM, or had a blank field were invited to complete surveys about their ED visit. Data analysis was conducted from April 2017 to November 2017.

The study found that sexual or gender minority patients had significantly better Communication Climate Assessment Toolkit scores with nonverbal registrar form collection compared with nurse verbal collection (mean [SD], 95.6 [11.9] vs 89.5 [20.5]; P = .03). No significant differences between the 2 approaches were found among non-SGM patients (mean [SD], 91.8 [18.9] vs 93.2 [13.6]; P = .59) or those with a blank field (92.7 [15.9] vs 93.6 [14.7]; P = .70). After adjusting for age, race, illness severity, and site, SGM patients had 2.57 (95% CI, 1.13-5.82) increased odds of a better Communication Climate Assessment Toolkit score category during form collection compared with verbal collection.

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In a gist (and to emphasize): Registrar form collection is the optimal patient-centered approach to collecting sexual orientation and gender identity information in the emergency department.

“Our interventional study assessing two potential methods to collect SOGI in the ED found that SGM patients reported significantly higher satisfaction with their experience in the ED with registrar nonverbal collection compared with nurse verbal collection,” the researchers stated. “In other words, SGM patients preferred a standardized collection process where all patients could report SOGI along with other demographical information vs being asked by a nurse during a clinical encounter. Non-SGM patients and those without reported SOGI information were no less satisfied with form collection compared with verbal collection.”

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