The initiative incorporated community engagement and aimed to:

• Meet new regulatory requirements
• Improve the patient/client experience
• Equip staff with the needed data to uncover and reduce health disparities

Upon completion of a first wave of education in May 2019, 69.1% of staff completed the online training and 26.7% of staff completed the optional in-person training. As of June 2020, SO/GI was collected by paper form for 35% of primary care patients and in 26.8% of unique patient encounters overall throughout the health network.
 
The initiative demonstrated the feasibility of implementing SO/GI data collection as an inclusive and community-driven culture change initiative. Next steps include providing ongoing training and support for clinicians, staff and patients, as well as implementing SO/GI data collection for pediatric patients/clients and identifying health disparities to create targeted interventions to improve the care experience for LGBTQ patients/clients.

An accompanying editorial by Madeline B. Deutsch, MD, MPH, associate professor of Clinical Family & Community Medicine, University of California, San Francisco, noted: “Quality improvement and population health efforts require SO/GI data to allow the creation of sexual and gender minority subpopulations with varying levels of granularity, which can then be compared to one another or to cisgender groups to identify programmatic and operational efforts to address disparities.”

Also featured in the October issue:

• A Comprehensive Estimation of the Costs of 30-Day Postoperative Complications Using Actual Costs from Multiple, Diverse Hospitals (Data from four U.S. hospitals in the American College of Surgeons National Surgical Quality Improvement Program)
• Development and Validation of WeCares, a Survey Instrument to Assess Hospitalized Patients and Family Member’s “Willingness to Engage in Your Care and Safety” (Brigham and Women’s Hospital, Boston)
• Deficiencies in Interpreter Use in a Clinical Trial Comparing Telephonic and Video Interpretation in a Pediatric Emergency Department (University of Washington, Seattle)
• Reducing the Use of Opioids for Pediatric Patients with Supracondylar Humerus Fractures (Nationwide Children’s Hospital, Columbus, Ohio)
• How Dirty Is Your Phone? Evaluating Restroom Behavior and Cell Phone Surface Contamination (University of North Texas Health Science Center, Fort Worth, Texas)
• Assessing and Supporting Late Career Practitioners: Four Key Questions (Review of five U.S. health systems)
• Considering the Safety and Quality of Artificial Intelligence in Health Care (The Joint Commission, Washington, D.C.)
• Patient Care Rounds in the ICU During COVID-19 (Mayo Clinic Health System, Mankato, Minnesota)

For more information, visit The Joint Commission Journal on Quality and Patient Safety website.

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Note for editors 
The article is “Systematic Collection of Sexual Orientation and Gender Identity in a Public Health System: The San Francisco Health Network SO/GI Systems-Change Initiative” by Nicole Rosendale, MD; Amie Fishman, MPH; Seth Goldman, MD; Seth Pardo, PhD; Ashley Scarborough, MPH; and Ayanna Bennett, MD. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 46, number 10 (October 2020), published by Elsevier. 

The Joint Commission Journal on Quality and
Patient Safety 
The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered. 

1 Institute of Medicine. The Health of Lesbian, Gay, Bisexual, 421 and Transgender People: Building a Foundation for Better Understanding, Washington, DC: National Academies 423 Press, 2011.