BRATTLEBORO — Brattleboro Memorial Hospital has been working on an initiative to become more inclusive, with training for employees and work to ensure patients’ preferred ways of identifying themselves are respected.
The hospital’s LGBTQ+ Leadership Council, established in 2017, aims to create a welcoming and affirming environment for employees, patients and families in all hospital areas.
The hospital teamed with Boston’s Fenway Institute, an education and research arm of Fenway Health — one of the leaders in LGBTQ+ health care.
LGBTQ+ refers to those who are lesbian, gay, bisexual, transgender, queer, questioning, intersex or asexual, and allied persons of any gender and sexuality.
The institute has performed a needs assessment for the hospital and will continue providing education for all hospital employees, both focused on LGBTQ+ health care, according to hospital CEO and President Steven Gordon.
To date, the hospital has spent about $25,000, accounted for in its annual budgets, Gordon noted.
The initiative was prompted by a letter Gordon said he received a few years ago from a transgender patient, complimenting the emergency department staff.
“She was expressing how well she was cared for, how people were very accommodating. She had not had that experience in other settings,” he said. “It got me thinking that if she took the time to express that attitude, let’s look at that and see how we can do a better job.”
He began researching other hospital models for serving the LGBTQ+ community and disparities the population faces.
Until recent years, the Fenway Institute’s National LGBT Health Center’s research states, many health care systems have operated under the assumption that all patients are heterosexual or cisgender — people who identify with the sex they were assigned at birth.
“... It has fallen to LGBTQ+ patients to either correct these assumptions or to keep quiet about their own identities and health care needs,” Gordon wrote in a recent news release.
This has led to LGBTQ+ people declining to seek the health care services they need, according to the center’s research.
“We are a very open community here in Brattleboro, and it really fits within our mission to better serve our community. The gay, lesbian, transgender community is a significant part of [that],” Gordon said.
Though no specific data to Brattleboro was available, a 2017 Gallup poll found Vermont leads states in LGBTQ+ identification, at 5.3 percent of the population.
Johanna Staveley, coordinator of the initiative and co-chair of the LGBTQ+ Leadership Council, said the institute first conducted a hospital-wide survey to assess its educational needs.
The survey found about 90 percent of hospital employees felt committed to being inclusive to all patients, but didn’t know how to approach it.
“On the good side, there was a lot of energy, but we don’t know what questions to ask. It was really basic,” she said.
In the first training from the institute in September — which Gordon noted was standing-room only — this need was addressed. Questions like “What are your pronouns?” and “How would you describe your sexual orientation?” were given as examples.
“It’s the simple questions that will help us to provide individualized, appropriate and affirming care to all people in our community,” Gordon said.
The presentation was filmed, Gordon added, to be used for future-employee orientation.
Staveley said the hospital has also made headway on changing policies and procedures to be more inclusive, such as with patient registration forms.
The forms prioritize the identity of the patient — name, gender, age — and then have a section after asking if these markers match official documents.
“In many places, those are flipped so that the official name that a [transgender] person may not be going by is the thing that’s prioritized,” she said. “We are just trying to shift that gravity so that the patient’s identity is the primary and then the other identifying information, which may or may not be relevant for the rest of their life, is gathered secondary.”
If a patient identifies as a different name or gender than on official documents, Staveley said the patient informs their provider of their birth information in order to find the records.
She added the hospital is working with their electronic medical record system to allow changes to be made, such as name and gender, on previous documents to avoid this in future visits.
Additionally, the hospital’s equal opportunity employment statement has been updated to include more nondiscrimination language, such as gender identity and genetic information.
Other changes consist of having gender-neutral bathrooms, inclusive signs across the hospital, and staff lanyards switched to rainbow colors — a symbol of the LGBTQ+ community.
Gordon said this is still the beginning of the initiative, but he’s proud of the progress so far.
“We’re pretty unique, especially as a small, rural hospital ... we’re really excited about this journey,” he said.