Patient Centered Methods to Collect Sexual Orientation and Gender Identity Status in the ED

Study Overview
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Brief Summary
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This trial is the final phase of a three phase PCORI-funded study to develop and test patient-centered approaches to collect sexual orientation and gender identity (SO/GI) information in the ED. From the results of Phase 1 qualitative interviews and national quantitative survey and Phase 2 Delphi rounds with the Stakeholder Advisory Board, we have determined two methods of collection favored by patients and providers to implement in the trial. The first method, nurse verbal collection, is in alignment with Partners recommended clinical practice and is therefore a quality improvement (QI) evaluation. The second method, non-verbal registrar form collection with nurse verbal confirmation, is a research intervention to evaluate and compare a new patient-centered approach to SO/GI collection. To compare the patient-centeredness of the two different approaches, satisfaction surveys will be administered to ED patients and staff members involved in collection. In summary, the study design (1) evaluates recommended current practice (QI), (2) evaluates a quality improvement project to increase recommended current practice, and (3) evaluates a new method of collecting SO/GI (research intervention).

Official Title
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Emergency Department Query For Patient-centered Approaches To Sexual Orientation And Gender Identity

Conditions
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Homosexuality, Gender Identity

Intervention / Treatment
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* Other: Methods to collect SO/GI information in the ED


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult ED patients who are cognitively and physically capable of informed consent Adult ED nurses and registrars who are cognitively and physically capable of informed consent Exclusion Criteria: Children Any person not cognitively and physically capable of informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: SO/GI Collection<br>Methods to collect SO/GI information in the ED | Other: Methods to collect SO/GI information in the ED<br>* In Mode 1, all patients presenting to the ED will have SO/GI information collected verbally by the nurse, which is standard of care. In Mode 2, all patients presenting to the ED will have SO/GI information collected in a non-verbal manner, in which the registrar will ask them to complete an electronic form.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Communication Climate Assessment Toolkit Questionnaire (Patient) | The primary outcome was patient satisfaction as measured by a modified Communication Climate Assessment Toolkit (CCAT) patient survey, an assessment of attitudes towards organizational climate and provider/patient communication.The CCAT is reliable, validated in geographically and ethnically diverse health care organizations, and accurately predicts patient-reported quality and trust. Containing 5/7 items from the full CCAT, our pre-specified modified scale included only questions that were applicable to the ED population, e.g. we kept the question Do you feel welcome at the hospital? but eliminated the question Was it easy to reach someone on the phone if you had a question? from analyses.Each scale item was scored as a 0 (most disagreement), ½ (neutral), or 1 (agreement), resulting in a scale score ranging from 0-5; higher scores were considered more favorable. The average score for the modified scale was calculated and multiplied by 20 to provide the overall score out of 100. | Through study completion (approximately 1 year) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Staff-reported Outcomes Measure Questionnaire | Measures responses to the staff survey question, Did you experience difficulty collecting sexual orientation data from patients? | Through study completion (approximately 1 year) | 
| Proportion of Patients Reporting SO/GI | Measures the proportion of all adult emergency department patients from whom SO/GI was collected during the study period | Through study completion (approximately 1 year) |