Sexual Orientation, Gender Identity, and Pronouns in the EMR: Impact of Education on Documentation
Poster #: 149
Session/Time: B
Author:
Daiwik Prakash Munjwani, BS
Mentor:
Amin Yehya, MD, MS
Research Type: Public Health
Abstract
INTRODUCTION:
Documentation of sexual orientation, gender identity (SOGI), and pronouns in electronic medical records (EMRs) is essential to providing inclusive, patient-centered care, yet these fields are often left incomplete. At our institution, a system-wide diversity, equity, and inclusion (DEI) educational program launched in September 2023 emphasized the importance of collecting and documenting SOGI and pronouns. Our objective was to evaluate the effect of a hospital-wide diversity-focused educational initiative on documentation of SOGI and pronouns in the EMR for patients discharged with heart failure.
METHODS:
This retrospective chart review included adults (≥18 years) discharged from a tertiary care heart hospital with a primary diagnosis of heart failure between August 14, 2022, and March 21, 2024. Data were extracted from the EMR (Epic) and entered into REDCap for analysis. Patients were categorized as pre-initiative (August 2022-August 2023) or post-initiative (September 2023-March 2024). Differences in documentation proportions for sexual orientation, gender identity, and pronouns before and after the initiative were compared using asymptotically normally distributed Z-test statistics.
RESULTS:
Of 1,489 eligible patients (449 pre-initiative, 1,040 post-initiative), documentation rates increased for sexual orientation (13.8% to 19.4%; +5.6%, P = .009), gender identity (81.5% to 93.5%; +12.0%, P < .001), and pronouns (12.3% to 18.5%; +6.2%, P = .003).
CONCLUSION:
Implementation of a DEI-focused educational program was associated with modest but statistically significant improvements in documentation of SOGI and pronouns in patients with heart failure. Additional interventions beyond education may be necessary to achieve optimal documentation rates.
Documentation of sexual orientation, gender identity (SOGI), and pronouns in electronic medical records (EMRs) is essential to providing inclusive, patient-centered care, yet these fields are often left incomplete. At our institution, a system-wide diversity, equity, and inclusion (DEI) educational program launched in September 2023 emphasized the importance of collecting and documenting SOGI and pronouns. Our objective was to evaluate the effect of a hospital-wide diversity-focused educational initiative on documentation of SOGI and pronouns in the EMR for patients discharged with heart failure.
METHODS:
This retrospective chart review included adults (≥18 years) discharged from a tertiary care heart hospital with a primary diagnosis of heart failure between August 14, 2022, and March 21, 2024. Data were extracted from the EMR (Epic) and entered into REDCap for analysis. Patients were categorized as pre-initiative (August 2022-August 2023) or post-initiative (September 2023-March 2024). Differences in documentation proportions for sexual orientation, gender identity, and pronouns before and after the initiative were compared using asymptotically normally distributed Z-test statistics.
RESULTS:
Of 1,489 eligible patients (449 pre-initiative, 1,040 post-initiative), documentation rates increased for sexual orientation (13.8% to 19.4%; +5.6%, P = .009), gender identity (81.5% to 93.5%; +12.0%, P < .001), and pronouns (12.3% to 18.5%; +6.2%, P = .003).
CONCLUSION:
Implementation of a DEI-focused educational program was associated with modest but statistically significant improvements in documentation of SOGI and pronouns in patients with heart failure. Additional interventions beyond education may be necessary to achieve optimal documentation rates.