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Healthcare Equality Index: Patient Non-Discrimination

The Core Four criteria of HRC’s national Healthcare Equality Index represent policies and practices that are considered foundational to LGBT patient-centered care. For this reason, any HEI participant that meets the Core Four criteria is awarded the designation “Leader in LGBT Healthcare Equality.”

To meet the first of the Core Four criteria, healthcare organizations must implement and document a patient non-discrimination policy (or patients’ bill of rights) that:

  • Uses the terms “sexual orientation” and “gender identity” AND
  • Is communicated to patients and employees

The HEI criterion reflects Joint Commission standard RI.01.01.01, EP 29 [PDF], which calls on accredited facilities to prohibit discrimination based on both sexual orientation and gender identity or expression. The HEI criterion also reflects the recommendations of The Joint Commission LGBT Field Guide.

An explicitly LGBT-inclusive patient non-discrimination policy, together with the training called for by the fourth Core Four criterion, can do much to reduce the discrimination that LGBT patients experience in healthcare settings.

Including the Terms “Sexual Orientation” & “Gender Identity” in Policy

When a healthcare organization includes the terms “sexual orientation” and “gender identity” in its patient non-discrimination policy, it sends an important message to patients and employees alike: LGBT people must receive equal treatment. In some cases, inclusion of these terms reflects state law, affirming that the organization is aware of and committed to legal requirements of non-discrimination. In areas without a state law prohibiting LGBT discrimination, adding “sexual orientation” and “gender identity” to a non-discrimination policy signals a clear and welcome commitment to equity and inclusion. As The Joint Commission LGBT Field Guide notes, explicit statements that healthcare organizations are committed to LGBT non-discrimination are deeply appreciated by LGBT members of the community and provide helpful guidance to employees.

It has become common for organizations’ non-discrimination statements to include the terms “sexual orientation” and “gender identity.” For example, leading healthcare-related organizations have adopted policies that prohibit discrimination against LGBT people by including the terms “sexual orientation” and “gender identity.”

Explicit prohibition of discrimination is foundational to LGBT patient-centered care. But as The Joint Commission LGBT Field Guide notes, it is also important to review patient services to ensure that LGBT people are treated equitably. Part A of the HEI’s Additional Best Practices section explains how to conduct this review.

Informing Patients & Employees of Policy

As recommended by The Joint Commission LGBT Field Guide, the first of the HEI Core Four criteria also calls on healthcare organizations with explicitly LGBT-inclusive patient non-discrimination policies to communicate those policies to their employees and patients. This practice provides useful guidance to employees and welcome assurance to patients.

HEI participants are asked to communicate their LGBT-inclusive non-discrimination policy in at least two of the following ways:

  • Posted on facility website
  • In materials routinely given to patients at admitting/registration
  • In materials routinely given to patients at other time(s)
  • In materials routinely available for take-away in patient waiting areas
  • Posted in patient waiting area(s)
  • Posted in employee work area(s)
  • In materials routinely given to employees at orientation