Author Biographical Info

Shermeen Chandani is a registered nurse with over nine years of experience working primarily in mental health care. She is a Doctor of Nursing Practice (DNP) student at the Cizik School of Nursing at the University of Texas Health Science Center at Houston. Her academic interests focus on healthcare quality improvement, emphasizing patient-centered and culturally responsive approaches across care settings.

Date of Doctor of Nursing Practice Project Completion

2025

Faculty Advisor

Daisy G. Mullassery DrNP, RN, WHNP-BC

Abstract

Abstract

Title: Improving Sexual and Gender Minority Cultural Competency in Outpatient Psychiatric Clinics

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The intervention included two 60-minute components: an evidence-based online module and a facilitated, skills-focused session emphasizing clinical application. Processes were implemented to standardize chart labels for preferred names and pronouns and reinforce intake documentation of SGM identifiers. Outcomes were measured using the Sexual Orientation Counselor Competency Scale (SOCCS; Versions 1 and 3) and audits of chart labels and intake screening documentation.

Results: Post-intervention SOCCS scores showed improvement, with mean increases of 0.97 in sexual orientation competency and 1.20 in gender identity/transgender competency, exceeding the project’s predefined benchmark. Chart audits demonstrated high compliance (97–98%), while intake screening documentation remained low (22%). Chart labeling procedures were adopted as permanent practice.

Implications for Practice: Targeted SGMCC training improved staff competency and supported sustainable documentation changes. Future efforts should focus on leadership engagement and expanding training to additional departments.

Keywords

Quality Improvement in Healthcare, Health Equity, LGBTQ+ Mental Health, Cultural Competency, Inclusive Healthcare Practices, Provider competency, Sexual and Gender Minority Health, Outpatient Mental Health Care, Transgender Mental Health, Patient Centered Care

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