Standard Work

Ambulatory Care Services

Title: SOGI Screening - Intake Date: 1/19/2018

Departments who must adopt: Adult Primary Care Operators who must adopt: MAs, LVNs, RNs

Task # Task description Reason

This is an addition to the existing intake standard work.

These questions should be integrated after review of the standing orders and at the beginning of the
section entitled “Screening Summary Tab”
If the PVS alerts that the patient is missing data in the SOGI fields: Data suggests that patients expect
Ask the patient about their sexual orientation and gender identity (SOGI), using the following script: to be asked in a healthcare setting
We ask every patient a few personal questions so that we can be more effective in providing and are unlikely to bring up SOGI
individualized care. This information is confidential, and only accessible to your healthcare team. At any unless asked. Asking about SOGI
time you can choose not to answer. respectfully is affirming for our
1  What gender do you identify as now (for example, male, female, transgender) non-cisgender, non-heterosexual
 What is your sexual orientation (for example, gay, straight, bi)? patients.
 Is this the same gender as on your birth certificate?
*see below for translation of script in other languages

Enter the patient’s responses in the relevant fields in NG.

2

Script Translations

Spanish:
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Nosotros les hacemos a cada paciente algunas preguntas personales, para que podamos más efectivamente
proporcionar un cuidado más personalizado. Esta información es confidencial y solo es accesible a su
equipo  de atención de salud. Usted en cualquier momento puede decidir no responder.
 
¿Con qué sexo o género se identifica usted,( por ejemplo: masculino, femenino, transgénero o transexual)? Es este el mismo sexo que tiene en su acta de
nacimiento?, Cual es su orientación sexual, (por ejemplo: homosexual, heterosexual, bisexual)?. Gracias por ayudarnos a darle una buena atención.
 
 
 Chinese:
We ask every patient a few personal questions so that we can be more effective in providing individualized care. This information is confidential, and
only accessible to your healthcare team. At any time you can chose not to answer. 
我們會問每個病人幾條私人問題，以便我們能夠更加有效地提供個人化的護理。這些資料是保密的，只有你的醫療團隊可以看到。在任何時
候你都可以選擇不回答。
 
What gender do you identify as now, (for example male, female, transgender)? 
你認為自己目前的性別是甚麼  (比如：男性，女性，變性)？
 
Is this the same gender as on your birth certificate?
這個性別與你的出生證明上所記錄的一樣嗎？
 
What is your sexual orientation, (for example, gay, straight, bi)?
你的性取向是甚麼 (比如同性，異性，雙性)？
 
Thank you for helping us take good care of you.
謝謝你的協助使我們能夠更好地給你護理。

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 Ambulatory Care Services

Frequently Asked Questions (draft as of 1/4/18)

About AHS’ REAL/SOGI Data Collection

1. What is REAL/SOGI?
 REAL- Race, Ethnicity and Language
 SOGI- Sexual Orientation and Gender Identity
2. Why are we asking these questions?
We ask these questions because:
 We care about providing the best possible health care to each patient. Answers to
these questions will help us tailor care to meet the needs of individual patients.
 We are federally required to collect information about our patients that may contribute
to inequality (or disparity) in care. We want each patient to receive the best care
possible.
 We need population data to help us identify potential inequality (or disparity) in care.
 We respect our patients and do not make assumptions about their preferred spoken
language, culture, sexual orientation or gender identity.

3. What types of questions are we asking?

Questions and terms are defined on the “AHS REAL/SOGI” Terms sheet.
SOGI
 What is your preferred name?
 What is your sexual orientation?
 What is your current gender identity?
 What sex were you assigned at birth on your original birth certificate?
REAL
 What is your race?
 Are you Hispanic?
 What is your ethnicity?
 What is your preferred spoken language?
HOUSING
 What is your current housing situation?
 In the past two months, have you been living in stable housing that you own, rent, or stay in as
part of a household?
 Are you worried or concerned that in the next two months you may NOT have stable housing
that you own, rent, or stay in as part of a household?
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4. When is the best time to ask these questions?

The American Hospital Association and America’s Essential Hospitals recommend collecting this
data at registration and/or immediately thereafter based on the results of several studies in healthcare
settings.
SOGI data is collected during MA intake because the EHR houses the SOGI data. REAL data is
collected at Registration because the registration software houses the REAL data; Patients have the
option to decline to answer the questions or to discuss them with their provider if they prefer.

5. Which patients should complete SOGI/REAL data?

SOGI: Every patient, age 18 and older, receiving primary care, emergency care, or being
admitted to our medical surgical unit should be asked the SOGI questions during the medical
intake. A patient can choose to update their answers at any time.
REAL: Most of the REAL questions are answered 1 time ever; with the exception of housing
status and related questions which should be asked with each visit during the registration process.

6. Is the information confidential?

Yes. Answers to these questions are always confidential, are protected by patient privacy laws, and
should only be viewed by a patient’s care team or those who are authorized to view the
information.

7. What are we doing with the information?

We are tracking the answers to these questions by population (groups of people) to identify
potential disparities in care. For example, are people of a specific race, ethnicity, or sexual
orientation reporting poorer health?

8. We always provide the best care to every patient. Do we really need to track this information?
Regulatory agencies like the Joint Commission have identified the struggle of some groups to
gain access to equitable care. Collecting race, ethnicity, and language (REAL) data in addition to
Sexual Orientation and Gender Identity (SOGI) data is the first step to identifying and resolving
health disparities that may be occurring at AHS. Acting on the data to reduce disparities will lead
to higher quality care and greater patient satisfaction.

9. What do I do if a patient refuses to complete the form or prefers to talk to their provider?
Always respect the wishes of the patient. If a patient is unsure about answering these questions,
answer their questions and assure them their information is confidential. Remind them of “decline
to answer” option. If they prefer to discuss their answers with their provider, coordinate with your
care team to honor the patient’s wishes.

10. At what age do we start asking these questions?

We are giving all adults (age 18 and older) the opportunity to respond to the SOGI questions. Over
time, we hope to expand these questions to patients 12 years and older. All patients regardless of age
should be given the opportunity to respond to the REAL questions. Note that responses from
underage (less than 18 years old) patients may be seen by their parent or legal guardian if entered in
the electronic health record. If you have questions or concerns, please ask your supervisor.
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11. Who do I contact if I have a question?

Your direct supervisor is your best resource.

12. What do I do if my patient doesn’t speak English or Spanish?

Interpreters are available in most languages. Our interpreters are aware of the script with which we
will be asking the SOGI questions and have translated the script in our most commonly used
languages.

13. Is REAL and SOGI data HIPAA protected?

Yes.

14. How are we training new Eligibility Clerks and MA’s?

All new Eligibility Clerks and MA’s receive a training which includes a cultural (why we ask
REAL and SOGI questions) and technical (how to gather and input the information) component as
part of their initial and ongoing training.

15. Will other members of the Care Teams be trained?

All involved staff will be trained.

16. How often are we asking these questions?

We will only ask the REAL and SOGI questions once, with the exception of housing status
which is asked at each visit. The patient can update their answers at any time and as often as
they want.

17. What if a patient refuses these questions or gets upset by the questions?
Follow the script provided in training to help patients understand the importance of the information.
It is important to inform our patients that we are asking ALL of our patients the same questions in
an effort to know our patients better and personalize their care. Patients always have the option to
decline to answer, and this option is available in the EHR.

18. I’m used to saying “sir” and “ma’am” when addressing patients. Should I stop doing that?
If you have not met the patient or don’t remember their preferences, either refer to the patient by
their full name or ask them how they would like you to address them. When someone is referred to
with the wrong pronoun it can make them feel disrespected, invalidated, dismissed, alienated, or
often, all of the above. Using gender neutral terms avoids this and allows for an inclusive
environment.

19. Should we tailor how we ask about SOGI based on age, ethnicity, or religion?
Since we are asking SOGI of all of our patients, we should ask patients the questions the same way
every time.
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