Becker's Hospital Review

17 PATIENT EXPERIENCE Rush unveils center for LGBTQ+ healthcare By Anuja Vaidya C hicago-based Rush University Medical Center has launched a center that aims to offer safe, accessible and comprehensive care to people identifying as lesbian, gay, bisexual, transgender, queer/questioning and other sexual identities, or LGBTQ+. The facility, called Affirm: The Rush Center for Gender, Sexuality and Reproductive Health, opened Jan. 21. The center offers access to primary care for all age groups, behavioral health services, gender-affirming clinical services, specialty care and surgery. Many studies have shown that members of the LGBTQ+ community face increased health risks, including a 2017 study published in Cureus, which shows LGBT youth are at a higher risk for substance use, sexually transmit- ted diseases, cancers and anxiety and depression, among other conditions. Research also shows that LGBT youth receive poor healthcare care due to stigma, lack of awareness or insensitivity among healthcare providers. "Patients often don't know where to turn when seeking medical care, and the prospect of having a negative experience can be daunting, turning them away from getting help," said Ravi Iyengar, MD, the center's co-medi- cal director. "That's when health suffers. By navigating patients to affirming and competent providers, we are advocating for their health and ultimately closing these gaps in care." The center will also conduct education and research alongside providing clinical services. n ER patients shed light on the trauma restraints can bring By Gabrielle Masson B eing restrained during emergency room visits can have lasting nega- tive effects on patients' well-being, according to research published Jan. 24 in JAMA Network Open. Researchers with New Haven, Conn.-based Yale School of Medicine interviewed 25 patients who had been restrained in two urban ERs. Nine of the 25 patients reported negative feelings about restraint use and felt abandoned by staff, or that they lost their dig- nity and self-determination. Ten patients had mixed feelings, while another six said they had positive feelings — "the staff have got my best interest at heart"— or felt they were to blame for the experience. Some patients reported complex personal contexts affecting the visit and difficulty resolving the experiences. e study found restraint use can aggravate some mental health conditions, such as PTSD and anxiety. One respondent said, "e experience in the emergency room, it's traumatic as hell," as cited by STAT. "Rapid control of an out-of-control situation is the default in ER settings," Matthew Wynia, MD, a physician and bioethicist at Auro- ra-based University of Colorado Anschutz Medical Campus, told STAT. He co-authored an editorial that accompanied the study. "[Clinicians] may not recognize how incred- ibly damaging an experience of restraint can be," Dr. Wynia added. Some patients said their experiences led them to lose trust in the healthcare system or avoid it entirely. Experts recommend creating a space in ERs where staff can de-escalate situations without restraints, while Dr. Wynia sug- gested having someone sit with a restrained patient to minimize feelings of isolation and abandonment. n Hospitality trumps care quality in patient surveys, study finds By Anuja Vaidya N either care quality nor patient survival rates have a significant effect on patient satisfaction ratings, according to a study published in the journal Social Forces. "Hospitality experiences create a halo effect of patient goodwill, while medical excellence and patient safety do not," the study authors wrote. Researchers examined CMS data on patient satisfaction, death rates and care quality for more than 3,000 hospitals between 2007 and 2010. They found that patient satisfaction scores for hospitals with the highest death rates were only 2 percentage points lower than scores for at hospi- tals with the lowest death rates. They also found that patients are more likely to take into consideration the visible "room and board" aspects of care when deciding satisfaction scores. For example, quiet rooms had a larger effect on patient satisfaction than care quality. Additionally, nurses' interpersonal skills, including their responsiveness and compassion, not their technical medical skills, played a far larger role in patient satisfaction. n

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