| Description |
Background: Transgender and gender-diverse individuals face significant barriers in accessing timely and appropriate gender-affirming care, including long wait times, provider knowledge gaps, inefficiencies in referral processes, and inappropriate referrals. These challenges are exacerbated by stigma, discrimination, and healthcare systems not optimized for their unique needs, leading to unmet healthcare needs and poor health outcomes. Literature highlights the importance of structured referral systems and provider education in improving access to gender-affirming healthcare. Local Problem: The existing referral process for gender-affirming care is inefficient, resulting in delays and misdirected referrals. This project aimed to develop and implement a gender-affirming transhealth toolkit to improve access to care for transgender patients by enhancing provider awareness, streamlining referral pathways, and reducing delays in accessing gender-affirming care. Methods: This evidence-based quality improvement initiative was conducted across six internal medicine clinics and three gender-affirming transgender surgical clinics in Salt Lake County, Utah. The project used a pre-and post-implementation design to evaluate the effectiveness of a gender-affirming transhealth QR code toolkit linking healthcare providers to a specialized gender-affirming care management team. The intervention included educational materials, training sessions, and the QR code system. Data on the intervention's feasibility, usability, and impact on referral trends were collected using surveys and feedback forms. Interventions: The gender-affirming transhealth toolkit was developed with input from healthcare providers, clinical staff, and administrative teams. It included educational materials, training resources, and a QR code for direct access to the care management referral form. Implementation followed an iterative Plan-Do-Study-Act (PDSA) approach based on provider feedback and utilization trends. The intervention was implemented in phases: assessment, gender-affirming transhealth toolkit development, training, and ongoing evaluation. Results: Post-implementation, the average monthly enrollment of transgender patients in the care management program increased from 8 to 14. Accurate referrals to gender-affirming care management teams increased by 40% post-intervention. Provider familiarity with the gender-affirming care management team improved significantly, with 71.4% of respondents reporting being "Very familiar" post-implementation compared to 10.5% pre-implementation. The perceived ease of the referral process also improved, with 100% of participants rating it as "Easy" to "Very easy" post-implementation. The gender-affirming transhealth toolkit was well-received, with high satisfaction rates and increased confidence in referring patients to appropriate services. Reported barriers to transgender healthcare access decreased, enhancing care coordination and efficiency. Conclusions: The gender-affirming transhealth toolkit effectively improved provider awareness and the accuracy of referrals to transgender healthcare management teams. The intervention addressed critical barriers to transgender healthcare access, such as inappropriate referrals, enhancing care coordination, and improving health outcomes for transgender patients. The gender-affirming transhealth toolkit's adaptability allows for implementation in various healthcare settings, including rural and underserved areas. Future efforts should focus on expanding this intervention to additional clinical settings and sustaining improvements through ongoing provider education. Future projects should evaluate the gender-affirming transhealth toolkit's effectiveness in diverse settings and explore additional strategies for improving transgender healthcare access. |
