Sexual and gender diversity in cancer care and survivorship

Schulz-Quach, Christian; Kennedy, Margo; Lyver, Brendan

doi:10.1097/spc.0000000000000628

Cited by 2 publications

(1 citation statement)

References 57 publications

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“…Each group is subjected to numerous stressors during visits to a healthcare institution, a multitude of factors that impact their experience at the healthcare institution can trigger stress responses, minority stress and responsive behavior which can increase the probability of WPV events [52]. Trauma-informed care and inclusive lens is a requirement to ensure that patients, (chosen) family members and visitors can feel as safe as possible [53,54,55]. Engaging with patients involved in past WPV or Code White incidents provides a different and often complementing perspective of WPV events.…”

Section: Interpretation Systematic Framework To Address Wpv In Health...mentioning

confidence: 99%

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Schulz-Quach,

Lyver,

Reynolds

et al. 2024

Preprint

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Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.15 events per 1000 visits (p<.0001). In response, UHN initiated a comprehensive quality improvement (QI) project to address WPV. This study presents the project's design, implementation, results, and key takeaways, aiming to showcase effective and trauma-informed strategies for mitigating WPV in healthcare settings. Methods: Our multi-intervention QI initiative was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework. We also leveraged the SEIPS 101 tools to aid in crafting each QI intervention. This approach amalgamated various methodologies to approach WPV, incorporating literature reviews, a modified Delphi method, qualitative interviews, surveys, quantitative data gathering and pragmatic interventions. Results: Our complex intervention contained a total of 12 subprojects. We reviewed existing literature (n=84) pertaining to WPV in healthcare. N = 229 quality indicators utilized to measure WPV in healthcare were extracted from the literature and underwent a Delphi process which yielded 17 quality indicators for a new organizational WPV dashboard. WPV theories were critically reviewed in the context of intervention development. Educational initiatives (n=2) were implemented including ad-hoc point of care training, as well as rollout of a comprehensive trauma-informed training program for WPV prevention, verbal de-escalation and management of escalated responsive behaviour. Further changes involved establishing a Code White Governance Committee, enhancing WPV reporting and addressing underreporting. Debriefing was structured into hot and cold debriefing models. Additionally, environmental indicators promoting mutual respect were introduced, alongside security enhancements including wearable video devices for all security guards and a 100% increase in ED security guards. Outreach initiatives were implemented including qualitative interviews with ED staff (n=75) and the development of a patient partner and community outreach group. Conclusions: WPV in healthcare is a complex phenomenon that urgently requires effective solutions. We developed a 13-step framework that offers guidance for healthcare institutions seeking to develop a systemic approach in addressing WPV tailored to their organization’s needs.

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Section: Interpretation Systematic Framework To Address Wpv In Health...mentioning

confidence: 99%

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Schulz-Quach,

Lyver,

Reynolds

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

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Mapping gender and sexual minority representation in cancer research: a scoping review protocol

Stirling,

Hunter,

Ludwig

et al. 2023

cmajo

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People from gender and sexual minority (GSM) groups are at high risk of experiencing inequities throughout the cancer continuum. [1][2][3] Inequities are defined as unfair, unacceptable and avoidable differences in health resulting from unequal distribution of power, prestige and resources across groups. 4,5 This risk is primarily attributed to the heterocisnormative environment of the health and cancer systems that discriminates against GSM populations and invalidates their experiences. Heterocisnormativity is defined as "the assumption that heterosexuality is the standard for defining normal sexual behavior and that male-female differences and gender roles are the natural and immutable essentials in normal human relations." 6 In the cancer system, this manifests in many ways, including a lack of GSM identifiers in cancer registries, [7][8][9] the exclusion of people from GSM groups from organized cancer screening programs, 10 a lack of culturally appropriate care, 7,11 and individuals from GSM groups with cancer experiencing homophobia and transphobia, and discrimination from cancer care providers. 7,11,12 The implications of heterocisnormativity are profound and observed in the cancer-related inequities GSM populations experience, such as lower screening rates, [13][14][15] higher incidence of viral-related cancers (e.g., HPV), 1,16 and receipt of culturally inappropriate and unsafe care. 12,17,18 Addressing these inequities necessitates a robust synthesis of existing research. Most knowledge syntheses on this topic have been narrative in nature. Few systematic reviews exist, and those that do have focused on specific phases of the cancer continuum (i.e., psychosocial care and survival) 19,20 or only included studies within a limited time frame. 21 Systematic data are lacking on cancer outcomes and experiences of people from GSM groups through all phases of the cancer continuum. In this review, we seek to address this gap through systematically mapping the evidence base describing cancer outcomes for adults from GSM groups and exploring the literature describing cancer care experiences for this population. This scoping review will answer the broad question of

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Sexual and gender diversity in cancer care and survivorship

Cited by 2 publications

References 57 publications

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Mapping gender and sexual minority representation in cancer research: a scoping review protocol

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