The Exec: NewYork Presbyterian's Juan Mejia on Strategies to Support LGBTQ Patients, Staff

The COO of NYP's Lower Manhattan Hospital heads the health system's LGBTQ Task Force, which focuses on diversity and inclusion work for patients, staff, and the broader community.

NewYork Presbyterian (NYP) is an academic health system that serves diverse communities across all five boroughs of New York City, Westchester, and Hudson Valley. There are more than 520,000 people from all walks of life living in those areas, including those with different backgrounds, ethnicities, economic statuses, gender identities, and sexualities.

NYP has numerous task forces to support the communities it serves, including the LGBTQ Task Force, which was created in 2015 to celebrate and support its lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities.

Juan Mejia, MPH, who serves as senior vice president and COO of the system's Lower Manhattan Hospital, leads the task force's work in creating a respectful and understanding environment for patients, staff, and the broader community.

Mejia recently spoke with HealthLeaders about the diversity and inclusion strategies and initiatives the task force has implemented across the system.

This transcript has been edited for clarity and brevity.

HealthLeaders: How was the LGBTQ Task Force created in 2015 and why is it needed?

Juan Mejia: [At] our hospital, we've always [been] focused on diversity and inclusion (D&I) initiatives and efforts. In 2015, we realized that we needed more of a focused effort specifically around our LGBTQ community. We needed a focused approach in reviewing our policies, programs, and training to make sure that not only is it meeting the requirements of what we should be having in our hospitals, but like everything else at NewYork Presbyterian, we want to be able to lead; that's the main reason we put together this LGBTQ task force.

Task force [is] probably not the best word; it's more of a steering committee that focuses on this across the organization. It is a subgroup of our bigger D&I strategy and is one of the many pillars that fall under our D&I strategy.

From a community perspective, we want to make sure that we have a place where patients feel welcome and where they feel like they belong. If you think about health justice in general, one of the biggest barriers is that oftentimes patients may have access to a doctor, but if they feel like they don't belong [or] don't feel like they're respected, oftentimes patients may not get the care that they need. That applies to our LGBTQ community  [and] to other patients who may have other disconnects. It's our responsibility to make sure that we create an environment where everyone feels like they belong.

The primary driver of why we're doing this, especially in New York City, [is] we have a diverse population. We have to ensure that we create a [diverse] environment.

HL: What is the task force's mission and what initiatives has the health system launched to serve that mission and the patients?

Mejia: The mission is to provide guidance for numerous initiatives impacting our LGBTQ community. That community is defined as our patients, our employees, [and] our external community.

{We have an] ongoing review of our policies to make sure that  [they] are inclusive for our patients, and that includes not just our patient policies, but also our workplace policies. Do we have workplace discrimination policies that are very specific to our LGBTQ employees to make sure that we have protections? That policy also extends to looking at whether our employee benefits are inclusive of [what] our LGBTQ employees might need.

Staff training and development are the top priorities of the task force, as is ensuring that we're continuing to provide opportunities for our staff to learn about the ongoing importance or evolution of care delivery models for our LGBTQ patients. We have a number of modules that we do online [and] a lot of in-person training through something that we call 'Dialogues and Diversity.' Ongoing training and doing it in different mechanisms is important.

[We also do] a lot of work around community engagement and community programming. So, ensuring that we're partnering closely with local community-based organizations and that we understand their needs and can support their mission as well. And when appropriate, being out in the community and providing care alongside our community partners to make sure that we are meeting the needs of our local community.

HL: What policy work has the task force done?

Mejia: We have a workplace discrimination policy that was generic. In the last eight or so years, we modified the policy to be very explicit that we cannot discriminate against LGBTQ employees. We were modifying the policy to make sure that it's very specific to what we do.

We have a protocol around room assignments, specifically for patients that are transgender. As an example, we assign beds based on the patient's gender identity. That's an example of a policy that was modified numerous years ago.

The good news here is there are a lot of best practices that are shared through the LGBTQ community. [There are] a lot of tools that the Human Rights Campaign has that many of us can go to. We don't always have to reinvent the wheel; there are a lot of great resources out there that we have used in the past. It's important that we share a lot of these best practices … by going to conferences [and learning] what other hospitals across the nation [are] doing that we can emulate to make sure that we continue to be leaders in this.

HL: How can other healthcare organizations follow your lead?

Mejia: The topic of health equity and health justice is one of our priorities, and when it comes to the mission of our hospital, we talk about health justice all the time. It always starts with our CEO down to the rest of the organization, understanding what is happening in the communities around us, and having open dialogues with our staff about this.

As healthcare leaders, we should all be talking about [and] sharing best practices around how to create an inclusive environment for our diverse populations. At the end of the day, the main reason to do this is for our patients, to make sure that our patients in our community feel like they have an environment where they belong, and they can comfortably and safely come to get care.

One best practice that we rolled out two years ago is our medical record. We were able to update our patient ID policies; The patient's ID band [is now] able to show the patient's preferred name as opposed to a patient's legal name. For a cisgender patient, that may not mean a lot because my legal name and the name that I use happen to be [the same], but if a person is transgender, the legal name and the preferred name may not be the same.

For numerous reasons, we previously were not able to show a patient's preferred name and we now are, which means that when our patients are interacting with staff, our team always knows the patient's preferred name based on the patient ID. [This] allows us to effectively and respectfully communicate with our patients.

Editor's note: This story was updated on March 2, 2023.