As all healthcare organizations know, employee training is critical for policies to be lived out fully and consistently. Organizations have found training particularly important for ensuring LGBTQ+ patient-centered care. Training employees in LGBTQ+ concerns not only ensures that LGBTQ+ patients receive equitable and culturally competent care. It also helps to improve the general hospital climate towards all LGBTQ+ people, specifically LGBTQ+ employees.
The Joint Commission’s LGBT Field Guide explicitly notes that a hospital can only provide welcoming and competent care through a workforce that is prepared to do so. The Field Guide urges healthcare facilities to provide its employees with training in LGBTQ+ patient-centered care, stating that “hospitals should offer employees high-quality training that equips them with the tools to provide equitable, knowledgeable, and welcoming care for LGBTQ+ patients and their families.” The Field Guide further provides a list of suggested LGBTQ+ topics to cover in trainings, varying methods to train employees, and other key recommendations in training employees in LGBTQ+ patient-centered care.
There are two HEI training requirements. The "Baseline" requirement and the "Training+" requirement.
BASELINE TRAINING REQUIREMENT
The Baseline Training Requirement varies by each healthcare facility.
Baseline - Executive Briefing
Baseline - 10% Requirement (previously known as the on-going training requirement)
Please note that each participating healthcare facility will only have ONE of these Baseline requirements. Once a facility has met the Baseline - Executive Briefing requirement, it's training requirement will be the Baseline - 10% Requirement as long as it continues to participate in the HEI survey and meet the baseline training requirement. Facilities are NOT required to complete the Executive Briefing each year.
TRAINING + REQUIREMENT - Additional Training in LGBTQ+ Patient-Centered Care
To meet the first component of this requirement, healthcare organizations must have key facility employees receive expert training in LGBTQ+ patient-centered care. Training programs should offer all incoming and current staff the information and skills they need to provide culturally competent care and services to their LGBTQ+ patients.
Training requirements vary by facility and are determined by whether or not the facility has previously met the HEI Executive Briefing Training Requirement, which is typically met during the first year of HEI participation. Facilities that have previously met the HEI Executive Briefing Training Requirement, need to meet the Baseline 10% Training Requirement. You can find your training requirement listed on your survey login page.
The Executive Briefing is currently being modified for the HEI 2026. More information about how to meet this requirement is coming soon.
Facilities that have previously met the HEI Training Requirement must have members of their staff participate in on-going expert training in LGBTQ+ Patient-Centered care. To meet this training requirement, facilities must complete a minimum number of training hours that equals 10% of the number of FTEs at your facility.
For example, if you have 1200 FTEs at your facility, your required number of training hours to complete for the HEI 2026 survey is 120 hours.
We encourage staff members who are new to the topic to take one of the general introductory trainings on LGBTQ+ patient-centered care available through any of the following sources:
Internal Trainings: A healthcare facility may receive training credit for the course(s) that they sponsor on LGBTQ+ culturally competent care and/or specific LGBTQ+ health topics. These trainings must be pre-approved before HEI credit will be given.
View Training Information to learn more about the Requirements and Guidelines for HEI Approval of Internal Trainings in LGBTQ+ Patient-Centered Care.
The National LGBTQIA+ Health Education Center: Offers over 60+ different webinars and online training options. View Training Information
Veterans Health Administration: Several TMS courses are pre-approved for use in the HEI. View Training Information
Other Pre-Approved Trainings: There are a number of external LGBTQ+ trainings and conferences that have been pre-approved for use in the HEI. View Training Information
To receive credit in the HEI, a facility must:
Provide staff training in LGBTQ+ Patient Centered Care at a minimum number of hours to meet the Training + distinction. The minimum number of hours to meet the “Training +” requirement is an additional 10% on top of the baseline requirement.
We have updated and strengthened our training requirements to help accommodate the range of organizations that participate in the HEI as well as the importance of new and ongoing trainings in LGBTQ+ patient centered care.
At least one senior manager (Director, Vice President or Chief level) in each of the following work areas must complete the training:
The senior managers that attend this training must be the highest ranking staff member from each of these work areas for the specific facility. Senior managers are typically at the level of Director or higher.
Yes. However, you must still have 5 senior managers attend, so you can substitute any additional senior manager from the four other management groups. In addition if your healthcare facility is a clinical site with multiple locations such as an FQHC, etc, then the clinic director/manager for each clinical site must also complete the training.
We are currently in the process of updating the Executive Briefing Training. We will provide more communication and the Executive Briefing process and the designation of executives once the training is completed.
No external training can be substituted for the Executive Briefing Training.
The range of facilities taking part in the HEI survey range from small to very large. To provide some equity to the process we have refined the minimum number of hours to meet the baseline 10% training requirement.
A minimum of hours equal to 10% of the number of FTEs at your facility equates to if you have 1200 FTEs in your facility than your baseline staff training requirement will be 120 LGBTQ+ patient-centered care training hours.
All staff that interface with patients are invited and encouraged to participate in these trainings. This includes all staff who provide care at your facility (nurses, physicians, residents, fellows, etc.) even if they are not employed by your facility. Note that trainings provided by affiliated medical schools as part of medical school curriculum do not count toward your facility's training requirement.
The Training+ requirement has been created to encourage the importance of LGBTQ+ patient-centered care trainings but also to celebrate those organizations that have excelled at exceeding their training requirements.
For new facilities or those that have not previously met the training requirement, the minimum number of hours to meet the “Training+” requirement equals 10% of the number of FTEs at your healthcare facility.
For returning facilities that have previously met the training requirement the minimum number of hours to meet the “Training+” requirement is an additional 10% on top of the baseline requirement for a total of 20% of the number of FTEs at your healthcare facility
Meeting the Training+ Requirement is necessary to achieve the Leader designation. The baseline training requirement is necessary to achieve all other designations.
For the HEI 2026, the HEI will accept any trainings completed from January 1, 2024 through the final survey deadline for that year (including any granted extensions).
On your survey login page, you will see a training summary box titled, "Training Information & Resources." Here, you will find all relevant training information pertaining to your facility such as what training requirement your facility needs to fulfill and the total amount of training hours your facility has completed.
The login page will be live and available to view starting in January 2025.
Yes, with pre-approval, a healthcare facility may receive credit for its internal training course(s) on LGBTQ+ culturally competent care and/or specific LGBTQ+ health topics. This is the most common way that organizations meet the HEI training requirements. These trainings may be offered in-person, online, or through your organization's learning management system (LMS). See our page on internal trainings for more information.
Internal training content approvals are now valid for two HEI cycles. For the HEI 2026, all trainings submitted for approval prior to January 1, 2022 should be resubmitted using our internal training approval form.
Yes, staff may attend other expert led trainings on LGBTQ+ health that provide CME/CEU credit (such as conferences, other webinars, etc.) and have that training count towards the baseline LGBTQ+ education requirement. In order to receive credit though, the training must first be submitted through our approval form.
Yes. Trainings offered by the National LGBTQIA+ Health Education Center and the VHA (VHA facilities only) are approved for use in the HEI. The trainings offered through the National LGBTQIA+ Health Education Center provide AMA PRA Category 1 Credit™. The CME/CEU credit types for the VHA courses vary.
To register for trainings offered through the National LGBTQIA+ Health Education Center, please follow the steps in this registration guide. Be sure to add your facility ID to your account to receive credit. For the VHA, you can review the list of approved trainings here.
You are not required to submit individual certificates from the National LGBTQIA+ Health Education Center or VHA courses, as we receive this information directly from both sources.
In general, we do not encourage group trainings as an option with our training program. There are over 60+ trainings for people to choose from so we want people to have the option to choose the trainings that best meet their needs and interests. The trainings also offer free CME/CEU credits which we cannot offer in a group setting.
However, group trainings can be a good option for front-line staff, those without computers, and other staff that do not need CME/CEU credit. You can do group viewings with trainings on the National LGBTQIA+ Health Education Center, but someone will need to navigate through the different videos and slides.
We encourage you to chose one of the LGBTQ+ introductory trainings for group viewing. Please be sure to compile participant information into a spreadsheet or formal LMS report, so we can credit your facility. You will get an hour (or more depending on training) for each attendee. (after review)
No, trainings can be of any length. If your staff are completing shorter trainings you will just need more staff to complete the trainings to meet your required minimum number of hours.
No. Trainings do not have to offer CME/CEU credits to count in the HEI. However, the trainings provided by the National LGBTQIA+ Health Education Center as well as many of the external pre-approved trainings do offer CME/CEU credit.