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Date of Award


Document Type


Degree Name

Master of Science in Nursing (MSN)

Thesis Committee Chairperson

Janice Hobba-Glose DNS, MSN-CNS, RN

Second Reader

Pamela Schmidt, MSN, NP-C,WHNP-BC, C-EFM


LGBTQ, primary care, Project ECHO, Practice Improvement Collaborative


Clinical Problem: The clinical problem that this paper will address are the health disparities and lack of appropriate care received for LGBTQ patients. Research studies show that LGBTQ patients are more likely to experience certain illnesses and diseases such as STDs and also participate in higher-risk activities as compared to their heterosexual and cisgender counterparts.

Significance: This clinical problem is significant because without intervention inappropriate care and health disparities will continue for LGBTQ patients, which account for approximately 4.5% of the population in the U.S (The Williams Institute, 2019). If no action is taken, LGBTQ patients may continue to experience discrimination and lack of appropriate screening and testing.

PICOT Question: Among the LGBTQ+ population in a primary care office, what is the impact of implementing a Practice Improvement Collaborative and Project Extension for Community Health Outcomes (ECHO) on (1) inclusion and safety (2) SOGI collection and reporting (3) riskbased sexual history taking and (4) appropriate STD and HIV screening?

Clinical Change: The clinical change is to implement a Project ECHO and a Practice Improvement Collaborative. A Project ECHO is a video-conferencing educational system for providers to meet with providers that specialize in the care of LGBTQ patients to gain knowledge and training to provide appropriate care for LGBTQ patients. A Practice Improvement Collaborative is an internal system that includes a quality improvement team that includes teaching through interdisciplinary collaboration and motivates and educates their respective teams.

Desired Outcome: After implementation of the clinical change, we hoped that there would be improvements in inclusiveness and safety of the LGBTQ patients, improved SOGI documentation, improved risk-based sexual history taking, and improved STD and HIV risk-based screening.

Summary: In summary, research suggests that implementation of a Project ECHO and a Practice Improvement Collaborative would be beneficial to improve care for LGBTQ patients in a primary care office. This paper will also discuss the plan for implementation of the evidence-based practice proposal into a primary care office.