Study: LGBTQ+ inclusive policies linked to lower nurse burnout, higher care quality

Editor's Note

Hospitals that embrace LGBTQ+ inclusive policies see better nurse retention, improved care quality, and stronger institutional endorsement, according to a large cross-sectional study published on March 25 in JAMA Network. The study examined data from 7,343 nurses across 111 hospitals in New York and Illinois, focusing on the impact of a hospital’s designation as an LGBTQ+ Healthcare Equality Leader (HEI Leader).

As reported in the article, nurses working in HEI Leader hospitals had significantly lower odds of high burnout (adjusted odds ratio [AOR], 0.69) and job dissatisfaction (AOR, 0.62), compared to peers in hospitals without this designation. They also reported higher odds of perceiving excellent or good care quality (AOR, 1.83) and were more likely to strongly recommend their hospitals (AOR, 1.72). The findings, adjusted for both individual nurse characteristics (eg, age, race, gender, years of experience) and hospital-level variables (eg, Magnet status, size, teaching status), reinforce theories of inclusive organizations that posit diversity policies improve employee well-being and institutional performance. Notably, the benefits of LGBTQ+ inclusion were consistent across demographics, with no significant interaction effects between HEI Leader status and nurse race, gender, or age.

HEI Leader hospitals meet comprehensive inclusion criteria, from non-discrimination and training, to equitable employee benefits and community engagement, the article noted. The study’s authors suggest inclusive policy environments likely reduce workplace discrimination and foster belonging, which in turn strengthens care quality and workforce stability. In addition to LGBTQ+ inclusion, Magnet status—a designation for nursing excellence—was also associated with significantly better job satisfaction and lower burnout. Meanwhile, high-specialty hospitals, such as those with transplant or cardiac programs, were linked to worse nurse outcomes, possibly due to care complexity and workload.

While the study is limited by its cross-sectional design, voluntary hospital participation, and focus on two progressive states, the implication stands: inclusive environments benefit both staff and patients. The authors recommend broader adoption of HEI standards and deeper investment in inclusive organizational practices to improve healthcare delivery and staff well-being.