Mass General Brigham Issues Patient Code of Conduct

By John Commins

With violence against healthcare workers reaching epic proportions, Mass General Brigham Hospital has launched a campaign to curb abuse from patients and visitors.

Under a newly imposed Patient Code of Conduct, patients and visitors who disrupt care, make verbal or physical threats — including racist, sexist, discriminatory or disrespectful comments about clinicians, other hospital staff, other patients and visitors — could face a verbal reprimand, and even expulsion from the Boston hospital and possible suspension of future care access.

“Just as we expect all of our employees and clinicians to treat each other and every patient and visitor with courtesy and respect, we have the same expectations of all of you,” Allison Bryant, MD, Mass General Brigham’s senior medical director for health equity, says in a YouTube video on the health system’s website.

“If there is a time where your actions violate the code, our staff will remind you of the expectations,” Bryant says. “Depending on the situation, it is possible that family members or visitors who violate the code may be asked to leave the premises and future visitations may be restricted.”

“If necessary patients who repeatedly act in disrespectful or discriminatory ways may be asked to make other arrangements for their care and obtaining future non-emergency care at MGB site may require review.”

Mass General Brigham says it created the patient code of conduct in response to the alarming increases in violence and hostility directed against hospital staff across the nation, including encounters that have resulted in the deaths and harassment of clinicians.

In January, two dozen Neo-Nazis held a protest in front of Brigham and Women’s Hospital and targeted for harassment two physician-advocates for health equity. In 2015, a Brigham cardiac surgeon was murdered by an angry patient.

A Bureau of Labor Statistics report found that injuries from violent attacks against medical professionals grew by 63% from 2011 to 2018. Hospital officials say the problem has intensified since the COVID-19 pandemic. A National Nurses United survey of more than 2,500 nurses in April found that nearly half (48%) reported an uptick in workplace violence – up from 22% in March 2021, a 119% increase.

“We are now more than three years into the pandemic and not only is staffing worse, but workplace violence is increasing,” NNU President Zenei Triunfo-Cortez, RN, says. “Nurses are experiencing alarming levels of moral distress and moral injury due to the unsafe working conditions. Since our last survey in September 2021, even more nurses have reported feeling more stress and anxiety as well as feeling traumatized by their experiences caring for patients.”

The threat of violence is one of several factors that are driving burned-out nurses from the profession, including chronic understaffing, an inability to manage surge capacity, and continued shortages of personal protection equipment, Triunfo-Cortez says.

Massachusetts Nurses Association President Katie Murphy, RN, says her union is “generally supportive of the new code of conduct, in the sense that we agree with the direction and goal of the policy and policies like it, but we may even want employers and the state to go further in some instances.”

“We have pending workplace violence protection legislation for that purpose, which would require each MA healthcare facility to work with its staff to create threat/violence protections unique to its environment.”

Murphy put some of the blame on the nation’s healthcare delivery system, saying “we must also acknowledge that patients and healthcare workers are under tremendous stress created by a system that too often values profits at the expense of local services, safe staffing, and quality care.”

“With healthcare violence rising during the pandemic, it is more important than ever that employers upgrade their policies in collaboration with nurses and other caregivers,” Murphy says.

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.