Viewpoint: The risks of patient codes of conduct

Mackenzie Bean (Twitter)

More hospitals are turning to patient codes of conducts to protect healthcare workers amid a rise in rude and violent behavior. However, banning patients — especially those with behavioral health needs — who don’t exhibit physical threats can pose a care quality concern, Lisa Morrise wrote in a Sept. 12 blog post for the Institute for Healthcare Improvement.

Ms. Morrise serves as executive director of Consumers Advancing Patient Safety. She detailed a recent healthcare experience involving her 30-year-old son Skyler Morrise, who has schizoaffective disorder. Mr. Morrise was dismissed from his health system after a disagreement with the mental healthcare clinic’s administrative manager about which provider he would see.

 In a letter to Ms. Morrise, the system said her son was being dismissed due to “disruptive and threatening behavior toward staff.” Ms. Morrise claims the system did not offer a way to appeal the dismissal and denied her son access to his medical records, requiring him to find all new providers and delaying his treatment.

While healthcare staff should be protected from patients who pose physical threats, the process for dismissing patients should involve written warnings and behavior plans for nonviolent patients, especially in behavioral health settings, Ms. Morrise wrote. Patients should also not be penalized for complaining about the care they receive, she argued.

“Dismissing patients who complain is a quality and safety concern,” Ms. Morrise said. “Complaints can help identify areas that need improvement. Patient insights support quality and governance initiatives. There should be no room for using dismissal as retribution for complaints.”