Rising violence against healthcare workers prompts Massachusetts hospitals to adopt new codes of conduct

Massachusetts hospitals have agreed to enforce new codes of conduct to protect healthcare workers from the growing threat of violence and abuse by patients.

The new policies will prohibit violence as well as offensive, abusive and discriminatory language and behaviour. Any patient who breaks the rules may be asked to leave and seek care elsewhere.

The commitment comes after the Massachusetts Health and Hospital Association reports that every 38 minutes, someone is assaulted, verbally abused or threatened in a Massachusetts healthcare facility. Most of the violent and verbal attacks come from patients and are directed at healthcare workers.

This type of behavior is increasing. The hospital association surveyed its member hospitals, which reported 13,734 “incidents of malpractice” last year, a 28% increase from 2021. The figures may represent an undercount as some incidents are likely to go unreported.

“Acts of violence are on the rise, both here in the community and across the country. And that’s absolutely unacceptable,” said Steve Walsh, president of the hospital association. “Our carers work so hard in the hardest of times. And because most of society has moved away from the pandemic, our hospitals and caregivers haven’t had the opportunity to do that.”

While there is no timetable for when they will be introduced, Walsh said the new codes of conduct are intended to be a “baseline” and that individual hospitals can go further.

Some hospitals have already done so. Brigham General’s code of conduct, announced in November, specifically prohibits patients and visitors from making offensive remarks about race, accent, gender and other personal characteristics. This includes refusing to see a healthcare provider because of their race.

Boston Children’s Hospital began beefing up security amid a spate of harassment last year — including bomb threats — that were sparked by misinformation about its transgender surgery program. Harassment also includes attacks on social networks and aggressive phone calls.

“We’ve become a political football,” Dr. Kevin Churchwell, CEO of Boston Children’s, said Friday at the hospital association’s annual meeting in Boston. “We really had to develop a more consistent evolutionary response to protect our caregivers.”

After the first bomb threat last year, Boston Children’s began “de-escalation training” to teach staff how to manage aggressive behavior, hospital officials told WBUR. The hospital is now rolling out wearable panic buttons that allow staff to quickly call security if they feel unsafe.

When patients rush into hospitals, nurses are often helpful. The hospital association reported that according to its study, 38% of abuse in Massachusetts targeted nurses last year. Security personnel were also frequent targets, accounting for 27% of incidents.

Hospitals and the Massachusetts Nurses Association are urging state lawmakers to pass different versions of legislation that could help prevent and manage violence in hospitals. Lawmakers did not act on the bills last session, and their new session is just beginning.

Joe Markman, a spokesman for the nurses’ union, said nurses generally supported stricter codes of conduct. But he stressed that hospitals need to do more.

“We want the state to go further by enacting laws that hold hospitals accountable for working with frontline staff on violence prevention plans, regularly reviewing those plans, providing strong support for assaulted workers and improving reporting of violence he said in an email.

The nurses’ union and hospital association are backing increased penalties for people who assault healthcare workers.

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