WHILE THE NUMBER of patients asking to be assigned to a different physician may be on the rise, so are the number of family members who exhibit bad behavior. That trend has some hospitals creating policies outlining behavioral expectations.
At Rochester Regional Health in Rochester, N.Y., Anil Job, MD, a hospitalist who now heads up the health system’s transfer command center, said that when family members become disruptive, he and his colleagues now rely on a written set of behavioral expectations to combat the bad behavior.
“It’s important to have healthy boundaries—and in our institution, we believe that we are allowed to set them.”
Anil Job, MD
Rochester Regional Health
“Some might call this a ‘behavioral contract,’ but that implies mutual agreement,” Dr. Job points out. “Instead, we’re noting in writing what behaviors we expect as well as the consequences of nonadherence.”
Provisions stipulate that all provider orders must be followed. They also define visiting hours, outline the frequency and method by which hospital staff will communicate with family members, and identify unacceptable behavior.
The plan notes, for instance, that staff will terminate any phone call in which family members become verbally abusive. And if bad behavior occurs on the hospital campus, according to plan provisions, hospital security will be notified and individuals will be escorted off the premises. In some cases, those individuals will have their visitation privileges revoked.
“There’s a belief that verbal abuse is somehow an accepted occupational hazard in health care,” says Dr. Job. “But I believe this contributes to moral injury and burnout.”
It’s like any other relationship, he adds: “It’s important to have healthy boundaries—and in our institution, we believe that we are allowed to set them.”
