This is the first study to examine patient mistreatment across the clinical team and to examine the experience of gender and sexual minorities.
University of Alabama at Birminghamresearchers have published new information on patient discrimination against healthcare workers who identify as non-binary gender individuals.
Published in Patient Experience Journal, lead author Katherine Meese, Ph.D., assistant professor in the Department of Health Services Administration and director of the UAB Center for Health Care Management and Leadership, says there needs to be pay more attention to stress caused by patient abuse. the care team.
“Healthcare organizations have paid increasing attention over the past decade to improving the patient experience,” Meese said. “However, discussion of patient behavior towards clinicians was almost entirely absent from the conversation.”
A survey of clinicians was conducted at a large academic medical center, resulting in a final analytical sample of 1,682 physicians, nurses, advanced practice providers, and clinical support staff. Nurses reported the highest incidence of patient abuse as a major stressor (18.69%), followed by advanced practice providers (11.26%), clinical support staff (10.36%) and doctors (7.69%).
The overall results indicate that nurses and those working in the emergency room and ambulatory or outpatient clinics were more likely to be stressed by mistreatment by patients than by clinicians. Members of gender or sexual minorities (not identifying as male or female) and younger healthcare workers (18 to 34 years old) were also more likely to be stressed by patient mistreatment.
Meese adds that during the height of the COVID-19 pandemic, there was an escalation in violence by patients towards healthcare workers across the country, sometimes ending tragically.
“This information is invaluable for healthcare leaders looking to determine where to target limited resources.”
“What I advocate is a more balanced discussion about how we address and improve the patient experience, while addressing the growing incidence of patient violence and clinician abuse,” said Meese. “Our healthcare workforce is already in a fragile state, with increasing burnout and intentions to leave the profession. The first step in the discussion is to better understand the extent of the problem.
Meese says recent research suggests that the majority of workplace abuse for doctors has come from patients and visitors to hospitals or clinics.
“Our research also highlights groups most at risk of stress from patient abuse,” she said. “It is important to note that this includes younger employees, nurses, gender non-binary people and those working in emergency rooms and outpatient settings. This information is invaluable to healthcare managers looking to determine where to target limited resources. »
A step in the right direction
Meese notes that many organizations have responded with an increased security presence on critical units, clear expectations for patient behavior, a no-tolerance policy for violations, and even panic buttons in patient rooms.
“Organizations may also need to think about how they measure and encourage improvements in patient experience,” Meese said. “Do they include a balanced approach taking into account the behavior of the patient? Is there a punitive model for not reaching a certain threshold in experience scores? »
Meese says she and her team are committed to understanding what factors are associated with the experience and well-being of healthcare workers so that we can ultimately support building and sustaining a workforce in healthy, thriving and thriving.
“Our first step is to ask interesting questions that are still unanswered, and the research design follows,” she said. “We are working with a variety of partner projects that involve testing leadership interventions, evaluating new models of team-based care delivery, addressing post-covid PTSD and peer support.”
The co-authors of this study include:
Alejandra Colón-López, MA, Department of Sociology, College of Arts and Sciences
Aoyjai P. Montgomery, Department of Epidemiology, School of Public Health
Laurence M. Boitet, Ph.D., Department of Health Services Administration
David A. Rogers, MD, UAB Medicine Chief Wellness Officer
Patricia A. Patrician, Ph.D., RN, Rachel Z. Booth Endowed Chair in Nursing, School of Nursing
This study was supported by a grant from the ProAssurance Corporation to David A. Rogers, MD