The joint mission of the University of Florida College of Medicine – Jacksonville and UF Health Jacksonville is to heal, to comfort, to educate and to discover through quality health care, elimination of health disparities, medical education, innovation and research. To help accomplish our mission, we are committed to achieving inclusive excellence in a safe environment where the entire health care team can thrive.

While much attention has been focused on addressing health care professionals’ bias toward patients, incidents of patient bias and discrimination toward clinicians and staff also occur and are difficult to navigate. Some describe such incidents with patient bias, prejudice and discrimination as profoundly painful, degrading, and emotionally or physically distressing. Bystanders can also experience distress and uncertainty about how to respond. These experiences can contribute to burnout of the health care team, which can potentially have consequences on patient care.

As a result, there is a new policy in place in the hospital setting that “prohibits discrimination and harassment on the basis of race, color, creed, religion, gender, sex, sexual orientation, gender identity and expression, marital status, national origin, age, disability, political opinions or affiliations, genetic information and veteran status.” UF Health Jacksonville recently established the clear policy and procedures to guide staff in responding to incidents of biased patient behavior or discrimination.

POLICY GUIDELINES

The policy includes the following:

• Guidance on how to address a patient who displays discriminatory behavior against staff
• Circumstances when a patient can be reassigned
• Reporting requirements for any instance meeting the policy criteria
• Support for affected staff

Reporting mechanisms will be streamlined since our health care team will use the same reporting system used to report incidents related to patient safety. Reporting will also be centralized to capture data across the entire organization to detect trends and identify departments or groups of the health care team at a higher risk for experiencing patient bias to provide additional support and education.

POLICY IMPLEMENTATION

It is critical as the policy is implemented to ensure that no patient care will be denied in an emergency as per the Emergency Medical Treatment & Labor Act, and it may be necessary to accommodate a patient’s reassignment request or ignore discriminatory behavior in an emergent situation. In addition, if a patient is reassigned because of inappropriate behavior, it is crucial that clinicians help the patient secure another qualified provider and medical care facility.

Understanding that the affected staff might endure short- and long-term effects, support will be provided to all staff recipients of inappropriate behavior. Support may include debriefing with affected staff to discuss the incident, evaluation of how the team responded and discussion of how best to address future discriminatory behaviors of patients. Individual and team counseling or support may be provided by the Center for Healthy Minds and Practice and/or the employee assistance program.

Our goal is to continue to provide high-quality medical care to all patients while having a supportive and respectful work environment for our entire health care team. This is one step further in our efforts to continue to work to cultivate a culture in which inclusion, diversity, equity and access serve as the foundation of our medical care, education, innovation and research efforts.