Know steps to prevent and respond to allegations
Allegations of sexual misconduct must be taken seriously, and risk managers should have steps in place to both prevent them and respond appropriately, say Deborah S. Stephens, RN, BSN, JD, CPHRM, risk manager at Spectrum Health in Grand Rapids, MI, and Bridget Tucker Gonder, RN, BSN, JD, CPHRM, associate legal counsel for the health system.
They suggest taking these steps to prevent sexual misconduct:
- Educate staff regarding patient rights.
- Set the standard for professional conduct.
- Develop a policy regarding sexual misconduct.
- Take all allegations seriously.
- Avoid conflicts of interest.
- Investigate complaints immediately.
- Teach boundary violation prevention techniques to all staff and physicians.
Spectrum has put most of its 10,000 employees and physicians through education sessions in the past two years, including discussion sessions and viewing of a video made in-house that illustrates some of the scenarios leading to misconduct allegations.
At Spectrum, employees are educated about boundary violations, which Stephens says can be the cause of many patients feeling they were the victims of sexual misconduct. The burden is on the health care provider to make sure the patient does not feel that boundary has been violated, Gonder says. It's not enough to say that your intentions were pure but the patient felt the situation was inappropriate, she says.
"We had one physician whose routine was to go sit on the patient's bed and chat, touch the patient on the arm and get very chummy for a few minutes, and then he would start the examination," Gonder says. "One patient was offended and thought that he was being sexual with her. When we told him, he was just shocked that it offended anyone. People have to be sensitive to how people are responding, and they have to know that not everyone likes to be touched."
That physician was saved when a female social worker who happened to be in the room confirmed the physician's intentions. Stephens says risk managers should encourage the use of chaperones and witnesses much more than is common in most organizations.
Investigate quickly and thoroughly
Once the allegation is made, they recommend following these steps to investigate:
1. Take the allegation seriously. Never dismiss a complaint out of hand.
2. Remain impartial until you have all the facts.
3. Remove the accused staff member from patient care while you investigate.
4. Start the investigation immediately.
5. Provide patient comfort in whatever way the patient feels is appropriate. This may include access to a counselor, social worker, or medical care.
6. Offer to put the patient in touch with local law enforcement.
7. Notify the patient's attending physician.
8. If the patient is a minor, notify the parent or guardian and child protective services.
9. Interview the staff member and any potential witnesses.
10. Follow your human resources policies.
11. Offer employee assistance services to the accused employee.
For more information on preventing and addressing sexual misconduct, contact:
- Deborah S. Stephens and Bridget Tucker Gonder, Spectrum Health, 100 Michigan St. N.E., Grand Rapids, MI 49503. Telephone: (866) 989-7999.