October 16, 2023

New Refusal of Care Policy to be effective Nov. 15

Beginning Nov. 15, a new refusal of care policy and standard operating procedure will become effective for the hospitals and clinics on the Nashville campus and surrounding areas (a policy and SOP for the regional hospitals will launch at a later date). The new policy and SOP will help employees understand what to do when a patient or family member refuses care or service based on an employee’s personal attributes, such as race, gender, or sexual orientation.

“While we might prefer to think this is an uncommon occurrence, research shows us that 59 percent of physicians and 53 percent of nurses experience bias from patients,” said Consuelo H. Wilkins, MD, MSCI, Senior Vice President and senior associate dean for Health Equity and Inclusive Excellence.

Although patients and families have a right to refuse care, this right does not outweigh our employees’ right to work in an environment free of racism, bias, and discrimination. This policy and SOP will help Vanderbilt Health consistently support an environment free of racism and discrimination.

To help support the new policy and SOP, training is beginning for impacted audiences, including employees who work in patient-facing roles, their local leaders, and senior leaders who can intervene if an escalation is necessary. This training details the steps employees should take if they experience or observe a refusal of care event.

Not only do the SOP and training help employees understand what to do in these situations, they detail employees’ rights and choices when experiencing such an event, as well as options for getting support for their own well-being. The new documents also provide detail on how to address the situation if the event requires action under Vanderbilt Health’s workplace violence policy.

A steering committee helped to design and develop the new policy, SOP, and related training, including committee co-chairs Wilkins and Clisby Hall, Donald Brady, MD, Travis Capers, Marilyn Dubree, Chad Fitzgerald, Mary Pawlikowski, Jennifer Pietenpol, PhD, Amy Schoeny, and Patty Wright, MD. Also integral to the project was Cecelia Theobald, MD.

“Our new refusal of care policy and SOP are an important step for helping make Vanderbilt Health a better place to work and receive care,” said C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer for VUMC. “We will closely monitor its impact on the organization and report our progress.”