D.14 Patient Responsibilities 02.pdf

DEPARTMENT OF VETERANS AFFAIRS (VA)

SALT LAKE CITY HEALTH CARE SYSTEM

Salt Lake City, Utah

MEMORANDUM 11.02 October 21, 2016

PATIENT RESPONSIBILITIES

1. PURPOSE:

To define the policies and procedures regarding the responsibilities of patients receiving care in any facility associated with the VA Salt Lake City Health Care System

(VASLCHCS).

2. POLICY:

a. Patients are responsible for fulfilling the part of the treatment plan to which they have agreed, and to regulate their behavior in accordance with standards of conduct defined and described in the VASLCHCS Patient Handbook.

b. Patients will be encouraged to comply with the treatment plan and if unable to do so, appropriate staff will review the situation.

c. VASLCHCS staff will take appropriate actions to ensure that patients do not threaten the safety of other patients and visitors, employees, their personal property and government property.

3. DEFINITIONS:

a. The role of the patient includes participation in treatment planning and willingness to undergo appropriate observations, examinations, and treatment, including referrals. A patient’s refusal to comply with the role of patient (without an agreed-to compromise between the patient and staff) terminates the treatment contract. Should another treatment contract not be agreed to, the patient will be released from the treatment facility to seek other care.

b. Unacceptable behavior includes:

(1) Possession of intoxicating beverages, narcotics, drug abuse paraphernalia, weapons, or firearms. Gambling on campus.

(2) Theft, damage, destruction, loss or misuse of property.

(3) Behavior that interferes with the delivery of safe medical care to other patients at the medical facility or impedes the operations of the facility.

(4) Unwanted approaches toward or unwanted contact with others

D.14 PATIENT RESPONSIBILITIES

36C25923R0008

MEMORANDUM 11.02 2

(5) Behavior that is intimidating, threatening, and/or dangerous and poses a threat to the health or safety of other patients, VA employees, or visitors to the facility.

(6) Verbal or physical abuse.

4. RESPONSIBILITY:

a. All employees have responsibility for:

(1) Encouraging patients to conduct themselves in a way that promotes safe and healthy treatment of all patients.

(2) Reporting disruptive behavior to their manager, VA Police, or city police in their jurisdiction, as the behavior warrants, entering a Disruptive Behavior Report through the “Disruptive Behavior Incident Link” on the SLCVA Home Page.

b. The VA Police at the George E. Wahlen Department of Veterans Affairs

Medical Center or local police at the Community Based Outpatient Clinics (CBOCs) will respond immediately with the help necessary to control threatening behavior.

5. PROCEDURES:

a. An inpatient who fails to conform to the treatment plan, is too sick to be discharged and is not already committed, should have a psychiatric consult. Options available following consultation include, but are not limited to, transfer to another hospital at the patient’s expense, transfer to a psychiatric unit, commitment, and transfer to the state psychiatric hospital.

b. When offenses do not justify formal charges, the treatment team may use behavior modification techniques to encourage the patient’s cooperation with the treatment plan and milieu, i.e., rewards for positive behaviors and withdrawal of privileges, passes or entertainment opportunities for negative behaviors.

c. The treatment team must document in the patient's clinical record the therapeutic approaches utilized and proven ineffective to help the patient comply with the treatment plan. The option of flagging the patient record to alert staff to the potential for violence should also be considered.

d. A patient accused of disorderly conduct will be handled through the appropriate legal channels if his/her behavior breaks local civil laws. If behavior disrupts the environment of care or causes staff to question the safety and welfare of the veteran or others, staff may file a Disruptive Behavior Report. The patient may be discharged from treatment at the VASLCHCS. Attempts will be made to transfer inpatient care of the patient

MEMORANDUM 11.02 3

to a facility that can manage such behavior. Current VA guidance regarding payment for care in another facility can be obtained from Patient Financial Services.

e. Any employee, patient, or visitor may file formal charges against any patient for injuries or serious threats. These will be directed to civil authorities with a copy through the physician in charge, the appropriate provider manager, and the Chief of Staff.

f. Any employee may file internal charges for injuries or serious threats from a patient by means of a memorandum to the Director through the physician in charge, the appropriate provider manager and the Chief of Staff documenting the incident.

g. If a patient on the grounds of the Medical Center is endangering the life or health of other individuals, an employee should telephone the VA Police, extension 4444, and the Director’s Office. The patient will be informed in writing of the disposition of the charges.

h. If a patient at a CBOC is endangering the life or health of other individuals, an employee will telephone the local police through 911. When the immediate threat is resolved, a CBOC staff member will telephone the Director’s Office to discuss the incident.

i. Any patient or visitor may file internal charges for injuries or serious threats from a patient by communication to the Patient Liaison Officer (or VA Police in an emergency).

6. RESCISSION: Center Policy Memorandum 11.02, “Patient Responsibilities,” dated

June 18, 2012.

7. RECERTIFICATION DATE: This policy is scheduled for recertification on or before the last working day of October 2019.

8. FOLLOW-UP RESPONSIBILITY: Chief of Staff (11)

//s//

Shella Stovall

Acting Director