Three Ways to Mitigate and Address Bad Patient or Family Behavior in Your Organization

November 13, 2023
Increased harassment of healthcare workers is leading to burnout and turnover

Healthcare worker reports of bullying, verbal abuse and other “bad behaviors” from patients, family members and coworkers have doubled since 2018, according to a recent Centers for Disease Control and Prevention (CDC) report. Surveyed healthcare professionals reported that being frequently harassed leads to higher levels of anxiety, depression, and burnout and may affect patient safety.

The same CDC report also identified that overall, 44.2% of healthcare workers said they were somewhat likely or very likely to look for a new job in 2022. In contrast, the report revealed that turnover declined among all other workers during this period. At a time of increasing shortages of healthcare professionals and physicians, losing any one of them to burnout caused by bad behavior should spur organizations to stop tolerating any level of harassment and unacceptable conduct in healthcare settings.

Bad behavior is contagious and at epidemic proportions

There are many opinions on the causes of bad behavior on the frontlines, including in clinics, hospitals and senior living organizations. According to a report in Harvard Business Review, the pandemic, the economy, wars, divisive politics and the changing nature of work all may be contributing to displays of verbal and physical harassment. Christine Porath, a professor of management at Georgetown University and researcher on incivility, surveyed over 2,000 people in more than 25 industries across the world looking at incivility trends and  seeking to gain insight into what’s happening on the front lines of business and society today. Her findings show that 78% of respondents witness incivility at work at least once a month, and 70% witness it at least two to three times a month, up from 61% in 2012. Seventy eight percent of respondents also believe that bad behavior from customers toward employees is more common than it was five years ago. Research1,2 also shows that instances of negative behaviors—like rudeness—can be contagious.

The negative impacts of tolerance of bad patient or family behavior on the workforce and patient safety include:
• Burnout, low morale, turnover, staffing shortages, recruiting difficulties, workers compensation claims
• Poor outcomes, errors3 and malpractice claims
• Distrust in healthcare providers and the system

Three ways to reduce and respond to bad behavior

  1. Reduce the risk of bad behavior by establishing a culture of zero tolerance
    • Implement an employee, patient and visitor code of conduct that identifies acceptable/unacceptable behavior, and outlines the consequences of bad behavior
    • Educate patients, families and the community with signage in waiting and patient care areas encouraging respectful behavior and identifying unacceptable behavior, give pamphlets to patients and visitors explaining the zero-tolerance culture, provide community education via news articles and social media posts, and involve the patient and family advisory council (if applicable)
  2. Respond appropriately and consistently to bad behavior
    • Implement empathetic communication training for all care team members
    • Teach front line employees and healthcare professionals how to recognize aggression warning signs, conflict management skills and de-escalation strategies
    • Provide written protocols and verbal scripts for immediately addressing aggressive, uncivil and unacceptable behavior
    • Outline a clear chain of command and when to involve security or law enforcement
  3. Support healthcare professionals
    • Provide emotional support for clinicians and frontline care team members. Reinforce the zero-tolerance policy by having management and administration stand behind healthcare professionals who act in response to bad behavior
    • Track and trend events of incivility, aggression and violence. Update your risk management plan based on event trends
Resources and next steps

Watch our recent webinar, Recognizing and Defusing Aggressive Behavior Before Violence Erupts, to learn more about ways to reduce and address aggressive behavior at your healthcare organization before violence ensues.

Are you a client? Sign in to MyAccount to access exclusive client versions of our risk reports. The expanded risk reports share actionable insights and strategies you can utilize to help reduce harm events and malpractice claims. After you sign in to MyAccount, follow Risk Resources > Tools & Resources > Publications > Risk Reports. You also have access to a host of Bundled Solutions (in Risk Resources) that cover a wide variety of topics to assist you in your risk mitigation efforts.


  1. Catching rudeness is like catching a cold: The contagion effects of low-intensity negative behaviors.  APA PsycNet. Accessed October 31, 2023. 
  2. Research: How One Bad Employee Can Corrupt a Whole Team. Harvard Business Review. Accessed October 31, 2023.  
  3. When Patient Rudeness Impacts Care: A Review of Incivility in Healthcare. Cureus. Accessed October 31, 2023.

Curi’s risk mitigation resources and guidance are offered for educational and informational purposes only. This information is not medical or legal advice, does not replace independent professional judgment, does not constitute an endorsement of any kind, should not be deemed authoritative, and does not establish a standard of care in clinical settings or in courts of law. If you need legal advice, you should consult your independent/corporate counsel. We have found that using risk mitigation efforts can reduce malpractice risk; however, we do not make any guarantees that following these risk recommendations will prevent a complaint, claim, or suit from occurring, or mitigate the outcome(s) associated with any of them.

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