Computer-Based Patient Bias and Misconduct Training Impact on Reports to Incident Learning System

Abstract Objective To assess the effect of computer-based training (CBT) and leadership communication on incident learning system reports pertaining to institutional policy that targets biased, prejudiced, and racist behaviors of patients and visitors toward health care employees. Patients and Methods Mayo Clinic developed a CBT module and comprehensive communication strategy to educate staff on the Patient and Visitor Conduct Policy. Additional goals were to demonstrate leadership endorsement and support of the policy, teach how to report an incident, and facilitate how policy enforcement might occur. Using descriptive statistics, we compared the reporting data before and after the intervention. Results Participants were 13,980 employees in 68 clinics and 18 hospitals in the US Midwest. Bias and misconduct incidents entered in the incident reporting system increased 312% (n=140 incidents; preintervention, n=34) in the quarter (ie, 3 months) immediately after intervention. The number of incidents in the next quarter stayed increased (234%; n=114) compared with the preintervention number. Secondary debriefing with employees showed the value of the education and the importance of leadership support at the highest level to facilitate comfort in policy enforcement. Conclusion Institutional policy that targets biased, prejudiced, and racist behaviors of patients toward employees in a health care setting can be augmented with employee education and leadership support to facilitate change. The CBT, paired with a robust communication plan and active leadership endorsement and engagement, resulted in increased reporting of biased, prejudiced, and racist behaviors of patients.