Addressing unsafe or disruptive inpatient behavior and workplace violence: Administrative discharge as a last resort

Healthcare workers face a disproportionately high risk of workplace violence compared to other industries, and disruptive patient behavior causes significant distress for care teams. To address this, we developed a structured, multidisciplinary response to unsafe inpatient behavior, that allows care teams to focus on patient care and maintain therapeutic relationships, while nonclinical administrators enforce hospital rules. In the event of recurrent violence, our framework also provides guidance for administrative discharge-the discharge of an adult inpatient from the hospital before medical readiness-which is available as a last resort to maintain a safe working and healing environment.