Becker's Clinical Quality & Infection Control

15 www.beckersinfectioncontrol.com or call (800) 417-2035 SIGN UP TODAY! Infection Control & Clinical Quality Becker's Infection Control & Clinical Quality E-Weekly a disability condition under the Americans with Disabilities Act, such as an allergic reaction. An analysis of reasonable accommodation looks at what the hospital has done, or can do, to accommodate the healthcare worker's wish to not receive the vaccination, such as the face mask option at Lahey Health. It starts with determining to what extent the hospital can reasonably accommodate the worker and whether the employee presents a direct threat to patient safety. "If you're a children's facility or work with immunosuppressed kids with can- cer, you're probably going to have the ability to demand everybody to get a vaccination because you're talking about a patient group that is incredibly vulnerable," Mr. Mavity says. "If it were a chiropractor's office, that would be less risk." The key to handling such situations, Mr. Mavity says, is to not make knee-jerk decisions and just fire the employee. Most first actions, he says, are not disci- plinary. Instead, healthcare organizations should speak with the employees and council them. "If a healthcare employer just said, 'If you don't get a flu vaccination, we're go- ing to fire you,' you'd see a lot of legal claims," Mr. Mavity says. "But you don't see that. You see, 'Let's go through this analysis.'" Employee rights vs. patient safety Although legal claims aren't common, they do happen. For instance, the Mas- sachusetts Nurses Association recently sued Brigham and Women's Hospital in Boston to block a policy still being considered that would require flu vaccinations for all employees. In another case, a customer service representative at Cincinnati Children's Hospital filed a lawsuit against the hospital for firing her for refusing the vaccine, which she declined due to her alleged veganism. "It's usually a prior adverse reaction, but often an issue of personal freedom," says Dr. Duncan, commenting on why employees may reject mandatory vaccines. But professionals largely agree that in healthcare, patient safety takes prece- dence over individual rights, both in practicality and in healthcare employee obligations. "On a practical matter, they should put patient care first," Mr. Mavity says. "You're going to see a balancing act, but at the end of the day if you're evaluat- ing risk on every level, you're going to err on the side of patient care." Dr. Duncan mentions the duty and responsibility of those in the healthcare field. "It's really the obligation of a healthcare worker, a moral and ethical obligation to take measures which are going to help preserve the safety of your patient, even if it comes at a small inconvenience," he says, adding the system's offering for employees to wear a mask is a concession to those employees who believe there should be more personal freedoms. At Lahey Health, 100 percent of leadership received the vaccine in the past two years. "I think that's an important demonstration to the rest of employees that we consider this a priority and a major safety effort," Dr. Duncan says. And so do a number of professional healthcare organizations, including, but not limited to, the American Academy of Family Physicians, American Acad- emy of Pediatrics, American College of Physicians, American Hospital As- sociation, National Patient Safety Foundation and the Society for Healthcare Epidemiology of America. "This is the number one vaccine-preventable cause of death in the United States, and it can cut the flu-related mortality in half. People have come to recognize that," Dr. Duncan says. "If they had an Ebola vaccine right now, how many people would be refusing it?" n

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