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University of Iowa Hospitals flag ‘disruptive’ patients

Aug 12, 2017 at 6:30 pm | Print View

IOWA CITY — With her arm outstretched for a blood draw at a University of Iowa clinic, Tara Armstrong focused her attention on something appearing on the phlebotomist’s computer.

“I asked her what the issue was,” she recalled of that February day.

A red box popped up in the 33-year-old patient’s medical record, and the phlebotomist was trying to make it disappear. But a curious Armstrong asked her to bring it back up.

“Disruptive patient alert,” the note read — entered by Lance Clemsen on Nov. 30, 2016.

Clemsen is a social work specialist for UI Hospitals and Clinics and chair of its 4-year-old “Disruptive Patient and Visitors Program.”

Armstrong’s experience highlights the tight rope health care providers like the UIHC walk in their commitment to serve a diverse and growing population at a time of increasing hospital violence nationally.

It also illustrates some of the ethical and logistical challenges of “disruptive patient” programs — which, while not widely known to the public, are becoming more common across the country.


The red box wasn’t Armstrong’s first encounter with Clemsen.

He got involved in her health care in 2014 after her treatment team leveled a series of complaints against her — including that she made inappropriate social media posts about clinic staff; followed or waited for providers in hallways; wandered the clinic after hours; and kept contacting staff members after they’d repeatedly answered her questions, according to March 23 letter from UIHC Deputy Counsel Nike Fleming.

Armstrong provided that and other records she has received from the UI to The Gazette.

Clemsen and other administrators met with Armstrong to discuss the concerns. In a 2015 email, Armstrong’s surgeon informed her “you have been labeled by them as disruptive.” But the behavior escalated, according to…

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