The Joint Commission Journal on Quality and Patient Safety
A Survey of the Impact of Disruptive Behaviors and Communication Defects on Patient Safety
Section snippets
Development
The convenience sample survey was conducted by VHA West Coast, one of 17 regional offices of VHA Inc., a national alliance of more than 1,400 not-for-profit hospitals across the United States. In the absence of any prototype surveys addressing issues around the frequency, seriousness, or impact of disruptive behaviors, the investigators developed the 22-question survey instrument—Nurse-Physician Relationships: Impact of Disruptive Behavior on Patient Care*
Physicians’ Disruptive Behavior
A total of 77% of the respondents reported that they had witnessed disruptive behavior in physicians at their hospitals. Of interest, 88% of the nurses reported witnessing disruptive behavior in physicians, and 51% of the physicians reported witnessing disruptive behavior in their peers (Figure 1a, page 466). When asked about which specialties were most likely to exhibit disruptive behaviors, respondents rated general surgery highest at 28%, and obstetrics/gynecology lowest (6%); all other
Discussion
The results from the survey show that disruptive behaviors can cause significant psychologic and behavioral disturbances that can have a critical effect on focus and concentration, collaboration, communication, and information transfer, which in turn can lead to potentially preventable adverse events, errors, compromises in safety and quality, and patient mortality.
The current survey focused predominantly on disruptive behavior between physicians and nurses, but our research has shown that
Recommendations
We offer the following recommendations on the basis of what we have observed in our experiences with information gathered apart from the survey process from more than 100 hospitals, which organizations can implement right now to address the issue of disruptive behavior.
Conclusion
Although disruptive behavior is a sensitive subject that may involve prominent physicians or employee staff, the issue must be addressed to ensure best patient care. The organization needs to be committed to a culture of zero tolerance and to develop policies and procedures that define appropriate behavior standards that hold staff accountable for their actions. Offering education programs that provide a better understanding of background issues that influence thoughts and behaviors and
References (32)
- et al.
Impact and implications of disruptive behavior in the peri-operative arena
J Am Coll Surg
(Jul. 2006) The impact of aviation-based teamwork training on the attitudes of health-care professionals
J Am Coll Surg
(Dec. 2004)To Err Is Human: Building a Safer Health System
(1999)Crossing the Quality Chasm: A New Health System for the 21st Century
(Mar. 2001)The long road to patient safety: A status report on patient safety systems
JAMA
(Dec. 2005)- The Joint Commission: Improving America’s Hospitals: A Report on Quality and Safety, 2007....
- Wachter R.: The end of the beginning: Patient safety five years after “To Err Is Human.” Health Aff (Millwood) Suppl...
The impact of nurse-physician relationships on nurse satisfaction and retention
Am J Nurs
(Jun. 2002)- et al.
Disruptive physician behavior contributes to nursing shortage
Physician Exec
(Nov.–Dec. 2002) - et al.
Disruptive behavior and clinical outcomes: Perceptions of nurses and physicians
Am J Nurs
(Jan. 2005)
Nurse-physician communication: The impact of disruptive behaviors on factors affecting decision making affecting patient outcomes of care
Ability of prospective assessment of personality profiles to predict the practice specialty of medical students
Baylor University Medical Center Proceedings
Ending Nurse-to-Nurse Hostility
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