Intimidating and disruptive behaviors

Chain of command provides healthcare staff with a formal process to use when attempting to get satisfactory resolution or to report concerns about questionable patient conditions or care delivery.

When hierarchical differences exist between healthcare clinicians, people lower in the hierarchy tend to be uncomfortable communicating problems or concerns.

Frontline healthcare clinicians, who have witnessed poor performance by their peers or supervisors, may be hesitant to use this means of communication because of the fear of retaliation or uncertainty about its importance in patient outcome.

Staff may also be reluctant to call a physician, supervisor, or other clinician, even in the face of the deteriorating status of a patient, fearing intimidation, confrontation, antagonistic discussion, or other disruptive behavior.

The Joint Commission instituted a new leadership standard effective January 1, 2009, that requires accredited hospitals to address healthcare clinician disruptive and inappropriate behaviors.

This standard expands the Joint Commission National Patient Safety Goal 2, which requires accredited organizations to improve the effectiveness of communication among caregivers to reduce risk, improve patient safety, and recommends standardization of communication whenever possible.

Don't mistake an occasional outburst or extended casual conversation for a disruption.

Whether you're paying your employees by the hour or strictly on commission, the bottom line is, time is money.

There were 177 events reported to the Pennsylvania Patient Safety Authority from May 2007 to October 2009 that detailed healthcare clinicians’ disruptive behaviors, many of which negatively affected patient care.

Of these events, 73 (41%) were due to conflicts between healthcare clinicians, 30 (17%) to procedures not followed, 17 (10%) to absence of responses or delays, 22 (12%) were listed as other, and behaviors for the remaining 35 (20%) were not given.

If you believe an employee is being disruptive and causing difficulties for her coworkers, request a private meeting for an informal chat.

Make her aware of how her behavior is affecting her coworkers -- and the company -- and find out if there is any valid reason for her actions.

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