Authors: Rosenstein, Alan H.; O'Daniel, Michelle

Source: Joint Commission Journal on Quality and Patient Safety, Volume 34, Number 8, August 2008 , pp. 464-471(8)

Publisher: Joint Commission Resources

Abstract:

Background: A recent survey was conducted to assess the significance of disruptive behaviors and their effect on communication and collaboration and impact on patient care.

Survey: VHA West Coast administered a 22-question survey instrument—Nurse-Physician: Impact of Disruptive Behavior on Patient Care—to a convenience sample. Of the 388 member hospitals (in four VHA regions) invited, 102 hospitals participated in the survey (26% response rate). Results from surveys received from January 2004 though March 2007 are represented. Of the 4,530 participants, 2,846 listed their titles as nurses, 944 as physicians, 40 as administrative executives, and 700 as "other."

Results: A total of 77% of the respondents reported that they had witnessed disruptive behavior in physicians—88% of the nurses and 51% of the physicians. Sixty-five percent of the respondents reported witnessing disruptive behavior in nurses at their hospitals—73% of the nurses and 48% of the physicians. Sixty-seven percent of the respondents agreed that disruptive behaviors were linked with adverse events; the result for medical errors was 71%, and patient mortality, 27%.

Discussion: The results from the survey show that disruptive behaviors lead to potentially preventable adverse events, errors, compromises in safety and quality, and patient mortality. Strategies to address disruptive behaviors should (1) prevent disruptive events from occurring, (2) deal with events in real time to prevent staff or patient harm, and (3) initiate postevent review, actions, and follow-up.

Recommendations: Twelve recommendations—including recognition and awareness, policies and procedures, incident reporting, education and training, communication tools, discussion forums, and intervention strategies—address what hospitals and other organizations can do now to address disruptive behaviors.

Document Type: Research article

Publication date: 2008-08-01

More about this publication?

• Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.
  
  Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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