In regard to the recent editorial in the Oct. 27 issue of Modern Healthcare (Disrupting the disrupters, p. 18), we would like to share some of the research findings of our work on disruptive behaviors over the past 10 years.
Our original research focused specifically on the impact of disruptive physician behaviors on nurse satisfaction and retention. We were amazed at the frequency of how often these behaviors were noted to occur and the profound effect they had on nurse morale.
Subsequent surveys showed an almost equal amount of disruptive behavior in nurses and other hospital employees, but more disconcerting was the downstream negative impact of disruptive behaviors on stress, loss of focus, concentration, communication, collaboration and information transfer resulting in medical errors, adverse events and significant compromises in patient safety, quality and even mortality.
Our recent article titled A survey of the impact of disruptive behaviors and communication defects on patient safety was published in the August issue of the Joint Commission Journal on Quality and Patient Safety and was intentionally timed to coordinate with the release of the new Joint Commission 2009 standard calling for hospitals to develop a disruptive-behavior policy and provide necessary education about this topic.
This is a serious issue with profound effects on patient care. The problem as we see it is both the lack of an effective, consistently applied process and the underlying reluctance on the part of leadership to address the issue head on. Administrators worry about antagonizing a physician who brings patients and revenue into the organization. Physicians are reluctant to counsel their peers particularly around issues related to behavioral compliance.
We all need to take responsibility and accountability for these actions as the risk of not addressing these issues can have unwanted effects on both staff relationships and patient care. We hope the Joint Commissions standards will help stimulate appropriate organizational action.
Alan RosensteinVice president and medical director Michelle ODaniel Director of member relations VHA West Coast Pleasanton, Calif.