Can Rules Stop Bad Behavior at Hospitals?
Bad behavior between doctors and nurses in hospitals can cost patients their lives. So about a year ago, the Joint Commission required hospitals to create a “zero-tolerance” policy for intimidating and disruptive behavior.
Recently, the American Medical News published an article that indicates that the requirement for a policy might not be working.
After reading the article you might ask yourself the question:
“Can a policy stop bad behavior?“
And what does “zero-tolerance” mean? Any bad behavior should get a nurse fired or a doctor’s privileges suspended?
Here’s a list of the “bad behaviors” that were reported in the American College of Physician Executives 2009 Doctor-Nurse Behavior Survey and the percentage of respondents that had observed that type of behavior in the last year in their organization …
Degrading comments and insults … 84.5%
Yelling … 73.3%
Cursing … 49.4%
Inappropriate joking … 45.5%
Refusing to work with a colleague … 38.4%
Refusing to speak to a colleague … 34.3%
Trying to get someone unjustly disciplined … 32.3%
Throwing objects … 18.9%
Trying to get someone unjustly fired … 18.6%
Spreading malicious rumors … 17.1%
Sexual harassment … 13.4%
Physical assault … 2.8%
Other … 10%
Could we really have a zero-tolerance policy for yelling? For inappropriate joking?
Who would decide what inappropriate is and then enforce it across all hospitals?
I’m not saying that any bad behavior including yelling and telling inappropriate jokes is a good thing. I just don’t know if “zero-tolerance” is the way to change behavior…
What do you think? Please leave a comment.
Thanks
Mark
Like
December 1st, 2009 at 1:58 pm
Mark, this is a very interesting topic that presents a cross section summary of behaviors. I would be interested in learning from readers if disruptive behavior in the hospital (or other health care environment) is “contagious.” That is, a number of studies have looked at social networks where individuals (especially influential ones) affect others who in turn affect others — for example, smoking, obesity, loneliness. Christakis and Fowler have discussed this in published papers, and a summary of recent work was published in the Washington Post today (Dec 1, 2009). Might this also be true of disruptive behavior?
At the other end of the spectrum, an international group called the Plexus Institute has been focusing on “appreciative inquiry” which learns from good interactions/events and seems to provide a new perspective. An example is studying a hospital where hospital-acquired infections dropped dramatically.
December 1st, 2009 at 6:52 pm
Anyone want to talk about the disruptive behaviors they have seen?
Mark