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The Joint Commission's sentinel event alert on disruptive behavior

Credentialing Resource Center Connection, August 28, 2008

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Anne Roberts, CPMSM, CPCS, is the director of medical affairs at Children's Medical Center of Dallas, where she oversees the medical administration, graduate medical education, and medical staff services departments.

Dear credentialing colleague:

The Joint Commission’s most recent Sentinel Event Alert (SEA) focuses on intimidating and disruptive behaviors in practitioners and the impact they may have on healthcare organizations. The SEA indicates that such behaviors—verbal outbursts and physical threats among them—can contribute to medical errors, poor patient satisfaction, and preventable adverse outcomes.

Disruptive behaviors are reported, tracked or trended in too few organizations. Many organizations have yet to implement a policy and procedure for handling complaints related to medical staff members’ disruptive behavior. While The Joint Commission’s had standards in place for many years requiring a process for handling impaired practitioners, its new focus on addressing disruptive behavior will now require organizations to implement a detailed process for how these issues are addressed.

Effective January 1, 2009, The Joint Commission will implement a new leadership standard, (LD.03.01.01), which states, “Leaders create and maintain a culture of safety and quality throughout the organization.” The elements of performance (EP) for this standard include the following:

EP 4: The hospital has a code of conduct that defines acceptable, disruptive and inappropriate behaviors

EP 5: Leaders create and implement a process for managing disruptive and inappropriate behaviors

In addition to this new standard, The Joint Commission lists several suggested actions in the SEA. To obtain a more detailed listing of all suggested actions, see the SEA at: http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm

Many organizations will need to review their code of conduct to ensure it emphasizes respect, outlines what is considered acceptable, outlines disruptive and inappropriate behaviors as well as ensuring that it governs the medical staff in an equivalent manner to hospital staff.

Remember, clear, effective communication is the key to success!

That's all for this week.

All the best,

Anne Roberts, CPMSM, CPCS

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