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Whether it's a goal or not, combat disruptive physician behavior

Staff Development Weekly: Insight on Evidence-Based Practice in Education, December 8, 2006

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When the JCAHO opened its field review last year for the proposed 2007 National Patient Safety Goals, one topic attracted a deluge of passionate, and sometimes horrifying, stories, anecdotes, and pleas for help: disruptive clinician behavior. Although the proposal did not make the final list of 2007 goals, the Joint Commission has said it will again be included on this year's field review for its list of possible 2008 goals.

There are steps that you can take to begin examining the issue in your facility and making some changes. Grena Porto, RN, MS, ARM, CPHRM, a healthcare consultant and a member of the JCAHO's sentinel events advisory group (SEAG), suggested the following:

• Clear expectations about acceptable behavior, (e.g., a "universal code of conduct") that applies to everyone. Define what you want (e.g., teamwork) and what you don't want (e.g., assault-actually say that) and then have accompanying policies developed with staff input and leadership enforcement.
• Training, coaching, and mentoring for those who struggle with parameters.
• Monitoring for a culture of violations. Try doing anonymous culture of safety surveys in the beginning if staff are fearful to speak up.
• Early intervention for even mild violations.
• Progressive discipline for repeated violations.

To get more steps, go to Briefings on JCAHO (BOJ). For the cost of just three stories, you can get the entire December issue of BOJ. Click here to choose between the PDF and HTML versions for just $30. Subscribers to the online version of BOJ have free access to this article. Subscribers to the print newsletter can find this article in their December issue.

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