Disruptive behaviors have been shown to have a negative impact on work relationships, team collaboration, communication efficiency, and process flow, all of which can adversely affect patient safety and quality of care. Despite the growing recognition of the damage that can be done, there are still pockets of resistance to taking action to address the issue head-on. Given the new call to action from the Joint Commission accreditation standard and the growing public accountability for patient safety, organizations need to recognize the full impact of disruptive behaviors and implement appropriate policies, procedures, and educational programs to raise levels of awareness regarding the seriousness of the issue, hold individuals accountable for their behavior, and provide training and support not only to reduce the incidence and consequences of disruptive events but also to improve efficiency of communication and team collaboration in an effort to improve outcomes of care.
DesRochesCRaoSFreemanJ. Physicians’ perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues. JAMA. 2010;304:187-193.
5.
DullDFoxL. Perception of intimidation in a perioperative setting. Am J Med Qual. 2010;25:87-94.
6.
RosensteinAO’DanielM. Disruptive behavior and clinical outcomes: perceptions of nurses and physicians. Am J Nurs. 2005;105:54-64.
7.
RosensteinAO’DanielM. A survey of the impact of disruptive behaviors and communication defects on patient safety. Jt Comm J Qual Patient Saf. 2008;34:464-471.
8.
Joint Commission. The Joint Commission Guide to Improving Staff Communication. Oakbrook Terrace, IL: Joint Commission Resources; 2005.
HicksonGBFederspielCFPichertJWMillerCSGauld-JaegerJBostP. Patient complaints and malpractice risk. JAMA. 2009;282:2951-2957.
13.
FullamFGarmanANJohnsonTJHedbergEC. The use of patient satisfaction surveys and alternative coding procedures to predict malpractice risk. Med Care. 2009;47:553-559.
14.
HicksonGBFederspielCFBlackfordJ. Patient complaints and malpractice risk in a regional healthcare center. South Med J. 2007;100:791-796.
Agency for Healthcare Research and Quality. National Healthcare Quality Report. Rockville, MD: Agency for Healthcare Research and Quality; 2010.
22.
EncinosaWHellingerF. The impact of medical errors on ninety-day costs and outcomes: an examination of surgical patients. Health Serv Res. 2008;43:2067-2085.
23.
BatesDWSpellNCullenDJ. The costs of adverse drug events in hospitalized patients. Adverse Drug Event Prevention Study Group. JAMA. 1997;277:307-311.
24.
ClassenDCPestonikSLEvansRSLloydJFBurkeJP. Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277:301-306.
25.
CohenMSmetzerJ. Intimidation: practitioners speak up about this unresolved problem. Jt Comm J Qual Patient Saf. 2005;31:594-599.
26.
KlevensREdwardsJRichardsC. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007;122:160-166.
Health Grades. Health Grades Seventh Annual Patient Safety in American Hospitals Study. Golden, CO: Health Grades; 2010.
30.
RosensteinAHO’DanielMWhiteSTaylorK. Medicare’s value-based payment initiatives: impact on and implications for improving physician documentation and coding. Am J Med Qual. 2009;24:250-258.
31.
StuddertDMMelloMMGawandeAA. Claims, errors, and compensation payments in medical malpractice litigation. N Engl J Med. 2006;354:2024-2033.
PfifferlingJH. Physicians’ disruptive behavior: consequences for medical quality and safety. Am J Med Qual. 2008;23:165-167.
36.
AgarwalRSandsDZDiaz-SchneiderJ. Quantifying the Economic Impact of Communication Inefficiencies in US Hospitals. Winter College Park, MD: University of Maryland Center for Health Information and Decision Systems; 2008. CHIDS Research Briefing, Vol. 3, No. 18.
37.
PronovostP. Learning accountability for patient outcomes. JAMA. 2010;304:204-205.
38.
ShanafeltTDBalchCMBechampsGJ. Burnout and career satisfaction among American surgeons. Ann Surg. 2009;250:463-471.
39.
LinzerMManwellLBWilliamsES. Working conditions in primary care: physician reactions and care quality. Ann Intern Med. 2009;151:28-36.
40.
KrasnerMSEpsteinRMBeckmanH. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009;302:1284-1293.
