From the Disputing Blog of Karl Bayer, Victoria VanBuren, and Holly Hayes.
by Holly Hayes
Health care leaders have known for years that disruptive behaviors are a serious problem. Verbal outbursts, refusing to take part in assigned duties and condescending attitudes all create breakdowns in the teamwork, collaboration and communication needed to deliver patient care. A study by The Institute for Safe Medication Practices (ISMP) found that 40 percent of clinicians have remained passive or kept quiet during patient care events rather than confront a known intimidator.
In May, we reviewed an accreditation standard (LD.01.03.01) issued by The Joint Commission in January expected to prompt hospitals to explore an expanded use of mediation to manage conflict in the healthcare setting.
Conflict Management Standard LD.01.03.01 states, “The governing body is ultimately accountable for the safety and quality of care, treatment, and services.” Elements of Performance, or how The Joint Commission will score the standard, include: Development of a code of conduct that defines acceptable, disruptive, and inappropriate behaviors; and creation and implementation of a process for managing disruptive and inappropriate behaviors.
A survey conducted by the American College of Physician Executives published in November, almost one year after the Joint Commission began requiring health care facilities to implement zero-tolerance policies for disruptive behaviors, tells us there is still work to be done in this area. According to anonymous responses to a national survey of 13,000 physician and nurse executives, ninety-seven percent experienced unprofessional outbursts and overreactions, with the majority saying these happened several times a year and sometimes weekly.
Physician and nurse executives respondants solutions to decreasing disruptive behavior included: setting clear expectations, implementing consistent enforcement and focusing on teamwork.
Mediation is one non-confrontational interaction strategy that can be implemented to resolve conflict, improve the working relationships of the parties involved and enhance teamwork and patient safety.