Behaviors that
Undermine a
Culture of Safety
1
Presence Health’s Commitment
Consistent with its Mission, Vision, Values and
Ethical and Religious Directives for Catholic Health
Care, Presence Health is committed to providing a
safe environment of care for patients and an
optimum practice environment for physicians and
other clinicians.
The presence of intimidating and disruptive
behaviors in an organization, however, erodes
professional behavior and creates an unhealthy or
even hostile work environment.
2
Intimidating and Disruptive Behavior….
• Puts patients at risk – can foster medical errors and impede
patient safety
• Is contrary to our mission of providing compassionate holistic
care with a spirit of healing and hope in the communities we
serve
• Diminishes the culture of service and organizational
excellence based in our values of Honesty, Oneness, People
and Excellence
• Lowers clinician and employee morale and satisfaction
• Must be reported to appropriate leaders to correct the
problem
• Contributes to poor patient satisfaction and preventable
adverse outcomes
• Increases the cost of care
• Can be exhibited by both physician and non-physician staff
3
Examples of Intimidating and Disruptive
Behaviors
• Overt actions such as verbal outbursts and physical
threats, as well as passive
• Demeaning others (patients, families, nurses,
physicians, other hospital personnel), or the hospital
itself
• Blaming or shaming other for adverse outcomes
• Inappropriate medical record entries concerning the
quality of care provided by the hospital or any other
individual
4
Examples of Intimidating and
Disruptive Behaviors
ooooooooooo------• Activities such as refusing to perform assigned tasks
or quietly exhibiting uncooperative attitudes during
routine activities
• Reluctance or refusal to answer questions, return
phone calls or pages; condescending language or
voice intonation
• Impatience with questions
5
Definition of inappropriate
words/actions:
Sexual comments, jokes or innuendos
• Flirtation, sexual harassment
• Seductive, aggressive or assaultive behavior
(inappropriate physical contact with another
individual that is threatening or intimidating)
• Racial, ethnic, socioeconomic or religious bias or
slurs
• Lack of regard for personal comfort and dignity of
others
6
What Can You Do?
Organizational staff, including hospital employees,
who observe or are subjected to, inappropriate
behavior by a physician or non-physician staff
member are responsible for communication with
their supervisor about the incident following their
initial chain-of-command process. Students shall
notify their instructor if such behavior occurs.
7
What Can You Do?
Documentation of disruptive behavior is critical.
Medical Staff members, nurses, and other hospital
employees who observe behavior by a physician or nonphysician that is disruptive to the hospital, shall document
each incident. Such documentation shall include:
–
–
–
–
–
–
The date and time of the questionable behavior
If the behavior affected or involved a patient in any way, then the name
of medical record number of the patient
The circumstances that precipitated the situation
A description of the behavior limited to factual, objective language as
much as possible
The consequences, if any, of the disruptive behavior
Record of any action to remedy the situation including date, time, place,
action and name(s) of those intervening.
8